A examine investigating short- and medium-term results on operate, bone mineral density and lean tissue mass post-total knee substitute in a Caucasian feminine post-menopausal inhabitants: implications for hip fracture threat.
Osteoporos Int. 2016 Aug;27(eight):2567-76
Authors: Hopkins SJ, Toms AD, Brown M, Welsman JR, Ukoumunne OC, Knapp KM
UNLABELLED: Important elevated hip fracture incidence has been reported within the yr following whole knee substitute. This examine demonstrates that bone and muscle loss is a post-surgical consequence of whole knee substitute, alongside poor outcomes in operate and exercise doubtlessly contributing to diminished high quality of life and elevated hip fracture threat.
INTRODUCTION: A major enhance in hip fracture incidence within the yr following whole knee substitute (TKR) surgical procedure has been reported. This examine investigated operate and exercise following TKR and the results of restricted mobility on bone and muscle loss and their potential contribution to hip fracture threat.
METHODS: Modifications in dual-energy X-ray absorptiometry (DXA) (GE Lunar Prodigy, Bedford MA), bone mineral density (BMD) on the neck of femur (NOF), whole hip area (TH) and lumbar backbone have been measured alongside leg lean tissue mass (LLTM) in post-menopausal Caucasian females following TKR (N?=?19) in comparison with controls (N?=?43). Lumbar backbone trabecular bone scores (TBSs) have been calculated. Ipsilateral/contralateral weight bearing, decrease limb operate, Three-day pedometer readings, ache ranges and falls have been additionally recorded. Measurements have been obtained at pre-surgery baseline and at 6 weeks, 6 months and 12 months post-surgery.
RESULTS: No statistically important variations have been demonstrated between teams at baseline bilaterally in LLTM or BMD on the NOF and TH. Losses in ipsilateral NOF and TH BMD and contralateral LLTM have been considerably greater within the TKR group at 6 months. Impairment in operate and weight bearing persevered within the TKR group 12 months post-operatively alongside deficits in bilateral muscle mass and ipsilateral NOF and TH BMD. Falls incidence was not considerably greater within the TKR group.
CONCLUSIONS: Bone loss on the hip with related muscle loss is a consequence of TKR that, along with poor affected person outcomes in operate and exercise, doubtlessly contributes to elevated hip fracture threat within the yr following surgical procedure.
PMID: 26919995 [PubMed – indexed for MEDLINE]