DEXA overestimates bone mineral density in adults with knee replacements  

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

机构地区：[1]Department of Orthopedics&Sports Medicine,Houston Methodist Hospital,6445 Main Street,Outpatient Center,Suite 2500,Houston,TX,United States [2]Department of Orthopedics,Washington DC VA Medical Center,50 Irving St.NW,Washington D.C,United States

出　　处：《Sports Medicine and Health Science》2020年第4期211-215,共5页运动医学与健康科学（英文）

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.

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 un-diagnosed.This overestimation was eliminated when using MAC.These 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.

关 键 词：Dual-energy-xray-absorptiometry DXA DEXA Bone density Total joint replacement Arthroplasty OSTEOPENIA Osteoporosis 

分 类 号：R58[医药卫生—内分泌]