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