Purpose. The purpose of this study was to evaluate periprosthetic bone mineral density (BMD) changes around a cementless short tapered-wedge stem and determine correlations between BMD changes and various clinical factors, including daily activity, after total hip arthroplasty (THA) with a short tapered-wedge stem. Methods. The study included 65 patients (65 joints) who underwent THA with a TriLock stem. At baseline, and 6, 12, and 24 months postoperatively, BMDs of the seven Gruen zones were evaluated using dual-energy X-ray absorptiometry. Correlations were determined between BMD changes and clinical factors, including the Harris hip score, body mass index, University of California at Los Angeles (UCLA) activity rating score, age at surgery, and initial lumbar BMD. Results. Minimal BMD changes were noted in the distal femur (Gruen zones 3, 4, and 5). However, significant BMD loss was noted in zone 7 at each time point. BMD loss was also noted in zone 1 at 6 and 12 months postoperatively, but BMD recovered after 18 months. Significant positive correlations were noted between BMD changes and the UCLA activity rating score in zones 1, 6, and 7. Additionally, negative correlations were noted between BMD changes and initial spine BMD in zones 2 and 3. Table legends. Table 1 Background of the patients. Table 2 Bone mineral density changes (%) at 6, 12, and 24 months postoperatively in the seven Gruen zones. Columns represent mean ± standard deviation. ※indicates P < 0.05 compared with baseline bone mineral density. Table 3 Correlations between periprosthetic bone mineral density changes and clinical factors (the Harris hip score, body mass index, University of California at Los Angeles activity rating score, age at surgery, and initial lumbar bone mineral density) in the seven Gruen zones at 24 months postoperatively. Correlation coefficients and P-values are presented. Boldface indicates P < 0.05. Conclusion. Periprosthetic BMD was maintained in the proximal femur, especially Gruen zone 1, with a short tapered stem. Daily activity may reflect improvements in periprosthetic bone quality after THA with a short tapered stem; however, this stem is not recommended in patients with low bone quality. To view tables, please contact authors directly

There is limited literature available looking into circumstances surrounding the development of stress fracture of the medial and lateral malleoli after ankle replacement. We present the preliminary results of a prospective study examining the effect of ankle replacement upon local bone mineral density and the phenomenon of stress shielding. We aimed to assess the effect of ankle replacement loading of the medial and lateral malleoli, by analysing the Bone Mineral Density (BMD) of the medial and lateral malleoli before and after Mobility total ankle replacement. Ten consecutive patients undergoing Mobility total ankle replacement for osteoarthritis had pre-operative bone densitometry scans of the ankle, repeated at 6 months after surgery. The bone mineral density of a 2 cm square area within the medial malleolus and lateral malleolus was measured. The pre-operative and postoperative bone densitometry scans were compared. The relation between the alignment of the tibial component and the bone mineral density of the malleoli was also analysed. The mean preoperative BMD within the medial malleolus improved from 0.57g/cm2 to mean 6 months postoperative BMD of 0.62g/cm2. The mean preoperative BMD within the lateral malleolus decreased from 0.39g/cm2 to a mean 6 months postoperative of 0.33g/cm2. The mean alignment of the tibial component was 88.50 varus (range 850 varus to 940 valgus). However, there was no correlation between the alignment of the tibial component and the bone mineral density on the medial malleolus (r = 0.09, p = 0.865). The absence of stress shielding around the medial malleolus indicates that ankle replacements implanted within the accepted limits for implant alignment, load the medial malleolus. However, there was stress shielding over the lateral malleolus resulting in decreased BMD in the lateral malleolus

To analyze the effect of tooth extraction site preservation on bone mineral density 6 months after surgery. From 2020 to 2021, two adjacent teeth (37, 38) of the same patient were extracted at the same time, and then 37 were selected for site preservation, implanted with Bio-oss bone powder, covered with double Bio-gide membrane, reduce tension and sutured. After 6 months of self-healing, 38 was taken CBCT, and the gray value measurement tool in the software was used to measure the bone mineral density of 37 bone graft areas and 38 extraction sockets. Bone density was high in the center of the bone graft area after the extraction site, and the density decreased in the adjacent alveolar socket, but the gray value was still higher than 38 for natural healing. Extraction site surgery can improve bone mass and quality at the extraction site. It is good for implanting

Introduction: Osteoporosis is one of the major diseases worldwide, affecting millions of elderly people, with severe economical and medical consequences. The most commonly used method for the determination of decreased bone quality is the assessment of Bone Mineral Density, measured by dual X-ray absorptiometry (DXA). However DXA is quantitative and not qualitative index of the bone structure. The purpose of this study was to correlate the bone mineral density measured by DXA with the mechanical properties of the femoral neck. Materials and Methods: Bone mineral density of the proximal femur of 30 patients (27 women, 3 men) undergoing total hip displacement was estimated by DXA. The average age of these patients was 63.7 years. Patients with sort femoral neck or previous surgeries in proximal femur were excluded from the study. After hip replacement bone samples (femoral head and neck) were frozen and stored at −60 °C. A plane bone slice with 6mm thickness was sawed of femoral neck using a double cutting saw. The exact specimen dimensions were measured using a sliding calliper with high accuracy. All bone specimens were destructively tested on a material testing machine, in order to determine the material properties (Young’s modulus and yield stress) of the samples. The maximum available compression load was 100 kN with a load rate of 10 kN/min. The operational parameters and experimental data were fully controlled and handled by a graphical software package. Finally all data were evaluated and statistically analyzed. Results: A strong linear correlation of bone mineral density (T-score) with maximum failure load of samples was noted (R2=0.852). No significant differences in Young’s modulus values, was found between bone samples. Conclusions: Bone mineral density measured by DXA, although has limitations, remain a strong predictor of bone strength in the femoral neck region

Introduction: There is limited literature available looking into circumstances surrounding the development of stress fracture of the medial and lateral malleoli after ankle replacement. We present the preliminary results of a prospective study examining the effect of ankle replacement upon local bone mineral density and the phenomenon of stress shielding. Aim: To assess the effect of ankle replacement loading of the medial and lateral malleoli, by analysing the BMD of the medial and lateral malleoli before and after Mobility total ankle replacement. Methodology: Ten consecutive patients undergoing Mobility total ankle replacement for osteoarthritis had pre-operative bone densitometry scans of the ankle, repeated at 6 months after surgery. The bone mineral density of a 2 cm square area within the medial malleolus and lateral malleolus was measured. The pre-operative and post-operative bone densitometry scans were compared. The relation between the alignment of the tibial component and the bone mineral density of the malleoli was also analysed. Results: The mean preoperative BMD within the medial malleolus improved from 0.57g/cm2 to mean 6 months postoperative BMD of 0.62g/cm2. The mean preoperative BMD within the lateral malleolus decreased from 0.39g/cm2 to a mean 6 months postoperative BMD of 0.33g/cm2. The mean alignment of the tibial component was 88.50 varus (range 850 varus to 940 valgus). However, there was no correlation between the alignment of the tibial component and the bone mineral density on the medial malleolus (r = 0.09, p = 0.865). Conclusion: The absence of stress shielding around the medial malleolus indicates that ankle replacements implanted within the accepted limits for implant alignment, load the medial malleolus. However, there was stress shielding over the lateral malleolus resulting in decreased BMD in the lateral malleolus

Introduction: There is limited literature looking into the circumstances surrounding the development of stress fractures of the medial and lateral malleoli after ankle replacement. We present the preliminary results of a prospective study examining the effect of total ankle replacement (TAR) upon local bone mineral density (BMD) and the phenomenon of stress shielding. Aim: To assess the effect of TAR loading othe medial and lateral malleoli, by analysing the BMD of the medial and lateral malleoli before and after Mobility TAR. Methodology: Ten consecutive patients undergoing Mobility total ankle replacement for osteoarthritis had pre-operative bone densitometry scans of the ankle, repeated at 6 and 12 months after surgery. The bone mineral density of a 2 cm square area within the medial and lateral malleoli was measured. The pre-operative and post-operative bone densitometry scans were compared. The relation between the alignment of the tibial component and the bone mineral density of the malleoli was also analysed. Results: The mean preoperative BMD within the medial malleolus increased from a mean of 0.57g/cm2 to 0.58g/cm2 at six months and 0.60g/cm2 at 12 months postoperatively. The mean preoperative BMD within the lateral malleolus decreased from 0.39g/cm2 to 0.34g/cm2 at six months postoperatively. However the BMD over the lateral malleolus increased to 0.356g/cm2 at 12 months. The mean alignment of the tibial component was 88.50 varus (range 850 varus to 940 valgus). There was no correlation between the alignment of the tibial component and the bone mineral density on the medial malleolus (r = 0.09, p = 0.865). Conclusion: The absence of stress shielding around the medial malleolus indicates that ankle replacements implanted within the accepted limits for implant alignment, load the medial malleolus. However, there was stress shielding over the lateral malleolus resulting in decreased BMD in the lateral malleolus

Varus deformity is found in 90% of patients with knee OA. Axis deviation of lower extremity influences joint biomechanics and produce alteration in bone mineral density. Structure and density of subchondral bone of the knee was previously examined by X-ray. Densitometry gives us a new method of bone mineral content measurement in the interesting regions of the skeleton. The aim of this study was the assessment of effect of varus deformity on bone mineral density in tibial epiphysis. Bone mineral densities (BMD) were estimated in 46 patients at a mean age of 62 years (15 to 78) who were operated on in Department of Orthopaedics. All of them represented osteoarthritis of the knee with varus deviation. BMD of the proximal tibia was evaluated on the Lunar DPX-IQ densitometer and analyzed in three regions of interest: medial, lateral and central. Lower extremity axis deviation was measured using the Metrecom devise (Faro). Results were compared to a control group of 20 patients without osteoarthritis of the knee and without deviation of lower extremity axis. Increased BMD was found on the overweighed compartment of the knee in comparison to the underweight one. These differences were not observed in the control group. We developed a coefficient, which is the ratio of BMD in the overweighed compartment compared to BMD in underweight one. In our patients the mean value of this coefficient was 3.3, and it ranged from 1,2 to 24,5 (SD 5,7). Significant correlation between varus axis deviation of the lower extremity and increased BMD coefficient was found

Background. Reduced bone mineral density is recognised as a risk factor for hip fractures and fragility fractures in general. Vitamin D is important in maintaining healthy bone mineral levels and can therefore affect risk of hip fracture. We investigated the correlation between vitamin D levels and bone mineral density, as well as fracture type, in neck of femur fractures and also assessed the relationship of vitamin D and social deprivation. Method. We included all patients admitted to our department, with a neck of femur fracture over one year (October 2013 to October 2014). We analysed vitamin D levels for all patients during admission and compared these to bone mineral density scores, based on DEXA scan results; hip fracture type & comminution, based on admission radiographs; and levels of social deprivation, based on the patient's address. Results. In total 360 patients were admitted over the study period, with a neck of femur fracture, of which 298 had vitamin D assessed and 76 had DEXA scans. Of these cohorts, 71% were found to be vitamin D deficient and 7% had osteoporosis. No significant correlation was found between vitamin D scores and bone density, or with level of vitamin D deficiency and fracture type or comminution. A significant correlation was however identified, between low vitamin D levels and decreasing levels of social deprivation (R=0.11, p=0.04). Conclusion. No relationship was identified between vitamin D levels and hip fracture type, suggesting that vitamin D cannot be used to predict patients at risk of more comminuted fractures. Although no relationship was also identified for bone mineral density and vitamin D, this may be because the sample size of DEXA scans was relatively small. Interestingly the relationship between vitamin D and social deprivation was the reverse of what was expected and suggests that affluent individuals may be at greater risk of low vitamin D

Femoral stem design affects periprosthetic bone mineral density (BMD), which may impact long term survival of cementless implants in total hip arthroplasty (THA). The aim of this study was to examine proximal femoral BMD in three morphologically different uncemented femoral stems designs to investigate whether one particular design resulted in improved preservation of BMDMethods: 119 patients were randomised to receive either a proximally coated dual taper wedge stem, a proximally coated anatomic stem or a fully coated collarless triple tapered stem. All surgeries were performed via the posterior approach with mobilization on the day of surgery. Dual energy x-ray absorptiometry scans (Lunar iDXA, GE Healthcare, Madison, WI) assessed BMD across the seven Gruen zones pre-operatively, and post-operatively at 6-weeks, 1-year, and 2-years and compared to the unoperated contralateral femur as a control. Patient reported outcome measures of pain, function and health were also included at these corresponding follow-ups. BMD increased in zones one (2.5%), two (17.1%), three (13.0%), five (10%) and six (17.9%) for all stems. Greater preservation of BMD was measured on the lateral cortex (zone 2) for both the dual taper wedge and anatomic stems (p = 0.019). The dual taper wedge stem also demonstrated preservation of BMD in the medial calcar (zone 7) whilst the anatomic and triple taper stem declined in this region, however this was not statistically significant (p = 0.059). BMD decreased on average by 2.1% inthe mid-diaphysis region, distal to the stem tip (zone 4) for all implants. All stems performed equivalently at final follow-up in all patient reported outcome measures. This study demonstrated maintenance of femoral BMD in three different cementless femoral stem designs, with all achieving excellent improvements in patient reported outcomes. There was no significant stress shielding observed, however longer follow-up is required to elucidate the impact of this finding on implant survivorship

Femoral stem design affects periprosthetic bone mineral density (BMD), which may impact long term survival of cementless implants in total hip arthroplasty (THA). The aim of this study was to examine proximal femoral BMD in three morphologically different uncemented femoral stems designs to investigate whether one particular design resulted in improved preservation of BMD. 119 patients were randomized to receive either a proximally coated dual taper wedge stem, a proximally coated anatomic stem or a fully coated collarless triple tapered stem. Dual energy x-ray absorptiometry scans (Lunar iDXA, GE Healthcare, Madison, WI) assessed BMD across the seven Gruen zones pre-operatively, and post-operatively at 6-weeks, 1-year, and 2-years comparing the unoperated contralateral femur as a control. BMD increased in zones one (2.5%), two (17.1%), three (13.0%), five (10%) and six (17.9%) for all stems. Greater preservation of BMD was measured on the lateral cortex (zone 2) for both the dual taper wedge and anatomic stems (p = 0.019). The dual taper wedge stem also demonstrated preservation of BMD in the medial calcar (zone 7) whilst the anatomic and triple taper stem declined in this region, however this was not statistically significant (p = 0.059). BMD decreased on average by 2.1% in the mid-diaphysis region, distal to the stem tip (zone 4) for all implants. All stems performed equivalently at final follow-up in all patient reported outcome measures. Implant design was shown to impact BMD changes. All stems preserved bone at the metaphyseal level in early follow-up, which theoretically indicates favorable implant fixation. There was no significant stress shielding observed, however longer follow-up is required to elucidate the impact of this finding on implant survivorship

To prevent bone loss, OPG/RANK/RANKL signalling pathway is a key in keeping the balance between the action of osteoblasts and osteoclasts. Aim of this study is to assess the influence of long-term nicotine exposure on bone mineral density (BMD) scores, RANKL and OPG levels of plasma and RANKL and OPG immunoreactivities of tissue in rats. In this study, totally 36 Swiss Albino rats (70±10 g) were used in three groups. Whereas normal drinking water was given for the control group (n:12), 0.4 mg/kg/day and 6.0 mg/kg/day nicotine was added to drinking water for low-dose nicotine (LDN) group (n:12) and high-dose nicotine (HDN) group (n:12), respectively for 12 months. At the end of 12. th. month, BMD scores were measured via X-ray absorptiometry and then bone turnover was assessed via measuring both RANKL, OPG levels in plasma and RANKL, OPG immunoreactivities in tail vertebrae of all rats. Lumbar spine and femoral regions BMD scores of the control group and the nicotine groups were not significantly difference. In HDN group, OPG levels of plasma were found significantly higher when compared with the control and LDN groups (p=0.001) unlike RANKL levels of plasma. RANKL and OPG immunoreactivities of tissue were found significantly lower in both LDN and HDN groups (p<0.001, p=0.004, respectively) in comparison to control group. No correlation was found between plasma levels and tissue immunoreactivities of RANKL and OPG. As a result, this study indicates that nicotine is not primarily responsible for the decline of BMD frequently seen in smokers

To investigate whether children with fractures have a low bone mineral density, 109 children (46 female and 63 male) aged 10.5 ± 2.9 years (range 5–16) sustaining either a single fracture (n=60 patients) or multiple fractures (n=49 patients) had Bone Mineral Density measurements [BMD] (Hologic QDR4500A) of L2 to L4. The Z score {(Patient’s BMD – mean aged related BMD)/ standard deviation of that age group)} was calculated using two previously published data from Shropshire children and American children. A z score of zero indicates that the patients’ BMD is exactly on the mean. The proportion above and below zero and was compared using the binomial theorem. Comparison of frequencies between the groups was undertaken using the Chi 2 test. In a scatter plot of z score against age, low z scores were frequent in girls under 8yrs using both reference data. In this group BMD z score was more likely to be below zero (p< 0.05). A low z score was more frequent in boys less than 8 years using American reference data but not Shropshire data. Girls and boys above 8 years did not show any evidence of low BMD. There was no difference in the frequency of low BMD in patients with multiple compared with single fracture. Girls and possibly boys below 8 years who have sustained a fracture show evidence of low BMD. Boys at any age and girls over 8 years did not show any evidence of having low bone density. Further work is needed to establish whether this risk continues into later life. Multiple fractures do not appear to confer additional risk of low bone density

Introduction. There is no published series described change in bone mineral density (BMD) after ankle replacement. We present the results of a prospective study examining the effect of total ankle replacement (TAR) upon local bone mineral density (BMD). Aim. To design a method and assess the effect of TAR loading on local ankle bones, by analysing the BMD of different area around ankle before and after Mobility TAR. Methods. 23 patients undergoing Mobility ankle arthroplasty for osteoarthritis had preoperative bone densitometry scans of the ankle, repeated at 1 and 2 years after surgery. BMD of 2 cm. 2. areas around ankle were measured. Pre- and postoperative data were compared. Results: Mean BMD within the lateral malleolus decreased significantly from 0.5g/cm. 2. to 0.42g/cm. 2. (17%, P > 0.01), at 1 & 2 years postoperatively. Mean BMD within medial malleolus decreased slightly from 0.67g/cm. 2. to 0.64 g/cm. 2. at the same period. However BMD at medial side metaphysic of tibia increased by 7%. There was little increase in BMD in tibia just proximal to implant and at talus. Discussion and Conclusion. Absence of stress shielding around distal tibia, just proximal to tibial component and talus indicates that ankle replacements implanted within the accepted limits for implant alignment, load distal tibia and talus. However, there was stress shielding over the lateral malleolus resulting in decreased BMD in lateral malleolus. Increase BMD at tibial metaphysis, proximal to medial malleolus indicates an increase in mechanical stress which may explain occasional postoperative stress fracture of medial malleolus or medial side ankle pain

To evaluate the effects of 6 and 18 months of abaloparatide (ABL) compared with placebo (PBO) on bone mineral density (BMD) in the acetabular regions of postmenopausal women with osteoporosis (OP). Acetabular bone loss, as may occur in OP, increases risk of acetabular fragility fractures. a. In total hip arthroplasty (THA), low acetabular BMD adversely affects primary stability, osseointegration, and migration of acetabular cups. c. ABL is an osteoanabolic agent for the treatment of men and postmenopausal women with OP at high risk for fracture. Effects of ABL on acetabular BMD are unknown. Hip DXA scans were obtained at baseline, 6, and 18 months from a random subgroup of postmenopausal women (aged 49–86 y) from the phase 3 ACTIVE trial randomized to either ABL 80 µg/d or PBO (n=250/group). Anatomical landmarks were identified in each DXA scan to virtually place a hemispherical shell model of an acetabular cup and define regions of interest corresponding to DeLee & Charnley zones 1 (R1), 2 (R2), and 3 (R3). BMD changes compared to baseline were calculated for each zone. Statistical P values were based on a repeated mixed measures model. BMD in all zones were similar at baseline in the ABL and PBO groups. BMD significantly increased in the ABL group at 6 and 18 months compared with PBO (all P<0.0001 vs PBO). BMD in the PBO group was relatively stable over time. ABL treatment resulted in rapid and progressive increases in BMD of all 3 acetabular zones. Increasing acetabular BMD has the potential to improve acetabular strength, which may reduce risk of acetabular fragility fractures. In bone health optimization prior to THA, increased acetabular BMD via ABL may provide better primary stability and longevity of acetabular cups in postmenopausal women with OP

Introduction:. Significant proximal femoral remodeling occurs after total hip arthroplasty (THA), with regions of bone loss, and regions of hypertrophy. This study compared three implants for changes in femoral bone mineral density over 2 years following primary uncemented hip arthroplasty with a conventional stem (THA), a novel femoral neck-sparing short hip stem (NS-THA), and resurfacing hip arthroplasty (RHA). Methods:. Seventy-one patients participated in this non-randomized, prospective study. All patients had a diagnosis of osteoarthritis and underwent primary uncemented hip arthroplasty. Dual Energy XRay Absorptomitry (DXA) scans were performed at preoperative, 3–7 days post-op, 6 weeks, 6 months, one, and two years post-op. Using custom 2 cm zones, 19 zones were observed for percent changes in bone mineral density (BMD). Radiographs and Harris Hip scores were obtained at each visit. Results:. Age, gender, and BMI were found to be statistically different with fewer females and lower age in the RHA group, and a lower age in the NS-THA group. In all three groups, regions that were located proximally were shown to be the most susceptible to bone loss. Combined 2 cm zones 1C/7C, 2A/6A, and 2B/6B showed statistical significance (p < 0.05). Bone loss in the proximal regions was 8–10% lower with the femoral neck-sparing short stem, and least in the RHA group, causing little to no BMD loss in proximal regions. Radiographic outcomes and clinical results including Harris Hip scores were equal between the groups. Conclusion:. Consistent with our hypothesis, it was found that hip arthroplasty with a conventional stem resulted in the highest proximal femoral bone loss, and resurfacing arthroplasty was associated with the least bone loss. The femoral neck-sparing short stem ameliorated the bone loss seen with traditional hip arthroplasty, and approximated the bone preservation seen with hip resurfacing. The short stem neck-sparing device may provide some of the benefits of hip resurfacing, but could potentially have wider indications for use

Purpose of study:. The purpose of the study is to evaluate the changes in peri-prosthetic bone mineral density following cemented and cementless total hip arthroplasty over a follow up period of 1 year. Description of methods:. Ethics approval was sought and granted by the South African Medical Association Research Ethics Committee (SAMAREC). Patient consent for participation was obtained. Recruitment of the cohort took place over 2 years. Patients received an uncemented (Synergy) or cemented (Spectron) prosthesis as clinically appropriate. Functional status according to the University of California Los Angeles activity scale (UCLA scale) and bone mineral density as measured by Dual Energy X-ray Absorptiometry (DEXA) was assessed pre-operatively and at 3 months, 6 months and 12 months post-operatively. An independent Contract Research Organisation was used to monitor the site. Summary of results:. As at August 2010, 59 unique patients had undergone 59 hip replacements, and 7 patients (8.5%) were still due their 12 month evaluation. The mean UCLA scored showed a marked and steady improvement post-operatively, with most of the gain demonstrated by 3 months. When evaluating all patients, the mean pre-operative values for Gruen Zones 2, 4, and Net were significantly lower than the mean 12 month values. When evaluating patients who received the uncemented prosthesis (n=40), the mean pre-operative values for Gruen Zones 2 and Net were significantly lower than the mean 12 month values, and the mean pre-operative values for Gruen Zones 1 and 3 were significantly higher than the mean 12 month values. When evaluating patients who received the cemented prosthesis (n=19), the median pre-operative values for Gruen Zones 1, 2, 3, 4, 7 and Net were significantly lower than the median 12 month values. Conclusion:. At 1 year post surgery overall bone density showed a significant increase in both the cemented and uncemented cohort

Introduction: This study prospectively measured fifty consecutive patients who had the preoperative diagnosis of osteoarthritis undergoing total knee arthroplasty (TKA) to evaluate the change of the bone mineral density (BMD) of the calcaneus. Materials & Methods: Broadband ultrasound attenuation through the calcaneus was measured to assess the BMD of patients. The BMD was measured preoperatively and 1 month (M), 3M, 6M, 1 year, and 2 years after TKA. Results: The mean BUA at each stage was 47.1, 45.8, 46.7, 46.7, 47.8 and 53.1, respectively. During the first 6 months, the BUA declined inconsistently in most patients, but by 1 year, the BUA recovered to the initial BUA before surgery and by 2 years, the BUA increased than the initial BUA, although there ware not satisfactory different. Despite a predicted age-related loss of 4% during 2 years, 78% of the calcaneus on the operative side had BMD higher than preoperative levels and 85% had BMD that was within the expected 4% age-related loss. Discussion: These results indicated that TKA might contribute to decrease the age-related BMD loss. The increase with TKA in patient mobility and the increased heel loading may be a mechanism whereby the calcaneus BMD increases. Conclusion: It is very important for surgeons to recognize the objection beneficial effects of TKA in addition to pain relief

The shape of the vertebral bodies from L1 to L4 was assessed from lateral dual-energy x-ray absorptiometry (DXA) images using an active shape model. The output from the model was compared to measurements of areal bone mineral density in L1 to L4 (aBMD) using a stepwise linear regression model. A significant relationship was found between aBMD and vertebral shape that suggests that the method may be useful for correcting artefacts such as osteophytes

The bone mineral density (BMD) can be measured by dual energy X-ray absorptiometry (DEXA) accurately and precisely. BMD measurements of proximal tibia, where the structure is dominantly trabecular bone, were made on 45 normal women, aged 24–91 (52.0±14.2) years, and on 46 normal men, aged 20–71 (53.7±15.5) years. The precision of BMD measurements of proximal tibia, expressed as the coefficient of variation, was smaller than 4%. Throughout this cross-sectional study, the following results were acquired. The mean BMD in male is higher than that in female. The BMD show a decrease with age at different rates in women and men. The BMD in both genders is found to increase with body weight. A positive correlation is found between the BMD and body height in women, not in men. In right proximal tibia, the BMD of medial regions are higher than that of lateral regions significantly. Our study also demonstrates that the excellent symmetry of the BMD of the bilateral proximal tibias in both genders, but not in men with age less than 50 years old. Through the study of BMD in proximal tibias using the DEXA, it may reflect the bone reactions to many factors, such as age, sex, body weight & height, and weight bearing etc. Such a kind of study might be an useful adjuvant tool to assess the bone remodelling around the knee joint following the different surgical procedures such as total knee arthroplasty or high tibial osteotomy and might predict the future surgical outcomes

Cementless implants have gained popularity in modern orthopaedic practice. The type implants and surface characteristics on fixation has been extensively investigated, however there is insufficient data on the effect of the host bone bed status on implant fixation. This study aims to determine if there is a correlation between the fixation strength of cementless press-fit implants and bone mineral density (BMD) of the host bone bed. Implants coated with pure titanium, Hydroxyapatite (HA) with or without Hyaluronic Acid (HY) and implants coated with bone growth factors – Bone Morphogenetic Protein 2 (BMP-2) were inserted into tibiae and femora of 32 skeletally mature ewes (109 implants) for a period of 1, 2 and 4 weeks. Mechanical pull-out testing was performed after each time interval to evaluate the ultimate load of failure (Nmm. −2. ). The BMD (gcm. −3. ) surrounding the implant site was measured using a CT scanner. The mean BMD (S.D.) was 1.515gcm. −3. (0.147gcm. −3. ). The mean (S.D.) mechanical pull-out strength at 1, 2 and 4 weeks was 0.37 (0.31), 3.14 (0.17) and 9.74 (2.31) Nmm. −2. respectively. The overall correlation co-efficient between BMD and pull out strength is 0.31. Early fixation strength of implants is independent of BMD, however, the strength of fixation increases with time in a ‘normal’ sheep population. This suggests that the fixation of implants is dependent on the type of implant and surface coating used rather than the density of the host bone bed