Osteoporosis and orthopedic surgery: effect of bone health on total joint arthroplasty outcome.

Linda A Russell

Journal: Current rheumatology reports 2014;15(11):371

PMID: 24085661

Abstract

Osteoporosis is a common condition. As the population ages, more patients with osteoporosis will require orthopedic procedures, including arthroplasty. Adverse outcomes are more likely for patients with osteoporosis requiring orthopedic procedures, for example those with intraoperative fractures, periprosthetic osteolysis with implant migration, and postoperative periprosthetic fractures. Cemented prosthetic hip replacements may be more successful among patients with poor bone quality. Femoral neck fracture is a concern during hip resurfacing among patients with osteoporosis. Vitamin D deficiency is common among patients undergoing joint arthroplasty and the ideal vitamin D level for joint arthroplasty has yet to be determined. Both bisphosphonates and teriparatide may aide successful osteointegration among patients undergoing noncemented joint arthroplasty. Focusing on bone health perioperatively should result in better outcomes for orthopedic procedures.

Address: Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA, [email protected].

DOI: 10.1007/s11926-013-0371-x