The Effect of Preoperative Bisphosphonate Use on Total Hip Arthroplasty Outcomes

Jeong, Seon‐Yong; Lee, Ji Won; Boucher, Henry R.

doi:10.1016/j.arth.2023.05.027

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…Notably, the use of bisphosphonates, a first-line treatment for osteoporosis, before revision surgery was associated with an almost two-fold increase in implant survival time [ 29 ]. However, there are also contrasting observations that bisphosphonates may even increase the risk of intra- and postoperative PPF [ 30 ]. Nonetheless, the mentioned study did not account for osteoporosis severity as a confounding factor, which is why the diagnosis of osteoporosis rather than bisphosphonate treatment was most likely decisive for the increased rate of PPF [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Patients with Periprosthetic Femoral Hip Fractures are Commonly Classified as Having Osteoporosis Based on DXA Measurements

Ritter,

Alimy,

Simon

et al. 2024

Calcif Tissue Int

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Periprosthetic femoral hip fractures are subject to an increasing incidence and are often considered to be related to osteoporosis. However, there are no available studies that have determined the frequency of osteoporosis in affected patients using gold standard dual-energy X-ray absorptiometry (DXA). In this retrospective comparative study, we analyzed the DXA results of 40 patients with periprosthetic femoral hip fractures who were treated surgically in our department. DXA measurements were performed at the total hip and the lumbar spine to determine bone mineral density T-scores. Data were compared to two age-, sex-, and BMI-matched control groups in which patients underwent DXA prior to aseptic revision surgery for other causes or primary THA (consisting of 40 patients each). The mean T-score in the periprosthetic fracture cohort was significantly lower (− 1.78 ± 1.78) than that of the aseptic revision (− 0.65 ± 1.58, mean difference − 1.13 [95% CI − 1.88 to − 0.37]; p = 0.001) and the primary THA cohort (− 0.77 ± 1.34, mean difference − 1.01 [95% CI − 1.77 to − 0.26]; p = 0.005). Accordingly, osteoporosis was detected more frequently (45%) in the fracture cohort compared to patients undergoing aseptic revision (12.5%) and primary THA (10%). In conclusion, almost half of the patients with periprosthetic femoral hip fractures have osteoporosis according to DXA measurements. A regular assessment of bone health in THA enables identification of patients with osteoporosis who likely benefit from initiation of osteoporosis medication and cemented stem fixation.

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Section: Discussionmentioning

confidence: 99%