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Bone mineral density assessment using radiofrequency echographic multispectrometry (REMS) in patients before and
Maryan Bobelyak1,2, Jan Vaculik1,2, Jan J Stepan3,4
1Orthopedic Department, Bulovka Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Abstract:
REMS-BMD by radiofrequency echographic multispectrometry is primarily determined by a patient's BMI, age, and sex. Only about 2.8% of the changes in femoral neck REMS-BMD can be attributed to replacement of the total hip with metal implants.
Purpose:
This study aimed to evaluate how total hip replacement affects femoral neck REMS-BMD and to examine the contributions of a patient's sex, age, and BMI to the REMS-BMD assessment.
Methods:
REMS-BMD was measured at the proximal femur using EchoStation (Echolight Spa, Lecce, Italy) in 27 women and 23 men with advanced hip osteoarthritis before surgery and again on the third day following total hip joint arthroplasty. For seven men, REMS-BMD was measured at both the proximal femur and lumbar spine, taking into account their actual as well as varying age, height, and weight.
Results:
The patients' ages ranged from 49 to 84 years, with the REMS-BMD T-score values for the femoral neck varying from + 1.8 to - 3.2. There was a significant correlation between the femoral neck REMS-BMD values measured before and after total hip arthroplasty. Post-surgery, the femoral neck REMS-BMD values showed a consistent decrease of - 0.021 g/cm2 (approximately 2.8%, p < 0.05) compared to pre-operative measurements. A model incorporating age, sex, and BMI accurately predicted femoral neck REMS-BMD in both pre- and postoperative settings, with no evidence of systematic bias. Variations in REMS-BMD were observed in both the femoral neck and lumbar spine when measurements were taken in the same patients under different conditions of age, height, and weight.
Conclusion:
Approximately 90% of the variability in REMS-BMD of the femoral neck can be attributed to the patient's age, sex, and BMI. Further research is needed to determine the extent to which REMS-BMD reflects areal or volumetric BMD, and how backscattered radiofrequency ultrasound signals influence the REMS-BMD.
