Underestimation and undertreatment of osteoporosis in patients awaiting primary total knee arthroplasty

被引:41
作者
Ha, Chul-Won [1 ]
Park, Yong-Beom [2 ]
机构
[1] Sungkyunkwan Univ, Samsung Med Ctr, Dept Orthopaed Surg, Sch Med, 81 Irwon Ro, Seoul 06351, South Korea
[2] Chung Ang Univ, Chung Ang Univ Hosp, Dept Orthoped Surg, Coll Med, 102 Heukseok Ro, Seoul 06973, South Korea
关键词
Total knee arthroplasty; Osteoporosis; Prevalence; Treatment; BONE-MINERAL DENSITY; PERIPROSTHETIC FRACTURES; OSTEOARTHRITIS; PREVALENCE; DIAGNOSIS; WOMEN; CLASSIFICATION; KOREA; RISK; HIP;
D O I
10.1007/s00402-020-03462-y
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Introduction Osteoporosis is generally regarded as a risk factor for periprosthetic fracture during or after primary total knee arthroplasty (TKA). Despite this, little is known about osteoporosis in patients undergoing elective primary TKA Therefore, we sought to investigate the prevalence of osteoporosis and rates of pharmacologic osteoporosis treatment prior to primary TKA. We hypothesized that preoperative osteoporosis is underestimated and undertreated in the primary TKA population. Materials and methods This retrospective study included consecutive 1972 patients scheduled for elective primary TKA at a single tertiary hospital (age, 50-89 years). Charts were reviewed for patient demographics, prior pharmacologic osteoporosis treatment and Knee Society (KS) scoring system and WOMAC score. Dual energy X-ray absorptiometry (DEXA) measurement of the lumbar vertebrae and proximal femur was performed in all patients on the day before surgery. The associations of BMD with age, sex, body mass index (BMI), and clinical outcome were analyzed. Results The prevalence of osteoporosis was 50.0% (53.4% in women and 7.0% in men). Among patients with osteoporosis, only 15.1% (149/986) of patients (15.0% in women and 30.0% in men) had pharmacological osteoporosis treatment prior to primary TKA. Age, sex and WOMAC stiffness showed association with osteoporosis. Sex (odds ratio (OR): 20.83, p < 0.001) was the most significant factor associated with osteoporosis. Conclusion Osteoporosis was highly prevalent in patients awaiting TKA, but the rates of diagnosis and pharmacologic osteoporosis treatment were low. Therefore, more attention needs to estimate and treat osteoporosis in patients awaiting primary TKA, especially in female patients.
引用
收藏
页码:1109 / 1114
页数:6
相关论文
共 26 条
[1]  
ALTMAN RD, 1991, J RHEUMATOL, V18, P10
[2]   Knee pain, knee osteoarthritis, and the risk of fracture [J].
Arden, Nigel K. ;
Crozier, Sarah ;
Smith, Helen ;
Anderson, Frazer ;
Edwards, Christopher ;
Raphael, Helen ;
Cooper, Cyrus .
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH, 2006, 55 (04) :610-615
[3]   Vitamin D Status, Bone Mineral Density, and the Development of Radiographic Osteoarthritis of the Knee The Rotterdam Study [J].
Bergink, Arjan P. ;
Uitterlinden, Andre G. ;
Van Leeuwen, Johannes P. T. M. ;
Buurman, Cok J. ;
Hofman, Albert ;
Verhaar, Jan A. N. ;
Pols, Huibert A. P. .
JCR-JOURNAL OF CLINICAL RHEUMATOLOGY, 2009, 15 (05) :230-237
[4]   Unrecognized Osteoporosis Is Common in Patients With a Well-Functioning Total Knee Arthroplasty [J].
Bernatz, James T. ;
Krueger, Diane C. ;
Squire, Matthew W. ;
IlIgen, Richard L., II ;
Binkley, Neil C. ;
Anderson, Paul A. .
JOURNAL OF ARTHROPLASTY, 2019, 34 (10) :2347-2350
[5]   Osteoporosis Is Common and Undertreated Prior to Total Joint Arthroplasty [J].
Bernatz, James T. ;
Brooks, Andrew E. ;
Squire, Matthew W. ;
Illgen, Richard I., II ;
Binkley, Neil C. ;
Anderson, Paul A. .
JOURNAL OF ARTHROPLASTY, 2019, 34 (07) :1347-1353
[6]   Subchondral tibial bone mineral density predicts future joint space narrowing at the medial femoro-tibial compartment in patients with knee osteoarthritis [J].
Bruyere, O ;
Dardenne, C ;
Lejeune, E ;
Zegels, B ;
Pahaut, A ;
Richy, F ;
Seidel, L ;
Ethgen, O ;
Henrotin, Y ;
Reginster, JY .
BONE, 2003, 32 (05) :541-545
[7]   Prevalence of Osteoporosis in Female Patients with Advanced Knee Osteoarthritis Undergoing Total Knee Arthroplasty [J].
Chang, Chong Bum ;
Kim, Tae Kyun ;
Kang, Yeon Gwi ;
Seong, Sang Cheol ;
Kang, Seung-Baik .
JOURNAL OF KOREAN MEDICAL SCIENCE, 2014, 29 (10) :1425-1431
[8]   The prevalence of osteoporosis in Korean adults aged 50 years or older and the higher diagnosis rates in women who were beneficiaries of a national screening program: The Korea National Health and Nutrition Examination Survey 2008-2009 [J].
Choi, Yong Jun ;
Oh, Han Jin ;
Kim, Dae Jung ;
Lee, Yunhwan ;
Chung, Yoon-Sok .
JOURNAL OF BONE AND MINERAL RESEARCH, 2012, 27 (09) :1879-1886
[9]   Prevalence and Management of Diabetes in Korean Adults Korea National Health and Nutrition Examination Surveys 1998-2005 [J].
Choi, Yong Jun ;
Park, Seok Won ;
Kim, Hyeon Chang ;
Kim, Jongoh ;
Kim, Hee Man ;
Kim, Dae Jung .
DIABETES CARE, 2009, 32 (11) :2016-2020
[10]   Periprosthetic femoral fractures-incidence, classification problems and the proposal of a modified classification scheme [J].
Frenzel, Stephan ;
Vecsei, Vilmos ;
Negrin, Lukas .
INTERNATIONAL ORTHOPAEDICS, 2015, 39 (10) :1909-1920