Femoral BMD Change Following Cemented or Cementless Total Knee Arthroplasty

Inclusion Criteria:

* Patients age greater than or equal to 55 years undergoing TKA with no prior total joint arthroplasty on the surgical side
* Normal BMD or osteopenia with Fracture Risk Assessment Tool (FRAX) not meeting Bone Health and Osteoporosis Foundation (BHOF) treatment recommendations, i.e., 10-year major osteoporotic fracture risk greater then or equal to 20 percent or hip fracture risk greater than or equal to 3 percent.

Exclusion Criteria:

* Known clinical osteoporosis defined as any one of the following:

  * Hip or spine T-score less than or equal to -2.5
  * History of low trauma fracture after age 50
  * FRAX fracture risk calculation greater than or equal to 20 percent for major osteoporotic fracture or greater than or equal to 3 percent for hip fracture
* Prior or current use of osteoporosis medications
* Current use of systemic glucocorticoids or bone-active medications
* Rheumatoid arthritis
* Laboratory abnormalities that in the opinion of study investigators may impact bone mineral density; including calcium, creatinine, albumin and parathyroid hormone (PTH)
* 25(OH)D less than 20 ng/mL
* Not suitable for study participation due to other reasons at the investigator's discretion