Importance of Routine Bone Mineral Density Screening Prior to Elective Total Joint Replacement

Miller, Adam; Beyer, David T.; Starring, Hunter M; Leonardi, Claudia; Bronstone, Amy; Dasa, Vinod

doi:10.3928/01477447-20191022-01

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…Similar results are noted in a population of patients with end-stage osteoarthritis, the most common indication for TJR, wherein 23% and 43% of patients were noted to have osteoporosis and osteopenia, respectively [8]. Despite the high frequency of osteoporosis or osteopenia in patients undergoing TJR surgery, BMD screening is rarely performed prior to surgery [15,16], with one chart review finding that only 15% of patients undergoing primary TJR received BMD assessment prior to surgery [17]. Even when patients are properly screened, many TJR patients are not being treated for osteoporosis [18], which is perhaps not surprising given the treatment gap that exists in the general population [19].…”

Section: Introductionsupporting

confidence: 53%

Biomechanics of Implant Fixation in Osteoporotic Bone

Anderson

Virdi

et al. 2020

Curr Osteoporos Rep

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Purpose of review:The purpose of this review is to critically evaluate the current literature regarding implant fixation in osteoporotic bone.Recent findings: Clinical studies have not only demonstrated the growing prevalence of osteoporosis in patients undergoing total joint replacement (TJR) but may also indicate a significant gap in screening and treatment of this co-morbidity. Osteoporosis negatively impacts bone in multiple ways beyond the mere loss of bone mass including, compromising skeletal regenerative capacity, architectural deterioration, and bone matrix quality, all of which could diminish implant fixation. Recent findings in both pre-clinical animal models and in clinical studies indicate encouraging results for the use osteoporosis drugs to promote implant fixation.Summary: Implant fixation in osteoporotic bone presents an increasing clinical challenge that may be benefitted by increased screening and usage of osteoporosis drugs.

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