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Related Experiment Videos

Long-term changes in bone mineral density following total knee replacement

C L Levitz1, P A Lotke, J S Karp

  • 1Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.

Clinical Orthopaedics and Related Research
|December 1, 1995
PubMed
Summary

Total knee arthroplasty can lead to significant bone density loss around the tibial component, decreasing by 5% annually after an initial stable period. This bone loss is crucial for surgeons to consider for prosthesis fixation.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Bone Metabolism

Background:

  • Total knee arthroplasty (TKA) is a common procedure for knee osteoarthritis.
  • Long-term prosthesis fixation relies on the mechanical integrity of the surrounding bone.
  • Understanding periprosthetic bone density changes is vital for successful TKA outcomes.

Purpose of the Study:

  • To evaluate bone density changes in the proximal tibia following TKA.
  • To assess the rate and pattern of bone loss beneath the tibial component.
  • To determine the long-term effects of TKA on periprosthetic bone mineral density.

Main Methods:

  • Dual photon absorptiometry and dual X-ray absorptiometry were used to measure bone density.
  • Measurements were taken at multiple sites around the tibial component (medial/lateral plateaus, central peg) at 1 week, 6 weeks, 6 months, 1 year, and 8 years post-surgery.

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  • 31 patients (average age 69) were included, with 7 followed for 8 years.

    • Main Results:

    • Bone density initially stabilized, then decreased by 5% per year after the first 6 weeks.
    • By 1 year post-surgery, bone density returned to 1-week post-surgery levels.
    • No statistically significant difference in bone density decrease was observed between men and women at 8 years.
    • Bone density changes were consistent across different regions under the tibial component.

    Conclusions:

    • A significant rate of proximal tibial bone density loss occurs after TKA.
    • This rate of bone loss (5% per year) exceeds that typically seen in osteoporosis.
    • Surgeons should account for this substantial periprosthetic bone loss when considering long-term fixation strategies for tibial components.