scholarly journals Is Peoperative Glenoid Bone Mineral Density A Risk Factor for Aseptic Glenoid Implant Loosening in Anatomic Total Shoulder Arthroplasty?

2020 ◽  
Author(s):  
Sandrine Mariaux ◽  
Raphaël Obrist ◽  
Alain Farron ◽  
Fabio Becce ◽  
Alexandre Terrier
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Bone Mineral ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Implant Survival ◽  
Implant Loosening ◽  
Mineral Density ◽  
Glenoid Loosening ◽  
The Impact

Abstract Background: Aseptic loosening of glenoid implants is the primary revision cause in anatomic total shoulder arthroplasty (aTSA). While supported by biomechanical studies, the impact of glenoid bone quality, more specifically bone mineral density (BMD), on aseptic glenoid loosening remains unclear. We hypothesized that lower preoperative glenoid BMD was associated with and a risk factor for aseptic glenoid implant loosening in aTSA.Methods: We retrospectively included 93 patients (69 females and 24 males; mean age, 69.2 years) who underwent preoperative non-arthrographic shoulder computed tomography (CT) scans and aTSA between 2002 and 2014. Preoperative glenoid BMD (CT numbers in Hounsfield unit) was measured in 3D using a reliable semi-automated quantitative method, in the following six contiguous volumes of interest (VOI): cortical, subchondral cortical plate (SC), subchondral trabecular, and three successive adjacent layers of trabecular bone. Univariate Cox regression was used to estimate the impact of preoperative glenoid BMD on aseptic glenoid implant loosening. We further compared 26 aseptic glenoid loosening patients with 56 matched control patients.Results: Glenoid implant survival rates were 89% (95% confidence interval CI, 81%-96%) and 57% (41%-74%) at 5 and 10 years, respectively. Hazard ratios for the different glenoid VOIs ranged between 0.998 and 1.004 (95% CI [0.996, 1.007], p≥0.121). Only the SC VOI showed significantly lower CTn in the loosening group (622±104 HU) compared with the control group (658±88 HU) (p=0.048), though with a medium effect size (d=0.42). There were no significant differences in preoperative glenoid BMD in any other VOI between patients from the loosening and control groups.Conclusions: Although the preoperative glenoid BMD was statistically significantly lower in the SC region of patients with aseptic glenoid implant loosening compared with controls, this single-VOI difference was only moderate. We are thus unable to prove that lower preoperative glenoid BMD is clearly associated with and a risk factor for aseptic glenoid implant loosening in aTSA. However, due to its proven biomechanical role in glenoid implant survival, we recommend extending this study to larger CT datasets to further assess and better understand the real impact of preoperative glenoid BMD on glenoid implant loosening/survival and aTSA outcome overall.Trial registration: Retrospectively registered

scholarly journals Is preoperative glenoid bone mineral density associated with aseptic glenoid implant loosening in anatomic total shoulder arthroplasty?

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sandrine Mariaux ◽  
Raphaël Obrist ◽  
Alain Farron ◽  
Fabio Becce ◽  
Alexandre Terrier
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Medium Effect ◽  
Implant Survival ◽  
Implant Loosening ◽  
Mineral Density ◽  
Glenoid Loosening ◽  
The Impact

Abstract Background Aseptic loosening of glenoid implants is the primary revision cause in anatomic total shoulder arthroplasty (aTSA). While supported by biomechanical studies, the impact of glenoid bone quality, more specifically bone mineral density (BMD), on aseptic glenoid loosening remains unclear. We hypothesized that lower preoperative glenoid BMD was associated with aseptic glenoid implant loosening in aTSA. Methods We retrospectively included 93 patients (69 females and 24 males; mean age, 69.2 years) who underwent preoperative non-arthrographic shoulder computed tomography (CT) scans and aTSA between 2002 and 2014. Preoperative glenoid BMD (CT numbers in Hounsfield unit) was measured in 3D using a reliable semi-automated quantitative method, in the following six contiguous volumes of interest (VOI): cortical, subchondral cortical plate (SC), subchondral trabecular, and three successive adjacent layers of trabecular bone. Univariate Cox regression was used to estimate the impact of preoperative glenoid BMD on aseptic glenoid implant loosening. We further compared 26 aseptic glenoid loosening patients with 56 matched control patients. Results Glenoid implant survival rates were 89% (95% confidence interval CI, 81–96%) and 57% (41–74%) at 5 and 10 years, respectively. Hazard ratios for the different glenoid VOIs ranged between 0.998 and 1.004 (95% CI [0.996, 1.007], p≥0.121). Only the SC VOI showed significantly lower CTn in the loosening group (622±104 HU) compared with the control group (658±88 HU) (p=0.048), though with a medium effect size (d=0.42). There were no significant differences in preoperative glenoid BMD in any other VOI between patients from the loosening and control groups. Conclusions Although the preoperative glenoid BMD was statistically significantly lower in the SC region of patients with aseptic glenoid implant loosening compared with controls, this single-VOI difference was only moderate. We are thus unable to prove that lower preoperative glenoid BMD is clearly associated with aseptic glenoid implant loosening in aTSA. However, due to its proven biomechanical role in glenoid implant survival, we recommend extending this study to larger CT datasets to further assess and better understand the impact of preoperative glenoid BMD on glenoid implant loosening/survival and aTSA outcome.

scholarly journals Is preoperative glenoid bone mineral density associated with aseptic glenoid implant loosening in anatomic total shoulder arthroplasty?

2020 ◽  
Author(s):  
Sandrine Mariaux ◽  
Raphaël Obrist ◽  
Alain Farron ◽  
Fabio Becce ◽  
Alexandre Terrier
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Medium Effect ◽  
Implant Survival ◽  
Implant Loosening ◽  
Mineral Density ◽  
Glenoid Loosening ◽  
The Impact

Abstract Background: Aseptic loosening of glenoid implants is the primary revision cause in anatomic total shoulder arthroplasty (aTSA). While supported by biomechanical studies, the impact of glenoid bone quality, more specifically bone mineral density (BMD), on aseptic glenoid loosening remains unclear. We hypothesized that lower preoperative glenoid BMD was associated with aseptic glenoid implant loosening in aTSA.Methods: We retrospectively included 93 patients (69 females and 24 males; mean age, 69.2 years) who underwent preoperative non-arthrographic shoulder computed tomography (CT) scans and aTSA between 2002 and 2014. Preoperative glenoid BMD (CT numbers in Hounsfield unit) was measured in 3D using a reliable semi-automated quantitative method, in the following six contiguous volumes of interest (VOI): cortical, subchondral cortical plate (SC), subchondral trabecular, and three successive adjacent layers of trabecular bone. Univariate Cox regression was used to estimate the impact of preoperative glenoid BMD on aseptic glenoid implant loosening. We further compared 26 aseptic glenoid loosening patients with 56 matched control patients.Results: Glenoid implant survival rates were 89% (95% confidence interval CI, 81%-96%) and 57% (41%-74%) at 5 and 10 years, respectively. Hazard ratios for the different glenoid VOIs ranged between 0.998 and 1.004 (95% CI [0.996, 1.007], p≥0.121). Only the SC VOI showed significantly lower CTn in the loosening group (622±104 HU) compared with the control group (658±88 HU) (p=0.048), though with a medium effect size (d=0.42). There were no significant differences in preoperative glenoid BMD in any other VOI between patients from the loosening and control groups.Conclusions: Although the preoperative glenoid BMD was statistically significantly lower in the SC region of patients with aseptic glenoid implant loosening compared with controls, this single-VOI difference was only moderate. We are thus unable to prove that lower preoperative glenoid BMD is clearly associated with aseptic glenoid implant loosening in aTSA. However, due to its proven biomechanical role in glenoid implant survival, we recommend extending this study to larger CT datasets to further assess and better understand the impact of preoperative glenoid BMD on glenoid implant loosening/survival and aTSA outcome.Trial registration: Retrospectively registered

scholarly journals Evaluation of association of fragility fracture and bone mineral density in Nepalese population

2013 ◽  
Vol 2 (2) ◽  
pp. 130-134
Author(s):  
Md. Farid Amanullah ◽  
BP Shrestha ◽  
GP Khanal ◽  
NK Karna ◽  
S Ansari ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
High Energy ◽  
Medical Illness ◽  
Mineral Density ◽  
T Score ◽  
Study Results

Background: Fragility fractures are one of the major health problems. Many factors are associated with it some of which are modifiable and some are not. If we know the value of T-score at which fragility fracture occurs and associated factors responsible for fragility fracture than we will be able to control this burden to the society. The objective of this study is to determine association between fragility fracture and bone mineral density (BMD) using bone densitometry and to know the value of T-score at which fragility fracture occurs. Methods: Patients presenting to B.P. Koirala Institute of Health Sciences with fragility fracture of distal end of radius, fracture around hip and vertebral fractures were included in the study to know the value of T-score at which fragility fracture occurs and their associated risk factor. Patients less than 50 years of age, high energy trauma fracture and pathological fractures were excluded from the study. Results: We found that being multipara, smoking, alcohol consumption, post-hysterectomized patients and steroid intake had significant association with fragility fracture. There was no association with religion, geographic location, associated medical illness, age, sex, associated injury and site of injury. Conclusion: The patients with risk factor for fragility fracture like smoking, alcohol consumption, multipara women, post-hysterectomized women and those who are on long term steroid therapy should undergo BMD test and the value at -3.254 are prone to fragility fracture and should be treated accordingly. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 130-134 DOI: http://dx.doi.org/10.3126/njms.v2i2.8956

scholarly journals A REVIEW: MECHANISTIC INSIGHTS INTO THE EFFECT OF THYROID DISORDERS ON ESTROGEN LEVEL AND BONE MINERAL DENSITY

2019 ◽  
pp. 9-17
Author(s):  
MINAKSHI JOSHI ◽  
SHRADHA BISHT ◽  
MAMTA F. SINGH
Keyword(s):  
Bone Mineral Density ◽  
Thyroid Hormone ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Disorders ◽  
Hypothyroid Patient ◽  
Mineral Density ◽  
Estrogen Level ◽  
The Impact

Thyroid hormone serves as an indispensable component for the optimum functioning of various biological systems. They curb body’s metabolism, regulates the estrogen level, regulates bone turnover, essential for skeletal development and mineralization. Within the scope of knowledge, it is intimately familiar that thyroid disorders have widespread systemic manifestations, among which in hypothyroidism, even though elevated TSH (thyroid-stimulating hormone) may reduce estrogen level which in turn stimulates osteoclasts and thus cause osteoporosis, while hyperthyroidism accelerates bone turnover. Hypothyroidism does not directly interfere with the skeletal integrity, but treatment with levothyroxine for the suppression of TSH to bring the hypothyroid patient to euthyroid state for a long haul; lead to simultaneous reduction in bone mass and in (bone mineral density) BMD. After the initial relevation of the correlation between thyroid disorders and osteoporosis in numerous studies have emphasized that both hypo and hyperthyroidism either directly or indirectly affects the bone mineral density or leads to the progression of osteoporosis. Therefore the present study is aimed and so designed to review all the possible associations between them and the impact of thyroid disorders on estrogen level and bone mineral density. The main findings of this review indicate that both excesses as well as deficiency of thyroid hormone can be potentially deleterious for bone tissue.

scholarly journals Bone mineral density predictors in long-standing type 1 and type 2 diabetes mellitus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefana Catalina Bilha ◽  
Letitia Leustean ◽  
Cristina Preda ◽  
Dumitru D. Branisteanu ◽  
Laura Mihalache ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Cross Sectional ◽  
The Impact

Abstract Background Despite the increased fracture risk, bone mineral density (BMD) is variable in type 1 (T1D) and type 2 (T2D) diabetes mellitus. We aimed at comparing independent BMD predictors in T1D, T2D and control subjects, respectively. Methods Cross-sectional case-control study enrolling 30 T1D, 39 T2D and 69 age, sex and body mass index (BMI) – matched controls that underwent clinical examination, dual-energy X-ray absorptiometry (BMD at the lumbar spine and femoral neck) and serum determination of HbA1c and parameters of calcium and phosphate metabolism. Results T2D patients had similar BMD compared to T1D individuals (after adjusting for age, BMI and disease duration) and to matched controls, respectively. In multiple regression analysis, diabetes duration – but not HbA1c- negatively predicted femoral neck BMD in T1D (β= -0.39, p = 0.014), while BMI was a positive predictor for lumbar spine (β = 0.46, p = 0.006) and femoral neck BMD (β = 0.44, p = 0.007) in T2D, besides gender influence. Age negatively predicted BMD in controls, but not in patients with diabetes. Conclusions Long-standing diabetes and female gender particularly increase the risk for low bone mass in T1D. An increased body weight partially hinders BMD loss in T2D. The impact of age appears to be surpassed by that of other bone regulating factors in both T1D and T2D patients.

scholarly journals High serum FSH is not a risk factor for low bone mineral density in infertile men

Bone ◽  
2020 ◽  
Vol 136 ◽  
pp. 115366
Author(s):  
Leen Antonio ◽  
Lærke Priskorn ◽  
Inge A. Olesen ◽  
Jørgen H. Petersen ◽  
Dirk Vanderschueren ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Bone Mineral ◽  
High Serum ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Infertile Men

scholarly journals FRACTURE — A RISK FACTOR FOR DEVELOPMENT AND PROGRESSION OF OSTEOPENIA AND OSTEOPOROSIS

2013 ◽  
Vol 16 (3) ◽  
pp. 28-34 ◽  
Author(s):  
E A Pobel
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Bone Mineral ◽  
Prospective Studies ◽  
Full Recovery ◽  
Mineral Density ◽  
Injured Limb ◽  
The Future ◽  
Post Traumatic ◽  
Posttraumatic Osteopenia

Analyzed literature data demonstrates the influence of fracture in individuals of different age on the risk of post-traumatic osteopenia and osteoporosis, as well as increase in the risk of the recurrent fractures. It is proved that the fracture leads to a decrease in bone mineral density (BMD) not only in the injured limb, but also other parts of the skeleton. In majority of prospective studies and metaanalysis it was shown that there is no full recovery of BMD after sustained fracture. Posttraumatic osteopenia and osteoporosis increase the risk of re-fracture in the future.

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