Periprosthetic DXA

The extraordinary advances in bone density technology since the 1970s have enhanced the physician’s ability to detect and manage metabolic bone disease. In the last 25 years, due to an improvements in hardware and software of dual-energy X-ray absorptiometry (DXA) there has been increasing interest within the orthopaedic community in the noninvasive measurement of bone mineral mass and bone remodelling around metal joint prostheses in clinical practice and research. This interest has been stimulated, in part, by the recognition and understanding that among the several diagnostic tools available in the clinical diagnosis of a failed arthroplasty are neither sensitive nor accurate for the diagnosis of early bone loss. Conventional X-ray imaging although qualitatively indicating changes due to bone remodelling, have limited usefulness in quantitative evaluation of the amount of bone resorption. Using DXA technique, the amount of bone mass after joint stem implantation can be determined with high precision, minimal radiation exposure and negligible affection by metallic implants. This chapter summarized the technical aspects and clinical applications of periprosthetic DXA in the two common and most currently well-accepted orthopaedic applications such as after total hip and total knee joints implants.