The utility of routine dual-energy x-ray absorptiometry scans in matched-pair cadaveric biomechanical trauma research

Background: Performing cadaveric dual-energy x-ray absorptiometry (DEXA) scanning is a routine part of orthopaedic biomechanical research, but it is not without cost. Matched pairs are often used in biomechanical studies to further equalize comparison groups. Despite the widespread use of matched-pair analysis, the practical utility of obtaining routine DEXA scans remains unknown. The authors' objective was to determine the value of DEXA scans in biomechanical cadaveric trauma studies. Methods: The authors identified 10 sequential journal articles from the Journal of Orthopaedic Trauma from February 2013 to February 2019 that were biomechanical studies with two comparison groups using matched pairs, which were DEXA-scanned prior to experimentation. For each study, the authors determined the number of pairs used, number of pairs discarded, any significant differences in bone density between groups compared, and how density results were reported for individual specimens or pairs. Results: None of the 113 matched pairs reported in these studies were discarded because of DEXA scan results. There were inconsistencies between studies on reported units of measurement and how the specimens were compared. No significant differences in density between the compared groups were reported in the 10 studies. No studies disclosed the bone density for any individual specimen or score difference for any individual pair. Conclusions: As currently used in the literature, routine DEXA scans of cadaveric matched-pair specimens do not typically lead to any modification of experimental design or reporting of results. Level of Evidence: Level IV.