{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T14:52:37Z","timestamp":1774968757765,"version":"3.50.1"},"reference-count":20,"publisher":"SLACK, Inc.","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:p>Published reports on patients with skeletal fluorosis undergoing total knee arthroplasty are rare. Skeletal fluorosis is a chronic condition that occurs secondary to the ingestion of food and water that contain high levels of fluoride. Although fluorosis may be described as osteosclerotic and marble-like in appearance, features may also include characteristics of osteomalacia and osteoporosis.<\/jats:p>\n          <jats:p>This article describes the case of a 67-year-old man with skeletal fluorosis who underwent total knee arthroplasty complicated by fracture. An intramedullary guide was used for the proximal tibia and distal femoral bone cuts intraoperatively. Following the completion of the femoral bone cuts, it was noted that the drill used to open the femoral canal had breached the medial femoral cortex. Multiple fractures were seen in both femoral condyles. A revision femoral stem was chosen to complete the total knee arthroplasty but, after further manipulation of the femur, it appeared that the fracture had displaced. A LISS plate (Synthes, West Chester, Pennsylvania) was used to ensure fracture reduction and implant stability. The remainder of the procedure was completed without complication. One year postoperatively, functional knee range of motion was limited to 70\u00b0 of flexion. Radiographs showed signs of healing and satisfactory implant position.<\/jats:p>\n          <jats:p>This case highlights the importance of the preoperative examination and the need to fully appreciate the bone quality of patients prior to undertaking an orthopedic procedure. Variation from the use of intramedullary guides should be considered in patients with questionable bone quality undergoing total knee arthroplasty.<\/jats:p>","DOI":"10.3928\/01477447-20121023-29","type":"journal-article","created":{"date-parts":[[2012,11,5]],"date-time":"2012-11-05T22:13:42Z","timestamp":1352153622000},"source":"Crossref","is-referenced-by-count":3,"title":["Total Knee Arthroplasty in a Patient With Skeletal Fluorosis"],"prefix":"10.3928","volume":"35","author":[{"given":"Mark","family":"Paiste","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathew","family":"Levine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James V.","family":"Bono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2308","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-55-2-193"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.162.1.8273699"},{"key":"e_1_3_2_4_2","first-page":"1555","article-title":"Total knee arthroplasty for the treatment of knee osteoarthritis caused by endemic skeletal fluorosis","volume":"16","author":"Rui L","year":"2012","unstructured":"Rui L, Ri-guang L, Chuan Y, Zhi-zhong G. Total knee arthroplasty for the treatment of knee osteoarthritis caused by endemic skeletal fluorosis. Chin J Tissue Engin Res. 2012; 16:1555\u20131557.","journal-title":"Chin J Tissue Engin Res"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0022034510384626"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2006.10.051"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)91073-2"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-196305000-00003"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02761130"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)00429-W"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-7325.1993.tb02666.x"},{"key":"e_1_3_2_12_2","first-page":"241","article-title":"Ten great public health achievements--United States, 1900\u20131999","volume":"48","author":"Centers for Disease Control and Prevention","year":"1999","unstructured":"Centers for Disease Control and Prevention. Ten great public health achievements--United States, 1900\u20131999. MMWR Morb Mortal Wkly Rep. 1999; 48:241\u2013243.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_13_2","volume-title":"Fluoride in Drinking Water: A Scientific Review of EPA\u2019s Standards","author":"Committee on Fluoride in Drinking Water, National Research Council","year":"2006","unstructured":"Committee on Fluoride in Drinking Water, National Research Council. Fluoride in Drinking Water: A Scientific Review of EPA\u2019s Standards. Washington, DC: National Academies Press; 2006."},{"key":"e_1_3_2_14_2","first-page":"163","article-title":"Review of 2006 USNRC report on fluoride in drinking water","volume":"39","author":"Carton RJ","year":"2006","unstructured":"Carton RJ. Review of 2006 USNRC report on fluoride in drinking water. Fluoride. 2006; 39:163\u2013172.","journal-title":"Fluoride"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.060912"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002960100132"},{"key":"e_1_3_2_17_2","article-title":"The accuracy of the extramedullary and intramedullary femoral alignment system in total knee arthroplasty for varus osteoarthritic knee [published online ahead of print April 8, 2012]","author":"Jung WH","unstructured":"Jung WH, Chun CW, Lee JH, Ha JH, Jeong JH. The accuracy of the extramedullary and intramedullary femoral alignment system in total knee arthroplasty for varus osteoarthritic knee [published online ahead of print April 8, 2012]. Knee Surg Sports Traumatol Arthrosc.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0435-9"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/8756-3282(89)90004-5"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-009-0146-7"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1210\/er.2006-0029"}],"container-title":["Orthopedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.healio.com\/doiresolver?doi=10.3928\/01477447-20121023-29","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T12:21:04Z","timestamp":1683116464000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.healio.com\/doi\/10.3928\/01477447-20121023-29"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2012,11]]}},"alternative-id":["10.3928\/01477447-20121023-29"],"URL":"https:\/\/doi.org\/10.3928\/01477447-20121023-29","relation":{},"ISSN":["0147-7447","1938-2367"],"issn-type":[{"value":"0147-7447","type":"print"},{"value":"1938-2367","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11]]}}}