{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:47:11Z","timestamp":1786978031604,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2005,2,18]],"date-time":"2005-02-18T00:00:00Z","timestamp":1108684800000},"content-version":"vor","delay-in-days":1875,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2000,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The change in bone mineral density at the proximal tibia during 2 years after total knee arthroplasty was studied in 28 knees (28 patients: 10 men and 18 women; median age: 71 years) with dual energy x\u2010ray absorptiometry. Bone mineral density was measured at the proximal tibia at nine regions of interest below the tibial component within 1 week after the operation (baseline); measurements were repeated at 3, 6, 12, and 24 months. All but one knee was malaligned before the operation, and all but three were corrected to within the normal range of alignment after it. The mean bone mineral density of all nine regions of interest at the proximal tibia temporarily decreased by 13% (p = 0.001) during the initial 3 months, probably due to a general metabolic reaction of the skeleton to the operative trauma combined with the effect of the postoperative immobilization, and then the initial level was regained for as long as 2 years. The overall changes in mean bone mineral density to 2 years were insignificant (p &gt; 0.05); however, a great variation (43.9% decrease to 98.0% increase) was observed on an individual basis. This change over time was significantly associated (R\n                    <jats:sup>2<\/jats:sup>\n                    = 0.36, p = 0.002) with the level of the baseline bone mineral density, which in turn was partly related (R\n                    <jats:sup>2<\/jats:sup>\n                    = 0.24, p = 0.009) to the amount of malalignment of the knee before the operation. Knees with high baseline levels (n = 14: 11 with varus and three with valgus alignment) displayed a decrease of 10.0 \u00b1 14.0% (mean \u00b1 SD, p &gt; 0.05) for as long as 2 years, whereas those with low baseline levels (n = 14: seven with varus and six with valgus alignment and one neutrally alignment and one neutrally aligned) had an increase of 19.1 \u00b1 38.2% (p = 0.038). In both groups, the mean bone mineral density converged to a level of 0.75\u20130.95 g\/cm\n                    <jats:sup>2<\/jats:sup>\n                    at 2 years.\n                  <\/jats:p>","DOI":"10.1002\/jor.1100180107","type":"journal-article","created":{"date-parts":[[2005,2,24]],"date-time":"2005-02-24T05:34:01Z","timestamp":1109223241000},"page":"40-47","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Changes in bone mineral density at the proximal tibia after total knee arthroplasty: A 2\u2010year follow\u2010up of 28 knees using dual energy x\u2010ray absorptiometry"],"prefix":"10.1002","volume":"18","author":[{"given":"Ming G.","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell G.","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,2,18]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"226","article-title":"Changes in bone mineral content following tibia shaft fractures","volume":"144","author":"Andersson SM","year":"1979","journal-title":"Clin Orthop"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0883-5403(87)80064-5"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453678709146399"},{"key":"e_1_2_1_5_2","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1302\/0301-620X.77B3.7744941","article-title":"Accuracy of DEXA measurement of bone mineral density after total hip arthroplasty","volume":"77","author":"Cohen B","year":"1995","journal-title":"J Bone Joint Surg [Br]"},{"key":"e_1_2_1_6_2","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1302\/0301-620X.77B3.7744940","article-title":"Bone loss after tibial fracture: evaluated by dual\u2010energy x\u2010ray absorptiometry","volume":"77","author":"Eyres KS","year":"1995","journal-title":"J Bone Joint Surg [Br]"},{"key":"e_1_2_1_7_2","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/00003086-198908000-00041","article-title":"Osteopenia after ankle fractures: the influence of early weight bearing and muscle activity","volume":"245","author":"Finsen V","year":"1989","journal-title":"Clin Orthop"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198365020-00016"},{"key":"e_1_2_1_9_2","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/00003086-198802000-00025","article-title":"Trabecular bone strength at the knee","volume":"227","author":"Hvid I","year":"1988","journal-title":"Clin Orthop"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453678809148787"},{"key":"e_1_2_1_11_2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/00003086-198911000-00004","article-title":"Rationale of the Knee Society clinical rating system","volume":"248","author":"Insall JN","year":"1989","journal-title":"Clin Orthop"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199702000-00017"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.62B3.7410467"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00266984"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650071210"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650091109"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650090319"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197203000-00037"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100100613"},{"key":"e_1_2_1_20_2","first-page":"68","article-title":"Long\u2010term changes in bone mineral density following total knee replacement","volume":"321","author":"Levitz CL","year":"1995","journal-title":"Clin Orthop"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02405043"},{"key":"e_1_2_1_22_2","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1302\/0301-620X.73B5.1894664","article-title":"Quantifying bone loss from the proximal femur after total hip arthroplasty","volume":"73","author":"McCarthy CK","year":"1991","journal-title":"J Bone Joint Surg [Br]"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02207242"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679708996261"},{"key":"e_1_2_1_25_2","first-page":"1","article-title":"RSA in the assessment of aseptic loosening","volume":"78","author":"Nilsson KG","year":"1996","journal-title":"J Bone Joint Surg [Br]"},{"key":"e_1_2_1_26_2","unstructured":"Nordstr\u00f6mP:Bone mass and physical activity body constitution and heredity in young women[Ph.D. thesis]. 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