The prevalence and treatment of osteoporosis in patients undergoing total hip arthroplasty and the levels of biochemical markers of bone turnover

Bone & Joint Research

article

Naoto Watanabe¹  Kazumasa Miyatake²  Ryohei Takada¹  Takahisa Ogawa¹  Yusuke Amano²  Tetsuya Jinno¹  Hideyuki Koga²  Toshitaka Yoshii¹  Atsushi Okawa¹ 

[1] Department of Orthopaedic Surgery, Tokyo Medical and Dental University;Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University

关键词: Bone mineral density;    TRACP-5b;    Total P1NP;    Osteoporosis;    Total hip arthroplasty (THA);    Hip;    biomarkers;    T-scores;    bone mineral density (BMD);    osteopenia;    hip joints;    dual-energy X-ray absorptiometry;    spine;   

DOI  :  10.1302/2046-3758.1112.BJR-2022-0252.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsOsteoporosis is common in total hip arthroplasty (THA) patients. It plays a substantial factor in the surgery’s outcome, and previous studies have revealed that pharmacological treatment for osteoporosis influences implant survival rate. The purpose of this study was to examine the prevalence of and treatment rates for osteoporosis prior to THA, and to explore differences in osteoporosis-related biomarkers between patients treated and untreated for osteoporosis.MethodsThis single-centre retrospective study included 398 hip joints of patients who underwent THA. Using medical records, we examined preoperative bone mineral density measures of the hip and lumbar spine using dual energy X-ray absorptiometry (DXA) scans and the medications used to treat osteoporosis at the time of admission. We also assessed the following osteoporosis-related biomarkers: tartrate-resistant acid phosphatase 5b (TRACP-5b); total procollagen type 1 amino-terminal propeptide (total P1NP); intact parathyroid hormone; and homocysteine.ResultsThe prevalence of DXA-proven hip osteoporosis (T-score ≤ -2.5) among THA patients was 8.8% (35 of 398). The spinal osteoporosis prevalence rate was 4.5% (18 of 398), and 244 patients (61.3%; 244 of 398) had osteopenia (-2.5 < T-score ≤ -1) or osteoporosis of either the hip or spine. The rate of pharmacological osteoporosis treatment was 22.1% (88 of 398). TRACP-5b was significantly lower in the osteoporosis-treated group than in the untreated group (p < 0.001).ConclusionOsteoporosis is common in patients undergoing THA, but the diagnosis and treatment for osteoporosis were insufficient. The lower TRACP-5b levels in the osteoporosis-treated group — that is, osteoclast suppression — may contribute to the reduction of the postoperative revision rate after THA.

【 授权许可】

CC BY-NC