Researchers continue to seek easier ways to evaluate the quality of bone and screen for osteoporosis and osteopenia. Until recently, radiographic images of various parts of the body, except the distal femur, have been reappraised in the light of dual-energy X-ray absorptiometry (DXA) findings. The incidence of osteoporotic fractures around the knee joint in the elderly continues to increase. The aim of this study was to propose two new radiographic parameters of the distal femur for the assessment of bone quality. Anteroposterior radiographs of the knee and bone mineral density (BMD) and T-scores from DXA scans of 361 healthy patients were prospectively analyzed. The mean cortical bone thickness (CBTavg) and the distal femoral cortex index (DFCI) were the two parameters that were proposed and measured. Intra- and interobserver reliabilities were assessed. Correlations between the BMD and T-score and these parameters were investigated and their value in the diagnosis of osteoporosis and osteopenia was evaluated.Objectives
Methods
Total knee replacement (TKR) is an effective
method of treating end-stage arthritis of the knee. It is not, however,
a procedure without risk due to a number of factors, one of which
is diabetes mellitus. The purpose of this study was to estimate
the general prevalence of diabetes in patients about to undergo
primary TKR and to determine whether diabetes mellitus adversely
affects the outcome. We conducted a systematic review and meta-analysis
according to the Meta-analysis Of Observational Studies in Epidemiology
(MOOSE) guidelines. The Odds Ratio (OR) and mean difference (MD)
were used to represent the estimate of risk of a specific outcome.
Our results showed the prevalence of diabetes mellitus among patients
undergoing TKR was 12.2%. Patients with diabetes mellitus had an increased
risk of deep infection (OR = 1.61, 95% confidence interval (CI),
1.38 to 1.88), deep vein thrombosis (in Asia, OR = 2.57, 95% CI,
1.58 to 4.20), periprosthetic fracture (OR = 1.89, 95% CI, 1.04
to 3.45), aseptic loosening (OR = 9.36, 95% CI, 4.63 to 18.90),
and a poorer Knee Society function subscore (MD = -5.86, 95% CI,
-10.27 to -1.46). Surgeons should advise patients specifically about
these increased risks when obtaining informed consent and be meticulous about
their peri-operative care. Cite this article:
