© 2017, the Author(s). The link between low bone mineral density (BMD) scores leading to greater fracture risk is well established in the literature; what is not fully understood is the impact of total knee replacements/revisions or arthroplasties on BMD levels. This literature review attempts to answer this question. Several different databases using specific key terms were searched, with additional papers retrieved via bibliographic review. Based on the available evidence, total knee replacements/revisions and arthroplasties lower BMD and thus increase fracture risk. This review also addresses the possible implications of this research and possible options to reduce this risk.

© 2017 Elsevier B.V. Corners hold vital information about size, shape and morphology of a vertebra in an x-ray image, and recent literature (Al-Arif et al. 2015) [1,2] has shown promising performance for detecting vertebral corners using a Hough forest-based architecture. To provide spatial context, this method generates a set of 12 patches around a vertebra and uses a machine learning approach to predict corners of a vertebral body through a voting process. In this paper, we extend this framework in terms of patch generation and prediction methods. During patch generation, the square region of interest has been replaced with data-driven rectangular and trapezoidal region of interest which better aligns the patches to the vertebral body geometry, resulting in more discriminative feature vectors. The corner estimation or the prediction stage has been improved by utilising more efficient voting process using a single kernel density estimation. In addition, advanced and more complex feature vectors are introduced. We also present a thorough evaluation of the framework with different patch generation methods, forest training mechanisms and prediction methods. In order to compare the performance of this framework with a more general method, a novel multi-scale Harris corner detector-based approach is introduced that incorporates a spatial prior through a naive Bayes method. All these methods have been tested on a dataset of 90 X-ray images and achieved an average corner localization error of 2.01 mm, representing a 33% improvement in localization accuracy compared to the previous state-of-the-art method (Al-Arif et al. 2015) [2].1