ArticleSICOT-J2025
Prevalence of low bone mineral density in robotic-assisted TKA candidates: insights from quantitative CT analysis.
Article in SICOT-J, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Knee-specific bone quality assessment for cementless total knee arthroplasty candidate selection: a narrative review.Knee surgery & related research · 2026Review
- Reframing Fixation Strategy in Total Knee Arthroplasty With Tibial Bone Density as a Central Criterion.JB & JS open accessReview
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOsteoporosis is a prevalent and often underdiagnosed condition that significantly increases the risk of fragility fractures. Dual-energy X-ray absorptiometry (DXA) is the standard diagnostic tool; however, many patients remain unscreened. Preoperative computed tomography (CT) scans obtained for robotic-assisted total knee arthroplasty (TKA) planning present an opportunity for opportunistic osteoporosis screening without additional radiation exposure.
methodsA retrospective observational study was conducted on 637 patients (307 males, 330 females) who underwent robotic-assisted TKA between January 2023 and December 2024. Preoperative CT scans were analyzed using quantitative computed tomography (QCT) software to determine T-scores, Z-scores, and percentage of bone mineral density (BMD) relative to a young-adult reference. Patients were categorized as normal (T-score ≥ -1.0), osteopenic (-2.5 < T-score < -1.0), or osteoporotic (T-score ≤ -2.5).
resultsAmong 597 patients with available T-score data, 41.0% were classified as normal, 32.3% as osteopenic, and 26.6% as osteoporotic. Notably, 37.0% of female patients were osteoporotic compared to 15.3% of male patients. Bone density parameters declined progressively with age, with females over 80 years exhibiting a mean T-score of -2.53 and BMD at 68.25% of the young-adult reference. DISCUSSION: Opportunistic screening using preoperative CT scans in robotic-assisted TKA patients reveals a high prevalence of undiagnosed low BMD, particularly among elderly women. Integrating QCT analysis into the preoperative workflow may facilitate early identification of at-risk individuals, informing surgical planning and enabling timely interventions to improve bone health.
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