Local bone quality affects the outcome of prosthetic total knee arthroplasty

Abstract

Osteoporosis and osteoarthritis commonly coexist in the elderly. In patients undergoing prosthetic total knee arthroplasty (TKA), the bone quality around the knee joint may affect the safety of prosthetic implantation and consequently satisfaction with the surgical outcome. We recruited 50 postmenopausal women undergoing TKA for primary osteoarthritis; 43 completed the study protocol. The bone quality parameters of the operated knee, including bone mineral density assessed using dual-energy X-ray absorptiometry and microarchitecture variables assessed using micro-computed tomography, were determined. Surgical outcomes were assessed according to immediate (<1 week) postoperative pain quantified using the visual analog scale and knee function quantified using the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 2 and 6 months postoperatively. The influence of bone quality parameters on surgical outcomes was analyzed using simple and multiple regression analyses. Volumetric bone mineral density (R 2 ¼ 0.187-0.234, p < 0.01), the structural model index (R 2 ¼ 0.103-0.181, p < 0.05), and trabecular separation (R 2 ¼ 0.289-0.424, p < 0.05) were significantly associated with postoperative pain and improvement according to the KOOS. In conclusion, local bone quality, including mineral content and microarchitecture, affects the surgical outcome of TKA. ß

Tissue viscoelasticity is related to tissue composition but may not fully predict the apparent-level viscoelasticity in human trabecular bone – An experimental and finite element study

“…As the bone is exposed daily to dynamic loading, its viscoelastic properties and their changes with age or disease, may critically contribute to e.g. stress fractures or biocompatibility of biomimetic bone materials (Adharapurapu et al, 2006;Huang et al, 2016).…”

The Importance of Bone Mineral Density in Hip Arthroplasty: Results of a Survey Asking Orthopaedic Surgeons about Their Opinions and Attitudes Concerning Osteoporosis and Hip Arthroplasty

“…Commonly, osteoporosis and osteoarthritis coexist in the elderly and can affect their quality of life [2]. Several studies suggest a high prevalence of unknown osteoporosis in patients scheduled to undergo hip arthroplasty [3, 4].…”

“…Bone mineral density varies among different body regions [2]. The bone mineral density of the hip is of particular interest to orthopaedic surgeons, due to its association with a higher risk of hip fracture [11].…”

Total Knee Arthroplasty in Patients with Rheumatoid Arthritis, Severe Osteoporosis, and Genu Valgum

“…The frequency of osteoporosis is high in patients with RA [5,6], and TKA in such patients can be highly di cult [8,9]. First, improper position, inappropriate traction, and rough operating during TKA could induce bone fracture [8,9,33]. Therefore, all surgical procedures in osteoporotic patients must be very careful and gentle; the tools, including power saw and drill, should be used instead of a bone knife and bone chisel.…”