Patients with Periprosthetic Femoral Hip Fractures are Commonly Classified as Having Osteoporosis Based on DXA Measurements.
Jacob RitterAssil-Ramin AlimyAlexander SimonJan HubertChristian RiesHazibullah WaizyFrank Timo BeilPublished in: Calcified tissue international (2024)
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.
Keyphrases
- bone mineral density
- postmenopausal women
- total hip
- total hip arthroplasty
- body composition
- total knee arthroplasty
- dual energy
- end stage renal disease
- newly diagnosed
- patients undergoing
- ejection fraction
- peritoneal dialysis
- prognostic factors
- computed tomography
- emergency department
- public health
- risk factors
- magnetic resonance imaging
- magnetic resonance
- physical activity
- weight gain
- risk assessment
- mental health
- climate change
- mass spectrometry
- social media
- big data
- health information
- hip fracture