scholarly journals Investigation on the contour and bone mineral density of the distal tibial cutting surface used for total ankle arthroplasty

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110280
Author(s):  
Dahang Zhao ◽  
Gonghao Zhang ◽  
Dichao Huang ◽  
Jian Yu ◽  
Kan Wang ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Cortical Bone ◽  
Bone Mineral ◽  
Ct Images ◽  
Total Ankle Arthroplasty ◽  
Tibial Tubercle ◽  
Mineral Density ◽  
Ankle Arthroplasty ◽  
Cutting Surface ◽  
Value Measurement

Purpose: This study was designed to investigate (1) the contour of the distal tibial cutting surface, and (2) the bone mineral density (BMD) of the distal tibial cutting surface used during total ankle arthroplasty (TAA). Methods: Eight-four distal tibial models were created using foot and ankle computerized tomographic (CT) images taken from normal people. The distal tibial cutting surface for TAA was determined to be 10 mm proximal to the tibial plafond. The bony contour and BMD values were determined from the CT image at that level. A bounding box was made on the contour and the width and length of the contour was measured. Regional BMD was evaluated by Hounsfield units (HU) value measurement, with 7 regions of interest (ROI) on 8 different directions for all the 84 CT images. Two different observers made independent measurements and mean HU values for all the 56 ROIs were calculated. Results: Great variations were found among the contours of the cutting surface especially in term of the shape of the anterior and posterior tibial tubercle, and the fibular notch. These variations could be grouped into six categories. For the BMD of the cutting surface, the medial border of the cutting surface did not included cortical bone. The HU value of seven ROIs, which included cortical bone, were significantly greater than all the other ROIs. Few statistical differences were found by multiple comparisons among HU value of all the 49 ROIs without cortex. Conclusions: Great variability existed in the shape and the BMD of the distal tibial cutting surface.

scholarly journals Change in Bone Mineral Density after Total Ankle Replacement: Two Year Follow Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0009
Author(s):  
Mohammad Alkhreisat ◽  
M Al-Maiyah ◽  
Jayasree Ramas Ramaskandhan ◽  
Andrea Pujol Nicolas ◽  
D Rawlings ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Stress Fracture ◽  
Bone Mineral ◽  
Total Ankle Replacement ◽  
Lateral Malleolus ◽  
Medial Malleolus ◽  
Specific Method ◽  
Mineral Density ◽  
Ankle Arthroplasty ◽  
Ankle Replacement

Category: Ankle, Ankle Arthritis Introduction/Purpose: Bone strength about the components is an important factor in Arthroplasty survival. This importance has been studied in total hip & knee replacement. However, there is paucity of literature Where little has been published regarding the quality of the bone and bone mineral content postoperatively surrounding Ankle Arthroplasty and circumstances surrounding the development of stress fracture. This prospective study used a method to quantify Bone Mineral Density BMD in different regions of the surrounding bones adjacent to tibia and talar components of uncemented Mobility ankle prosthesis, and to study the effect of loading on local ankle bone in the presence of un-cemented three components ankle replacement, by analyzing the BMD of the areas around tibia and talus before and after Mobility total ankle replacement. Methods: Twenty three Ankles (7Females, 15 Males) who underwent a Mobility Total Ankle Arthroplasty (TAA) between March 2008 and April 2009 were included prospectively in this study. They underwent a Bone Density Scan using the DEXA HOLIGIC Scanner with the specific method designed for measuring BMD. Seven areas (R1-R7) around the prosthesis were studied (Please see attached figure). Scans were carried out pre-operatively and repeated at 1 and 2 years post-operatively. The results were also compared with clinical outcomes, using (AOFAS scores) both pre, 1 and 2 years post-op. Results: Mean age of patients was 63.3 years (SD 9, range 43 to 80). AOFAS scores showed significant improvement (from 28.8 pre-op to 78.7,76.9 at 12 and 24 months post-op respectively; p<0.05). BMD within the lateral malleolus decreased significantly from 0.5g/cm2 to 0.42g/cm2 (17%, P < 0.01), at one and two years postoperatively - R2. There was an insignificant increase in Mean BMD at medial side metaphysis of tibia increased by,7% (+0.07 g cm -2, R6), but this just failed to reach statistical significance, mean BMD within medial malleolus decreased slightly from 0.67g/cm2 to 0.64 g/cm2 at the same period which was statistically insignificant. There was little insignificant increase in BMD in tibia just proximal to implant (R7) and at talus (R5). Conclusion: Stemmed implant causes changes in Tibial BMD around prosthesis. There was stress shielding over the lateral malleolus resulting in decrease BMD in lateral malleolus and to a lesser extent of the medial malleolus. The increase in BMD at tibial metaphysis indicates an increase in mechanical stresses at that region, which may explain occasional postoperative stress fracture of medial malleolus or medial sided ankle pain. There is no further change in BMD from year 1 to year 2 following TAR.

scholarly journals A Metabolic Screen in Adolescents Reveals an Association Between Circulating Citrate and Cortical Bone Mineral Density

2019 ◽  
Vol 34 (7) ◽  
pp. 1306-1313 ◽  
Author(s):  
John P Kemp ◽  
Adrian Sayers ◽  
William D Fraser ◽  
George Davey Smith ◽  
Mika Ala‐Korpela ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Cortical Bone ◽  
Bone Mineral ◽  
Mineral Density ◽  
Cortical Bone Mineral Density
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