scholarly journals Quantitative measurements of adaptive bone remodeling around the cemented Zimmer® segmental stem after tumor resection arthroplasty using dual-energy x-ray absorptiometry

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Christina Enciso Holm ◽  
Peter Horstmann ◽  
Michala Skovlund Sørensen ◽  
Karen Dyreborg ◽  
Michael Mørk Petersen
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Metastatic Bone Disease ◽  
Regions Of Interest ◽  
Trabecular Metal ◽  
Mineral Density ◽  
X Ray ◽  
Tumor Prosthesis ◽  
Cemented Stem

Abstract Background Limb salvage surgery (LSS) is the preferred method for treatment of patients with sarcomas and to a greater extent also to patients with metastatic bone disease. The aim of the present study was to evaluate the adaptive remodeling of the periprosthetic cortical bone after insertion of a tumor prosthesis with cemented stem. Methods A prospective study of 21 patients (F/M = 12/9), mean age 55 years (range 15–81) with metastatic bone disease (n = 9), sarcomas (n = 8) or aggressive benign tumors (n = 4) who underwent bone resection due to a tumor, and reconstruction with a tumor-prosthesis (Zimmer® Segmental 130 mm straight fluted cemented stem with trabecular metal (TM) collars) in the proximal femur (n = 10), distal femur (n = 9) or proximal tibia (n = 2). Measurements of bone mineral density (BMD) (g/cm2) were done postoperatively and after 3, 6, and 12 months using dual-energy X-ray absorptiometry. BMD was measured in 4 regions of interest around the cemented stem and in one region of interest 1 cm proximal from the ankle joint of the affected limb and measurement of the contralateral ankle was used as reference. Repeated measures ANOVA and students paired t-test was used to evaluate BMD changes over time. Results At 1-year follow-up, BMD decreased compared to baseline in all four regions of interest with a statistically significant bone loss of 8–15%. The bone loss was most pronounced (14–15%) in the 2 regions of interest closest to the trabecular metal (TM) collar and lowest (8%) adjacent to the tip of the stem. Conclusion After 1 year the decrease in bone mineral density of the ankle on the affected limb was 9% and the contralateral ankle was close to baseline, thus suggesting that the periprosthetic bone mineral density changes during follow-up, mainly are caused by stress shielding and immobilization. Trial registration The study was approved by the Scientific Ethical Committee of the Capital Region of Denmark (J. No. H-2-2014-105) and the Danish Data Protection Agency (J. No.:2012–58-00004).

scholarly journals Quantitative Measurements of Adaptive Bone Remodeling Around the Cemented Zimmer® Segmental Stem After Tumor Resection Arthroplasty Using Dual-energy x-ray absorptiometry

2020 ◽  
Author(s):  
Christina Enciso Holm ◽  
Peter Frederik Horstmann ◽  
Michala Skovlund Sørensen ◽  
Karen Dyreborg ◽  
Michael Mørk Petersen
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Tumor Resection ◽  
Regions Of Interest ◽  
Trabecular Metal ◽  
Mineral Density ◽  
X Ray ◽  
Tumor Prosthesis ◽  
Cemented Stem

Abstract Background: Limb salvage surgery is the preferred method for treatment of patients with sarcomas and to a greater extent also to patients with metastatic bone disease. The aim of the present study was to evaluate the adaptive remodeling of the periprosthetic cortical bone after insertion of a tumor prosthesis with cemented stem. Methods :A prospective study of 21 patients (F/M=12/9), mean age 55 years (range 15-81) with metastatic bone disease (n=9), sarcomas (n=8) or aggressive benign tumors (n=4) who underwent bone tumor resection and reconstruction with a tumor-prosthesis (Zimmer® Segmental 130 mm straight fluted cemented stem with trabecular metal collars in the proximal femur (n=10), distal femur (n=9) or proximal tibia (n=2) . Measurements of bone mineral density (BMD) (g/cm 2 ) were done postoperatively and after 3, 6, and 12 months using dual-energy X-ray absorptiometry. BMD was measured in 4 regions of interest around the cemented stem and in one region of interest 1 cm proximal from the ankle joint of the affected limb and measurement of the contralateral ankle was used as reference. Repeated measures ANOVA and students paired t-test was used to evaluate BMD changes over time. Results: At 1-year follow-up, BMD decreased compared to baseline in all four regions of interest with a statistically significant bone loss of 8-15%. The bone loss was most pronounced (14-15%) in the 2 regions of interest closest to the trabecular metal collar and lowest (8%) adjacent to the tip of the stem. Conclusion: After one year the decrease in bone mineral density of the ankle on the affected limb was 9% and the contralateral ankle was close to baseline, thus suggesting that the periprosthetic bone mineral density changes during follow-up, mainly are caused by stress shielding and immobilization. Trial registration The study was approved by the Scientific Ethical Committee of the Capital Region of Denmark (J. No. H-2-2014-105) and the Danish Data Protection Agency (J. No.:2012-58-00004).

scholarly journals Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

2021 ◽  
Vol 18 (15) ◽  
pp. 8144
Author(s):  
Gabriella Martino ◽  
Federica Bellone ◽  
Carmelo M. Vicario ◽  
Agostino Gaudio ◽  
Andrea Caputo ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Rating Scale ◽  
Osteoporotic Fractures ◽  
Oral Bisphosphonates ◽  
Mineral Density ◽  
X Ray ◽  
Hamilton Anxiety Rating Scale ◽  
Anxiety Levels

Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 > HAM-A 2 > HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was >75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (β = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.

scholarly journals Cortical Consolidation due to Increased Mineralization and Endosteal Contraction in Young Adult Men: A Five-Year Longitudinal Study

2011 ◽  
Vol 96 (7) ◽  
pp. 2262-2269 ◽  
Author(s):  
Claes Ohlsson ◽  
Anna Darelid ◽  
Martin Nilsson ◽  
Johanna Melin ◽  
Dan Mellström ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Bone Mass ◽  
Bone Mineral ◽  
Peak Bone Mass ◽  
Volumetric Bone Mineral Density ◽  
Mineral Density ◽  
Site Specific ◽  
X Ray

Abstract Context: Peak bone mass is an important factor in the lifetime risk of developing osteoporosis. Large, longitudinal studies investigating the age of attainment of site-specific peak bone mass are lacking. Objective and Main Outcome Measures: The main outcome measures were to determine the site-specific development of peak bone mass in appendicular and axial skeletal sites and in the trabecular and cortical bone compartments, using both dual x-ray absorptiometry and peripheral computed tomography. Design, Setting, and Population: In total, 833 men [aged 24.1 ± 0.6 yr (mean ± sd)] from the original population-based Gothenburg Osteoporosis and Obesity Determinants Study (n = 1068) were included in this follow-up examination at 61.2 ± 2.3 months. Areal bone mineral density (aBMD) was measured with dual x-ray absorptiometry, whereas cortical and trabecular volumetric bone mineral density and bone size were measured by peripheral computed tomography at baseline and at the 5-yr follow-up. Results: During the 5-yr study period, aBMD of the total body, lumbar spine, and radius increased by 3.4, 4.2, and 7.8%, respectively, whereas a decrease in aBMD of the total hip of 1.9% was observed (P < 0.0001). Increments of 2.1 and 0.7% were seen for cortical volumetric bone mineral density of the radius and tibia, respectively (P < 0.0001), whereas cortical thickness increased by 3.8% at the radius and 6.5% at the tibia due to diminished endosteal circumference (radius 2.3% and tibia 4.6%, P < 0.0001). Conclusion: aBMD decreased at the hip but increased at the spine and radius, in which the increment was explained by continued mineralization and augmented cortical thickness due to endosteal contraction in men between ages 19 and 24 yr.

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