Osteoporosis Undertreated in Joint Replacement Patients

Osteoporosis is common in patients undergoing total joint arthroplasty (TJA), yet the condition is often undertreated, according to a study published in the July issue of the Journal of Arthroplasty.

James T. Bernatz, M.D., from the University of Wisconsin in Madison, and colleagues retrospectively reviewed medical records of 200 consecutive adults (106 female and 94 male) aged 48 to 92 years who underwent elective TJA (100 total hip and 100 total knee) at a single tertiary-care center. Rates of preoperative osteoporosis screening and prevalence were evaluated.

The researchers found that 119 patients (59.5 percent) met criteria for dual-energy X-ray absorptiometry (DXA) testing, but only 17.6 percent (21 patients) had DXA testing in the two years before surgery. One-third of patients meeting DXA testing criteria had osteoporosis by T-score. Using the National Osteoporosis Foundation criteria for pharmacologic osteoporosis treatment, 24.5 percent of patients (49 patients) qualified, but only 11 of these 49 patients received a prescription for pharmacotherapy within six months before or after surgery.

"This lack of preoperative osteoporosis screening and treatment may contribute to periprosthetic fracture risk," the authors write.

Several authors disclosed financial ties to the biomedical industry.

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