ABSTRACT
Osteoporosis is a disease of low bone mass which leads to an increased risk of fracture. The prevalence of osteoporosis is greatest amongst postmenopausal women who also form a large portion of patients with osteoarthritis presenting for total knee arthroplasty. We present a case of a 77-year-old female with knee osteoarthritis and osteoporosis on denosumab who underwent robotic-assisted total knee arthroplasty. Postoperatively, she suffered an atraumatic midshaft femur fracture at the pin site associated with the use of intraoperative robotic technology. This is a unique complication related to the use of robotics which requires additional skeletal fixation versus standard arthroplasty surgical technique. We recommend caution and further study regarding the use of robotics in total knee arthroplasty in the setting of osteoporosis and denosumab use.
Subject(s)
Arthroplasty, Replacement, Knee , Femoral Fractures , Osteoarthritis, Knee , Osteoporotic Fractures , Aged , Arthroplasty, Replacement, Knee/adverse effects , Female , Femoral Fractures/etiology , Femoral Fractures/surgery , Femur/surgery , Humans , Osteoarthritis, Knee/surgery , Osteoporotic Fractures/etiologyABSTRACT
When Phanerochaete chrysosporium was cultured using conditions which promote the expression of cellobiose dehydrogenase (CDH), but not the ligninolytic peroxidases, the fungus effectively solubilized and mineralized an insoluble, crosslinked polyacrylate and an insoluble polyacrylate/polyacrylamide copolymer. Addition of iron to the cultures increased CDH activity in the cultures and the rate and extent of solubilization and mineralization of both polymers. Solubilization of both polymers was observed when incubated with purified CDH, ferric iron and hydrogen peroxide.
