Abstract
Bone density may influence the primary fixation of cementless implants, and poor bone density may increase the risk of implant failure. Before deciding on using total joint replacement as treatment in osteoarthritis of the trapeziometacarpal joint, it is valuable to determine the trapezium bone density. The aim of this study was to: (1) determine the correlation between measurements of bone mineral density of the trapezium obtained by dual-energy X-ray absorptiometry (DXA) scans by a circumference method and a new inner-ellipse method; and (2) to compare those to measurements of bone density obtained by computerized tomography (CT)-scans in Hounsfield units (HU). We included 71 hands from 59 patients with a mean age of 59 years (43–77). All patients had Eaton–Glickel stage II–IV trapeziometacarpal (TM) joint osteoarthritis, were under evaluation for trapeziometacarpal total joint replacement, and underwent DXA and CT wrist scans. There was an excellent correlation (r = 0.94) between DXA bone mineral density measures using the circumference and the inner-ellipse method. There was a moderate correlation between bone density measures obtained by DXA- and CT-scans with (r = 0.49) for the circumference method, and (r = 0.55) for the inner-ellipse method. DXA may be used in pre-operative evaluation of the trapezium bone quality, and the simpler DXA inner-ellipse measurement method can replace the DXA circumference method in estimation of bone density of the trapezium.
Highlights
Implant failure in total joint replacement of the trapeziometacarpal joint is a major problem, especially concerning the trapezium cup component [1,2,3,4,5,6]
The aim of this study was to: (1) compare the dual-energy X-ray absorptiometry (DXA) bone mineral density measurements of the trapezium using a previously described method to mark the circumference of the trapezium in comparison with a new and simpler method to mark the inner-ellipse of the trapezium; and (2) determine whether these DXA measurements correlate with Hounsfield units obtained from computed tomography (CT) scans of the trapeziums
We found higher trapezium bone mineral density (BMD) for men using DXA circumference method (p < 0.001) and by using DXA inner-ellipse method (p = 0.01)
Summary
Implant failure in total joint replacement of the trapeziometacarpal joint is a major problem, especially concerning the trapezium cup component [1,2,3,4,5,6]. Schreiber et al [17] tested if Hounsfield units on CT scans correlated with BMD in a clinical study with patients undergoing both lumbar spine DXA and CT imaging. They found moderate correlations between both BMD (r2 = 0.44) and T-scores (r2 = 0.48) using DXA scans and Hounsfield units, and concluded that relevant clinical CT scans performed for other purposes can provide an alternative method for determining regional bone density at no additional expense for the patient. If the correlation between DXA and CT measured bone mineral density of the trapezium is good, the preoperative CT scans of the wrist may be used to determine the trapezium bone density prior to decision making of surgical treatment in TM joint osteoarthritis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
