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Shoulder Arthroplasty Patients Are Underscreened for Osteoporosis.
J Am Acad Orthop Surg
December 2024
From 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).
Introduction: Osteoporosis screening and subsequent treatment has been shown to be efficacious in decreasing the rates of fragility fractures and periprosthetic fractures (PPF). However, current screening and treatment rates are low. This study aims to determine (1) the prevalence of total shoulder arthroplasty (TSA) patients who meet criteria for osteoporosis screening, (2) the prevalence of those screened, and (3) the 5-year cumulative incidence of fragility fracture (FF) and periprosthetic fractures (PPF).
View Article and Find Full Text PDFThe effect of fixation type on periprosthetic fractures in high-risk patients who have osteoporosis undergoing total joint arthroplasty.
J Orthop
October 2024
LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, USA.
Introduction: Minimizing the burden of periprosthetic fractures (PFF) following total joint arthroplasty (TJA) with regard to morbidity and mortality remains an outcome of interest. Patient and surgical risk factors, including osteoporosis and fixation type, have not truly been optimized in patients undergoing TJA as a means to reduce the risk of PFF. As such, we examined: (1) What percentage of patients who underwent THA and total knee arthroplasty (TKA) met the criteria for osteoporosis screening? (2) How did the 5-year rate of PFF and fragility fracture differ in the high-risk and low-risk groups for osteoporosis between the cemented and cementless cohorts? (3) What percentage of the aforementioned patients received a dual x-ray absorptiometry (DEXA) scan before THA or TKA?
Methods: We queried an all-payer, national database from April 1, 2016 to December 31, 2021, to identify high-risk and low-risk patients who underwent TJA with a cementless or cemented fixation.
Harmonization of clinical practice guidelines for primary prevention and screening: actionable recommendations and resources for primary care.
BMC Prim Care
May 2024
Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.
Background: Clinical practice guidelines (CPGs) synthesize high-quality information to support evidence-based clinical practice. In primary care, numerous CPGs must be integrated to address the needs of patients with multiple risks and conditions. The BETTER program aims to improve prevention and screening for cancer and chronic disease in primary care by synthesizing CPGs into integrated, actionable recommendations.
View Article and Find Full Text PDFCan Hip and Knee Arthroplasty Surgeons Help Address the Osteoporosis Epidemic?
Clin Orthop Relat Res
September 2023
Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD, USA.
Background: Osteoporosis is a known, modifiable risk factor for lower extremity periprosthetic fractures. Unfortunately, a high percentage of patients at risk of osteoporosis who undergo THA or TKA do not receive routine screening and treatment for osteoporosis, but there is insufficient information determining the proportion of patients undergoing THA and TKA who should be screened and their implant-related complications.
Questions/purposes: (1) What proportion of patients in a large database who underwent THA or TKA met the criteria for osteoporosis screening? (2) What proportion of these patients received a dual-energy x-ray absorptiometry (DEXA) study before arthroplasty? (3) What was the 5-year cumulative incidence of fragility fracture or periprosthetic fracture after arthroplasty of those at high risk compared with those at low risk of osteoporosis?
Methods: Between January 2010 and October 2021, 710,097 and 1,353,218 patients who underwent THA and TKA, respectively, were captured in the Mariner dataset of the PearlDiver database.
Osteoporosis Screening-2 Steps May Be Too Much for Women Younger Than 65 Years.
JAMA Intern Med
September 2018
Department of Family Medicine, University of North Carolina at Chapel Hill.
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