Variable bone mineral density reductions post-unicompartmental knee arthroplasty
Purpose Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to identify how the bone mineral density (BMD) changes up to 1 year post-arthroplasty. Methods Dual X-ray absorptiometry scans were obtained...
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Published in | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 23; no. 8; pp. 2230 - 2236 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.08.2015
John Wiley & Sons, Inc |
Subjects | |
Online Access | Get full text |
ISSN | 0942-2056 1433-7347 1433-7347 |
DOI | 10.1007/s00167-014-3014-5 |
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Abstract | Purpose
Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to identify how the bone mineral density (BMD) changes up to 1 year post-arthroplasty.
Methods
Dual X-ray absorptiometry scans were obtained from 11 UKA patients at 10 days and 3, 6, and 12 months post-surgery. Patients were scanned in both anteroposterior and lateral knee orientations.
Results
Most subjects saw a large decline in BMD in the first 6 months following surgery, followed by some recovery in bone mass. The biggest change occurred under the tibial intercondylar eminence, which decreased significantly by an average of 18 % at 6 months and was 15 % at 1 year. The average bone loss under the tibial tray was low; however, the bone loss at the anterior portion was higher with a significant average decrease of 14 %. There was no change in BMD under the tibial keel. There was significant bone loss of 13 % under the femoral component; the regions anterior and posterior to the central femoral implant peg both had significant bone loss of 14 %. The bone response between patients was very variable, with some patients losing bone steadily, and others gaining it rapidly after an early fall.
Conclusions
While the overall reduction in BMD under both components was low, it was significant and there was substantial individual variation superimposed on this. Improving our understanding of this response to surgery may impact on prosthesis survival.
Level of evidence
Therapeutic study: case series with no comparison group, Level IV. |
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AbstractList | Purpose
Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to identify how the bone mineral density (BMD) changes up to 1 year post-arthroplasty.
Methods
Dual X-ray absorptiometry scans were obtained from 11 UKA patients at 10 days and 3, 6, and 12 months post-surgery. Patients were scanned in both anteroposterior and lateral knee orientations.
Results
Most subjects saw a large decline in BMD in the first 6 months following surgery, followed by some recovery in bone mass. The biggest change occurred under the tibial intercondylar eminence, which decreased significantly by an average of 18 % at 6 months and was 15 % at 1 year. The average bone loss under the tibial tray was low; however, the bone loss at the anterior portion was higher with a significant average decrease of 14 %. There was no change in BMD under the tibial keel. There was significant bone loss of 13 % under the femoral component; the regions anterior and posterior to the central femoral implant peg both had significant bone loss of 14 %. The bone response between patients was very variable, with some patients losing bone steadily, and others gaining it rapidly after an early fall.
Conclusions
While the overall reduction in BMD under both components was low, it was significant and there was substantial individual variation superimposed on this. Improving our understanding of this response to surgery may impact on prosthesis survival.
Level of evidence
Therapeutic study: case series with no comparison group, Level IV. Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to identify how the bone mineral density (BMD) changes up to 1 year post-arthroplasty. Dual X-ray absorptiometry scans were obtained from 11 UKA patients at 10 days and 3, 6, and 12 months post-surgery. Patients were scanned in both anteroposterior and lateral knee orientations. Most subjects saw a large decline in BMD in the first 6 months following surgery, followed by some recovery in bone mass. The biggest change occurred under the tibial intercondylar eminence, which decreased significantly by an average of 18 % at 6 months and was 15 % at 1 year. The average bone loss under the tibial tray was low; however, the bone loss at the anterior portion was higher with a significant average decrease of 14 %. There was no change in BMD under the tibial keel. There was significant bone loss of 13 % under the femoral component; the regions anterior and posterior to the central femoral implant peg both had significant bone loss of 14 %. The bone response between patients was very variable, with some patients losing bone steadily, and others gaining it rapidly after an early fall. While the overall reduction in BMD under both components was low, it was significant and there was substantial individual variation superimposed on this. Improving our understanding of this response to surgery may impact on prosthesis survival. Therapeutic study: case series with no comparison group, Level IV. Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to identify how the bone mineral density (BMD) changes up to 1 year post-arthroplasty.PURPOSERadiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to identify how the bone mineral density (BMD) changes up to 1 year post-arthroplasty.Dual X-ray absorptiometry scans were obtained from 11 UKA patients at 10 days and 3, 6, and 12 months post-surgery. Patients were scanned in both anteroposterior and lateral knee orientations.METHODSDual X-ray absorptiometry scans were obtained from 11 UKA patients at 10 days and 3, 6, and 12 months post-surgery. Patients were scanned in both anteroposterior and lateral knee orientations.Most subjects saw a large decline in BMD in the first 6 months following surgery, followed by some recovery in bone mass. The biggest change occurred under the tibial intercondylar eminence, which decreased significantly by an average of 18 % at 6 months and was 15 % at 1 year. The average bone loss under the tibial tray was low; however, the bone loss at the anterior portion was higher with a significant average decrease of 14 %. There was no change in BMD under the tibial keel. There was significant bone loss of 13 % under the femoral component; the regions anterior and posterior to the central femoral implant peg both had significant bone loss of 14 %. The bone response between patients was very variable, with some patients losing bone steadily, and others gaining it rapidly after an early fall.RESULTSMost subjects saw a large decline in BMD in the first 6 months following surgery, followed by some recovery in bone mass. The biggest change occurred under the tibial intercondylar eminence, which decreased significantly by an average of 18 % at 6 months and was 15 % at 1 year. The average bone loss under the tibial tray was low; however, the bone loss at the anterior portion was higher with a significant average decrease of 14 %. There was no change in BMD under the tibial keel. There was significant bone loss of 13 % under the femoral component; the regions anterior and posterior to the central femoral implant peg both had significant bone loss of 14 %. The bone response between patients was very variable, with some patients losing bone steadily, and others gaining it rapidly after an early fall.While the overall reduction in BMD under both components was low, it was significant and there was substantial individual variation superimposed on this. Improving our understanding of this response to surgery may impact on prosthesis survival.CONCLUSIONSWhile the overall reduction in BMD under both components was low, it was significant and there was substantial individual variation superimposed on this. Improving our understanding of this response to surgery may impact on prosthesis survival.Therapeutic study: case series with no comparison group, Level IV.LEVEL OF EVIDENCETherapeutic study: case series with no comparison group, Level IV. Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to identify how the bone mineral density (BMD) changes up to 1 year post-arthroplasty. Dual X-ray absorptiometry scans were obtained from 11 UKA patients at 10 days and 3, 6, and 12 months post-surgery. Patients were scanned in both anteroposterior and lateral knee orientations. Most subjects saw a large decline in BMD in the first 6 months following surgery, followed by some recovery in bone mass. The biggest change occurred under the tibial intercondylar eminence, which decreased significantly by an average of 18 % at 6 months and was 15 % at 1 year. The average bone loss under the tibial tray was low; however, the bone loss at the anterior portion was higher with a significant average decrease of 14 %. There was no change in BMD under the tibial keel. There was significant bone loss of 13 % under the femoral component; the regions anterior and posterior to the central femoral implant peg both had significant bone loss of 14 %. The bone response between patients was very variable, with some patients losing bone steadily, and others gaining it rapidly after an early fall. While the overall reduction in BMD under both components was low, it was significant and there was substantial individual variation superimposed on this. Improving our understanding of this response to surgery may impact on prosthesis survival. Therapeutic study: case series with no comparison group, Level IV. Purpose: Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to identify how the bone mineral density (BMD) changes up to 1 year post-arthroplasty. Methods: Dual X-ray absorptiometry scans were obtained from 11 UKA patients at 10 days and 3, 6, and 12 months post-surgery. Patients were scanned in both anteroposterior and lateral knee orientations. Results: Most subjects saw a large decline in BMD in the first 6 months following surgery, followed by some recovery in bone mass. The biggest change occurred under the tibial intercondylar eminence, which decreased significantly by an average of 18 % at 6 months and was 15 % at 1 year. The average bone loss under the tibial tray was low; however, the bone loss at the anterior portion was higher with a significant average decrease of 14 %. There was no change in BMD under the tibial keel. There was significant bone loss of 13 % under the femoral component; the regions anterior and posterior to the central femoral implant peg both had significant bone loss of 14 %. The bone response between patients was very variable, with some patients losing bone steadily, and others gaining it rapidly after an early fall. Conclusions: While the overall reduction in BMD under both components was low, it was significant and there was substantial individual variation superimposed on this. Improving our understanding of this response to surgery may impact on prosthesis survival. Level of evidence: Therapeutic study: case series with no comparison group, Level IV. |
Author | Patel, Rajesh Hansen, Ulrich N. Cobb, Justin P. Amis, Andrew A. Tuncer, Mahmut |
Author_xml | – sequence: 1 givenname: Mahmut surname: Tuncer fullname: Tuncer, Mahmut organization: Department of Mechanical Engineering, Imperial College London – sequence: 2 givenname: Rajesh surname: Patel fullname: Patel, Rajesh organization: Department of Musculoskeletal Surgery, Charing Cross Hospital, Imperial College London – sequence: 3 givenname: Justin P. surname: Cobb fullname: Cobb, Justin P. organization: Department of Musculoskeletal Surgery, Charing Cross Hospital, Imperial College London – sequence: 4 givenname: Ulrich N. surname: Hansen fullname: Hansen, Ulrich N. organization: Department of Mechanical Engineering, Imperial College London – sequence: 5 givenname: Andrew A. surname: Amis fullname: Amis, Andrew A. email: a.amis@imperial.ac.uk organization: Department of Mechanical Engineering, Imperial College London, Department of Musculoskeletal Surgery, Charing Cross Hospital, Imperial College London |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24770381$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1302_0301_620X_103B7_BJJ_2020_1224_R3 crossref_primary_10_1186_s13018_020_1566_2 crossref_primary_10_1007_s10237_019_01193_7 crossref_primary_10_1016_j_knee_2021_08_019 crossref_primary_10_1007_s00402_023_04991_y crossref_primary_10_1016_j_arth_2019_10_027 |
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Copyright | The Author(s) 2014 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015 |
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Keywords | Bone density changes BMD UKA DXA Unicompartmental knee arthroplasty |
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PublicationTitle | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was... Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study was to... Purpose: Radiolucencies are commonly observed in unicompartmental knee arthroplasty (UKA) patients within 1 year of arthroplasty. The objective of the study... |
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SubjectTerms | Absorptiometry, Photon Adult Aged Arthroplasty, Replacement, Knee - adverse effects Bone Density Bone Resorption - diagnostic imaging Bone Resorption - etiology Female Humans Joint replacement surgery Knee Knee Joint - diagnostic imaging Knee Joint - surgery Knee Prosthesis Male Medicine Medicine & Public Health Middle Aged Orthopedics Patients Prosthesis Design Scanners Tibia - diagnostic imaging Tibia - surgery Transplants & implants |
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Title | Variable bone mineral density reductions post-unicompartmental knee arthroplasty |
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