Measurement of bone mineral density by dual-energy x-ray absorptiometry around an uncemented knee prosthesis

Spittlehouse, A.J.; Getty, C.J.M.; Eastell, Richard

doi:10.1016/s0883-5403(99)90010-4

Cited by 41 publications

(39 citation statements)

References 10 publications

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“…Some measurements of bone density have been made in the distal femur after primary knee replacement, using dual photon absorptiometry (Petersen et al 1995(Petersen et al , 1996 or dual energy Xray absorptiometry (Liu et al 1995, Spittlehouse et al 1999, van Loon et al 2001. However, the use of these data for validating the model is limited because there is no agreement on the definition of the regions of interest; various ROIs have been used in each study.…”

Section: Discussionmentioning

confidence: 99%

Stemmed femoral knee prostheses

Lenthe¹,

Willems²,

Malefijt³

et al. 2002

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Stemmed femoral knee prostheses

Lenthe¹,

Willems²,

Malefijt³

et al. 2002

Acta Orthopaedica Scandinavica

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“…However, the quantitative evaluation of periprosthetic bone density is unreliable on plain radiographs. Changes in bone density must exceed 20-50% in order to be visually observable on standard radiographs (Mintzer et al 1990, Robertson et al 1994, Petersen et al 1995, Lewis et al 1998, Karbowski et al 1999, Spittlehouse et al 1999, Soininvaara et al 2000.…”

mentioning

confidence: 99%

“…DXA can provide reproducible, high-quality measurements of periprosthetic BMD. Commercially available software allows the measurement of BMD adjacent to metal implants (Insall et al 1989, Robertson et al 1994, Kroger et al 1998, Karbowski et al 1999, Spittlehouse et al 1999, Soininvaara et al 2000, with an average precision error of 2.2-2.9% in the tibial regions of interest (ROI) (Soininvaara et al 2000).…”

mentioning

confidence: 99%

Periprosthetic tibial bone mineral density changes after total knee arthroplastyOne-year follow-up study of 69 patients

Soininvaara

Miettinen

Jurvelin

et al. 2004

Acta Orthopaedica Scandinavica

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Background The critical structure supporting the prosthetic components in total knee arthroplasty (TKA) is tibial trabecular bone. The quality of tibial bone can be evaluated by bone mineral density (BMD) measurements.Patients and methods We prospectively measured changes in BMD in the proximal tibia after cemented TKA in osteoarthrotic knees. 69 patients were scanned by dual-energy X-ray absorptiometry (DXA) within a week after surgery, and after 3, 6 and 12 months.Results At baseline, the medial region of interest (ROI) BMD was higher in the varus knees than in the valgus aligned knees (p = 0.02). The medial metaphyseal ROI showed a decrease in BMD during the follow-up in preoperatively varus knee joints (p < 0.001). In preoperatively valgus knees, there was a slight increase in medial compartment BMD which was not significant (p = 0.2). Alignment correction in both groups showed bone remodeling giving similar medial and lateral BMD values, suggesting that the bone became equally strong in both compartments of the metaphysis. There was no association between increasing American Knee Society (AKS) scores and bone remodeling.Interpretation We suggest that this remodeling is caused by postoperative changes in tibial loading. Our results support the clinical importance of recreating proper valgus alignment of the knee joint in the TKA operation, thus possibly providing better conditions for longevity of the tibial component.

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“…In anteroposterior views CV (coefficient of variation) varied from 6.5 to 15.9% in a study by Spittlehouse et al 20 Li and Nilsson 1 and Trevisan et al 21 reported precision values lower than 6% (CV). However, exclusion of cement in the manual analysis in our study makes comparison with other studies uncertain.…”

Section: Discussionmentioning

confidence: 95%

“…24 Low bone density has been proven to complicate identification of bone regions, and to cause poor precision. 20,24 Even a small amount of soft tissue around the knee causes difficulties in establishing the baseline. To diminish this problem we used rice bags around the knee, as they have the same absorption properties as soft tissues.…”

Section: Discussionmentioning

confidence: 99%

Joint area constraint had no influence on bone loss in proximal tibia 5 years after total knee replacement

Saari

Uvehammer

Carlsson

et al. 2007

Journal Orthopaedic Research

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After total knee replacement (TKR) the bone mineral density (BMD) decreases in the proximal tibia. Our aim was to evaluate if changes in constraint of the cemented AMK TKR (DePuy, Johnson & Johnson, Leeds, UK) had any effect on postoperative bone remodeling in the proximal tibia. We used dual-energy X-ray absorptiometry in 43-53 knees to record changes in BMD in three regions of interest around the tibial component up to 5 years after operation with the AMK (DePuy) TKR. The knees had been randomly allocated to receive a flat or a concave tibial insert with retention of the posterior cruciate ligament when preoperative deformity was less severe, and either a concave or a posterior-stabilized (PS) insert with resection of the posterior cruciate ligament when deformity was more pronounced. All designs were associated with loss of BMD in the proximal tibia. The mean bone loss varied from 5 to 23% depending on the region of interest. There were no statistically significant differences between the groups, and the alteration of tibial insert constraint did not influence the bone remodeling. However, low precision values may have impaired the detection of differences. ß

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Measurement of bone mineral density by dual-energy x-ray absorptiometry around an uncemented knee prosthesis

Cited by 41 publications

References 10 publications

Stemmed femoral knee prostheses

Stemmed femoral knee prostheses

Periprosthetic tibial bone mineral density changes after total knee arthroplastyOne-year follow-up study of 69 patients

Joint area constraint had no influence on bone loss in proximal tibia 5 years after total knee replacement

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