An exploratory retrospective study of low bone density and perioperative D-dimer and Wells score after unicompartmental knee arthroplasty

An exploratory retrospective study of low bone density and perioperative D-dimer and Wells score after unicompartmental knee arthroplasty. Download PDF Abstract The present study aimed to examine the association between bone mineral density (BMD) and perioperative D-dimer levels and Wells scores in patients undergoing unicompartmental knee arthroplasty (UKA), with adjustment for potential confounding factors including age and sex. The study was exploratory and was not designed to establish causality or to evaluate imaging-confirmed thrombotic outcomes.

A retrospective cohort study of 97 consecutive UKA procedures was conducted. BMD was categorized as normal, osteopenia, or osteoporosis based on dual-energy X-ray absorptiometry. Serum D-dimer was measured preoperatively and on postoperative day 3 (POD 3), together with the Wells score.

The primary analysis employed multivariable Gamma regression with log link, adjusted for BMI and preoperative D-dimer, withan extended model additionally incorporating age and sex. Model robustness was evaluated through non-parametric bootstrap resampling (10,000 iterations), permutation testing (10,000 permutations), and female-only sensitivity analysis. A further sensitivity analysis reclassified bone density using the femoral neck T-score alone, rather than the lowest T-score of the lumbar spine or femoral neck.

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