Yoshinori Ishii1, Hideo Noguchi2, Junko Sato2, Hana Ishii3, Koji Todoroki2, Shin-Ichi Toyabe4. 1. Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama 361-0037, Japan. Electronic address: ishii@sakitama.or.jp. 2. Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama 361-0037, Japan. 3. Kouseiren Takaoka Hospital, 5-10 Eirakutyo Takaoka, Toyama 933-8555, Japan. 4. Niigata University Crisis Management Office, Niigata University Hospital, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata 951-8520, Japan.
Abstract
BACKGROUND: Proximal tibial bone mineral density (BMD) has been studied for its potential impact on subsidence and loosening of the tibial component after total knee arthroplasty (TKA). However, no known studies of proximal tibial BMD after TKA have evaluated the effect of major impact factors such as body weight (BW), muscle strength, and level of activity. We aim to determine whether factors such as level of activity, quadriceps strength, BW, gender, age, and prosthetic design affect proximal tibial BMD over the mid- to long-term following TKA. METHODS: We evaluated 36 patients (72 knees) who were undergoing bilateral TKA performed by a single surgeon. Median follow up time was 115months (range, 60-211months) for a minimum of five years. We measured BMD in the proximal tibia and used a hand-held dynamometer to measure quadriceps isometric strength, recording the maximum value of three measurements for each patient. RESULTS: Univariate analyses using Spearman's correlation coefficient for continuous variables revealed a weak negative correlation between age and BMD (r=-0.316, P=0.007) and a moderate positive correlation between BW and BMD (r=0.430, P<0.001). However, no significant correlations were found between the other factors above and BMD for continuous and discrete variables. Based on multivariate analyses, only BW had a significant effect on BMD (β=0.342, P=0.003). CONCLUSIONS: BW is the most impact factor on the proximal tibial BMD after mid- to long-term follow up TKA. Therefore, the management of BW may contribute to prevention of decline of tibial BMD for TKA patients owing to aging.
BACKGROUND: Proximal tibial bone mineral density (BMD) has been studied for its potential impact on subsidence and loosening of the tibial component after total knee arthroplasty (TKA). However, no known studies of proximal tibial BMD after TKA have evaluated the effect of major impact factors such as body weight (BW), muscle strength, and level of activity. We aim to determine whether factors such as level of activity, quadriceps strength, BW, gender, age, and prosthetic design affect proximal tibial BMD over the mid- to long-term following TKA. METHODS: We evaluated 36 patients (72 knees) who were undergoing bilateral TKA performed by a single surgeon. Median follow up time was 115months (range, 60-211months) for a minimum of five years. We measured BMD in the proximal tibia and used a hand-held dynamometer to measure quadriceps isometric strength, recording the maximum value of three measurements for each patient. RESULTS: Univariate analyses using Spearman's correlation coefficient for continuous variables revealed a weak negative correlation between age and BMD (r=-0.316, P=0.007) and a moderate positive correlation between BW and BMD (r=0.430, P<0.001). However, no significant correlations were found between the other factors above and BMD for continuous and discrete variables. Based on multivariate analyses, only BW had a significant effect on BMD (β=0.342, P=0.003). CONCLUSIONS: BW is the most impact factor on the proximal tibial BMD after mid- to long-term follow up TKA. Therefore, the management of BW may contribute to prevention of decline of tibial BMD for TKA patients owing to aging.
Authors: Thomas Anijs; Sanne Eemers; Yukihide Minoda; David Wolfson; Nico Verdonschot; Dennis Janssen Journal: J Biomed Mater Res B Appl Biomater Date: 2021-10-18 Impact factor: 3.405