DEXA overestimates bone mineral density in adults with knee replacements

作     者：Katharine D.Harper Terry A.Clyburn Stephen J.Incavo Bradley S.Lambert 

作者机构：Department of Orthopedics&Sports MedicineHouston Methodist Hospital6445 Main StreetOutpatient CenterSuite 2500HoustonTXUnited States Department of OrthopedicsWashington DC VA Medical Center50 Irving St.NWWashington D.CUnited States 

出 版 物：《Sports Medicine and Health Science》 (运动医学与健康科学（英文）)

年 卷 期：2020年第2卷第4期

页      面：211-215页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：The procedures were approved by the institutional review board for research involving human subjects(IRB PRO00015628) and all volunteers signed a written informed consent prior to participating in the experimental procedures 

主　　题：Dual-energy-xray-absorptiometry DXA DEXA Bone density Total joint replacement Arthroplasty Osteopenia Osteoporosis 

摘      要：We examined bone mineral density(BMD)measurements made by dual-energy-xray-absorptiometry(DEXA)taken from 100 patients(♂46/♀54,66±6yr)who previously underwent single total-knee arthroplasty(TKA)to determine if automated software-based artifact detection(ASAD)adequately removes implant artifact from the DXA image before analysis and if potential inaccuracies could be overcome through manual artifact correction(MAC).We also sought to determine if software-based inaccuracies would result in fracture risk misclassification(Low-BMD/Osteopenia=Young-Adult T-Score−1).Select Results:When using ASAD,limbs with implants had higher BMD(+12.0​±​1.7%,p​​0.001)compared to control limbs resulting in a 2.5​±​0.2%overestimation of total-body BMD(single implant).Consequently,the prevalence of osteopenia in 95%of patients who would have been observed to have low leg BMD(18/19 patients)and 80%of those found to have low total-body BMD(4/5 patients)would have gone *** overestimation was eliminated when using *** results reveal a potential issue with ASAD for total-body DEXA scans in TKA patients and highlight the importance of careful review and MAC in those with joint replacements before making diagnostic decisions.