Longitudinal Assessment of Periprosthetic Bone Mineral Density around Total Ankle Replacement: preliminary report with clinical correlation

Congress:

ECR 2020

Poster Number:

C-11955

Type:

Scientific Exhibit

Keywords:

Performed at one institution, Observational, Prospective, Prostheses, Demineralisation-Bone, Diagnostic procedure, Absorptiometry / Bone densitometry, Musculoskeletal joint, Musculoskeletal bone, Bones, Musculoskeletal

Authors:

L. Tofanelli¹, D. Albano², S. FAENZA³, C. Di Silvestri², C. Messina⁴, L. M. Sconfienza⁴; ¹MILANO, Italy/IT, ²Milano/IT, ³Desio/IT, ⁴Milan/IT

DOI:

10.26044/ecr2020/C-11955

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-11955

Purpose

Joint replacement survival is associated with the quality of the surrounding bone. Longitudinal radiological evaluation of periprosthetic bone ismainly conductedby serial plain radiographs assessment, with the use of computed tomography (CT) and magnetic resonance imaging (MRI)as complementary tools (1). Dual-energy X-ray absorptiometry (DXA) is able to measure periprosthetic bone mineral density (pBMD) around total ankle replacement (TAR) using metal removal software (2). We evaluated pBMD changes in patients undergoing TAR and correlating these possible changes with clinical joint assessment.

Methods and materials

Twelve patients were prospectively evaluated with preoperative lumbar spine and hip DXA for bone metabolism assessment. PBMD was evaluatedby an operator with sevenyears of experience in DXA using a Hologic QDR-Discovery W densitometer (Hologic Inc., Bedford, MA, USA). See fig. 1 for the specific protocol of patient positioning, both for the frontal position (A) and lateral position (B) (see ref. 2). PBMD was measured at up to 6 different regions of interest(ROIs) in the lateral-frontal projections, at tibia, talus and calcaneus. We evaluated pBMD with...

Results

There was a statistically significant decrease in the calcaneal BMD (P

Conclusion

Our preliminary results show an improvement in clinical scores, despite no statistically significant variation was found in the pBMD. We found a statistically significant decrease in BMD of the calcaneal area with TAR, possibly due to disuse. Longer follow-up studies are required to determine the usefulness of measuring pBMD around TAR

Personal information and conflict of interest

L. Tofanelli; Milan, ITALY/IT - nothing to disclose D. Albano; Milan/IT - nothing to disclose S. Faenza; Desio/IT - nothing to disclose C. Di Silvestri; Milan/IT - nothing to disclose C. Messina; Milan/IT - Grant Recipient at Bracco, Abiogen, Ibsa L. M. Sconfienza; Milan/IT - Grant Recipient at Bracco, Abiogen, Fidia

References

Chang C, Huang A, Palmer W (2015) Radiographic Evaluation of Hip Implants. Semin Musculoskelet Radiol 19:012–020. doi: 10.1055/s-0034-1396763 Messina C,Usuelli FG, Maccario C, Di Silvestri CA, Gitto S, Cortese MC, Albano D, Sconfienza LM.Precision of Bone Mineral Density Measurements Around Total Ankle Replacement Using Dual Energy X-ray Absorptiometry.J Clin Densitom. 2019 Feb 1. pii: S1094-6950(18)30250-6.