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Patients undergoing total knee arthroplasty have higher BMDs and lower incidenec of osteoporosis.
Osteoporosis and abnormal bone remodeling may be proven to be significant factors influencing the outcome of arthroplasty surgery, predisposing to complications of aseptic loosening and peri-prosthetic fracture. Therefore, researchers aimed to investigate the baseline bone mineral density (BMD) and bone turnover in patients about to undergo arthroplasty of the hip and knee.
The study by Ishii Y, et al. measured the BMD of the hip and the lumbar spine using dual-energy X-ray absorptiometry (DEXA) scans in a cohort of 119 patients awaiting hip or knee arthroplasty. Additionally, bone turnover using urinary deoxypyridinoline (DPD), a type I collagen crosslink, normalized to creatinine was also assessed.
The prevalence of DEXA proven hip osteoporosis (T-score ≤ -2.5) among hip and knee arthroplasty patients was found to be lower, 2.8% (4 of 143). Spinal osteoporosis prevalence was higher, 6.9% (12 of 175). A total of 60 of 143 (42%) had osteopenia or osteoporosis of either the hip or the spine. The mean T-score for the spine was -0.7 (sd1.6), which was within normal limits, and the mean hip Z-score was −1.2 (sd1.0), which is defined as osteopenia. The mean Z-scores of 0.9 (SD 1.4) in the spine and 0.6 (SD 0.9) in the hip were positive. The median urinary DPD/creatinine was raised in both female patients at 58.1 (interquartile range (IQR): 13.7 to 188.4).
According to results, the hip and knee arthroplasty patients have higher BMD of the hip and spine as compared to their heathy peers, and a lower prevalence of osteoporosis. Raised DPD levels suggests abnormal bone turnover, requiring further investigation to determine the significance of BMD and DPD on arthroplasty outcome, and whether these parameters should be routinely measured prior to surgery.
The Open Orthopaedics Journal
Preoperative Bone Mineral Density and Bone Turnover in Women Before Primary Knee Arthroplasty
Yoshinori Ishii et al.
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