Unrecognized Osteoporosis Is Common in Patients With a Well-Functioning Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Bone Metabolism
• Geriatric Medicine

Background:

• Peri-prosthetic fractures following total knee arthroplasty (TKA) are linked to adverse outcomes and increased healthcare expenses.
• Osteoporosis is frequently underdiagnosed in patients who have undergone TKA.
• This study investigates the prevalence of osteoporosis in a cohort of patients with well-functioning TKAs.

Purpose of the Study:

• To determine the prevalence of osteoporosis in a healthy cohort of patients with well-functioning TKAs.
• To compare osteoporosis prevalence between male and female patients post-TKA.
• To assess the potential contribution of undiagnosed osteoporosis to peri-prosthetic fracture risk.

Main Methods:

• A cross-sectional study involving 30 adults (59-80 years) with primary unilateral TKA.
• Dual-energy X-ray absorptiometry (DXA) was used to assess bone mineral density (BMD) 2-5 years post-TKA.
• Fracture risk and skeletal status were evaluated using the Fracture Risk Assessment Tool and WHO criteria; National Osteoporosis Foundation criteria guided treatment recommendations.

Main Results:

• 20% of patients exhibited T-scores ≤ -2.5, indicating osteoporosis.
• 60% of patients had T-scores between -1 and -2.5, suggesting osteopenia.
• 36.7% of patients met criteria for pharmacologic osteoporosis treatment, and 5 patients had occult vertebral fractures.

Conclusions:

• A significant proportion of patients (36.7%) exhibit occult osteoporosis meeting treatment guidelines after TKA.
• Osteoporosis prevalence and BMD are comparable between genders in this TKA cohort.
• Increased awareness and routine BMD screening post-TKA are recommended for arthroplasty surgeons and bone health specialists to mitigate peri-prosthetic fracture risk.