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Quality of bone before TKR

Posted , 8 users are following.

chris00938
chris00938

Something that has puzzled me - there seems to not be any concern about the quality of bone (as in osteoporosis) before TKRs.  Does it not matter what the bones are like, or is it a case of 'if it needs doing, it needs doing' so it's irrelevant?  Has anyone been asked about this aspect?

0 likes, 18 replies

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  • freestork
    freestork chris00938

    Posted

    My consultant said my bones had creypiness and where catching on sinues also arthritis had started on the outside and also at the back of the joint so a ful TKR was the best thing x
    • chris00938
      chris00938 freestork

      Posted

      Ah, I know what you mean Freestork.  When mine were x-rayed years back they could see the arthritis everywhere including the kneecap.  What I was wondering was general bone strength/osteoporosis/osteopenia and how that affected knee replacements, or if it was even considered.
    • jan01779
      jan01779 chris00938

      Posted

      I  guess if they had thise conditions they would need a bone density  scan?
  • jan01779
    jan01779 chris00938

    Posted

    My surgeon looked at my dexa bone scan 2 years before the op. If I  had  had 3  intra-articular steroid injections within a year he would not have gone ahead. 

    I have afriend who had polio and  they would not to a TKR on her as quads far too atrophied.

    • chris00938
      chris00938 jan01779

      Posted

      Aha - INTERESTING!  A couple of years ago GP put me on bisphosphenates before my bone scan results had come back, but taking them a few times made me so ill that I went back to the surgery.  By that time the results had come back and I saw a nurse rather than the GP I'd booked with,  and she told me to wait in the waiting room while SHE spoke to the GP, and then she came out with another prescription for the same thing (that went straight in the bin).  BUT in the meantime my husband had got a copy of the results from the hospital and I was below 'medication advised' level!  So I adjusted diet and supplements and when I asked the surgeon who did the knee what the bone was like he said 'fine', so hoping all is well!  But I do wonder if people have osteoporosis badly it affects the success of the TKRs and wonder why I wasn't asked about that aspect.

  • Cementless
    Cementless chris00938

    Posted

    I did ask this exact question because I do have osteopenia. I requested a new bone density prior to my TKR Oct. 19, 2016. I am allergic to the bone cement and the plan was to NOT use bone cement. My bone density still showed osteopenia and the ortho explained to me that once he got to the bone if he looked bad (closer to osteoporosis) he would have to use some cement. My bones looked good and no concern for osteopenia either. I had a cementless TKR! It takes longer to recover because the bones have to fill in the space of the implant.
    • chris00938
      chris00938 Cementless

      Posted

      Ah - now I understand your name LOL!  Interesting about the osteopenia.  My husband wondered if they can tell, looking at x-rays, how the bone is around the knees, but I don't know if they can?

    • Cementless
      Cementless chris00938

      Posted

      It makes you wonder sometimes about the x-rays and bone density tests. Since my bone density showed osteopenia but when the ortho got into the knee, my bones looked good!
    • chris00938
      chris00938 Cementless

      Posted

      I have heard people debate about the accuracy of the tests, but also they tend to test the spine and hips, so I guess the knees can be different - I don't know!

    • Cementless
      Cementless chris00938

      Posted

      The bone density includes the femur (part of the hips) which is important because the implant attaches to the femur (and tibia).
  • marilyn10235
    marilyn10235 chris00938

    Posted

    I had a DEXA scan in 2015 because of the removal of my thyroid, I was diagnosed with Osteopenia in 2009, so should have scans every 3 years, but missed 2012 as our daughter in law had terminal cancer & I looked after the grandchildren! Just never got around to booking it!

    The surgeon did check to DEXA results from the previous year, I seem to remember a questionnaire from when I booked the op, I had to take a form over to the Treatment Centre to book it & they gave me a form to fill in!

    Marilyn

    XX

    • chris00938
      chris00938 marilyn10235

      Posted

      I had a form to fill in, but it didn't mention this aspect, and it just didn't arise.  It does with some, by the sound of it though.

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