August 01, 2019
1 min read

Osteoporosis may be undertreated prior to TJA

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James T. Bernatz

Although almost 25% of patients undergoing total joint arthroplasty were eligible to receive osteoporosis medications, recently published results found 5% of patients received therapy preoperatively or postoperatively.

To determine preoperative osteoporosis risk factors, prior DXA testing and prior osteoporosis pharmacotherapy, James T. Bernatz, MD, and colleagues retrospectively reviewed the charts of 200 patients who underwent elective TJA at a single tertiary-care center. Researchers used the Fracture Risk Assessment Tool to estimate fracture risk and applied National Osteoporosis Foundation criteria for screening and treatment to all patients.

Results showed 59.5% of patients met criteria for DXA testing. Of these patients, 17.6% underwent DXA testing in the 2 years prior to surgery. T-score results showed 33% of patients had osteoporosis, according to results. Researchers found 24.5% of patients met National Osteoporosis Foundation criteria for pharmacologic osteoporosis treatment. Within 6 months before or after surgery, 11 patients who met National Osteoporosis Foundation criteria received a prescription for pharmacotherapy, researchers noted.

“Osteoporosis is an often unrecognized comorbidity in the total joint arthroplasty population. Osteoporosis has been associated with poor clinical and radiographic outcomes following joint replacement,” Bernatz told “Thus, it is important for joint replacement surgeons to be aware of this modifiable risk factor and initiate screening and/or treatment in patients at risk for poor bone health.” – by Casey Tingle


Disclosures: Bernatz reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.