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Alisa Malyavko¹, Amil R Agarwal, Jacob D Mikula

¹From the Department of Orthopaedic Surgery, George Washington University, Washington, DC (Dr. Malyavko and Agarwal), and the Johns Hopkins Department of Orthopaedic Surgery, Adult Reconstruction Division, Baltimore, MD (Dr. Mikula, Dr. Best, and Dr. Srikumaran).

The Journal of the American Academy of Orthopaedic Surgeons

|December 5, 2024

概括

骨质疏松症在全肩关节整形手术患者中很常见,但查率很低. 高风险人群面临骨折风险增加,突出需要更好的查和管理.

科学领域:

整形外科手术整形外科手术
内分泌学在内分泌学.
老年医学老年医学

背景情况:

骨质疏松症的查和治疗可以减少脆弱性骨折和周围假肢骨折 (PPF).
目前的骨质疏松症查和治疗率仍然低于最佳水平.
肩膀整形术 (TSA) 患者代表了骨质疏松症查至关重要的人群.

研究的目的:

在TSA患者中确定骨质疏松症查流行率.
确定符合骨质疏松症查标准的TSA患者的比例.
在TSA患者中计算脆弱性骨折 (FF) 和PPF的5年发生率.

主要方法:

利用PearlDiver数据库识别50岁以上的TSA患者.
用ICD代码将患者分为高风险和低风险骨质疏松症组.
通过Kaplan-Meier分析分析了骨质疏松症查 (DXA扫描) 率和计算的5年FF/PPF发病率.

主要成果:

65.5%的TSA患者被归类为患骨质疏松症的高风险患者.
只有11.7%的高风险TSA患者接受了手术前的骨质疏松症查.
高风险患者显示,PPF (HR: 1.4) 和FF (HR: 2.42) 的5年累积发病率显著更高.

结论:

在TSA患者中,骨质疏松症的患病率很高,再加上低查率.
高风险的TSA患者患有脆弱性骨折和周围假肢骨折的风险较高.
在TSA患者中增加骨质疏松症查和管理可以减轻未来骨折风险.

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