High prevalence of osteoporosis in elderly patients scheduled for total knee arthroplasty

Key findings of the study were:

• Of the included 109 patients, 19 patients (17.4%) were diagnosed with osteoporosis and 50 (45.9%) with osteopenia.

• There was no difference between the sexes in terms of age and BMI.

• In the osteoporotic patients, a clinically relevant underdiagnosis concomitant with a serious treatment gap was observed in 95.0% of the patients.

• Body mass index, OA grade, and glucocorticoid use were identified as independent factors associated with BMD.

• No differences in BMD were found between the patients scheduled for TKA vs. THA.

The authors concluded that – "In elderly patients ≥70 years in Central Europe with endstage OA scheduled for TKA, a substantial proportion was diagnosed with reduced BMD. Most osteoporosis patients did not receive adequate treatment, indicating clinically relevant underdiagnosis and undertreatment. Low BMI, high OA severity, and the use of glucocorticoids were identified as independent factors associated with poor BMD. No differences in BMD were found when comparing patients before TKA and THA. Considering the impact on outcome, general DXA screening for elderly patients ≥ 70 years of age should be recommended before TKA. Population differences need to be respected concerning the prevalence of osteoporosis in orthopedic cohorts."

Further reading:

Prevalence of osteoporosis and osteopenia in elderly patients scheduled for total knee arthroplasty. Maximilian M. Delsmann, Constantin Schmidt et al Archives of Orthopaedic and Trauma Surgery (2022) 142:3957–3964 https://doi.org/10.1007/s00402-021-04297-x