Osteoporosis increases risk for revision for periprosthetic fracture after TKA
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Key takeaways:
- Patients with osteoporosis had an increased risk for revision at 5 years after TKA vs. patients without osteoporosis.
- Osteoporosis was associated with PJI and aseptic loosening in patients with obesity.
According to published results, patients with osteoporosis had a two-fold increased risk for revision for periprosthetic fracture at 5 years after total knee arthroplasty compared with patients without osteoporosis.
Researchers analyzed data from 418,054 patients who underwent primary TKA from 2010 to 2021. Among the cohort, 41,760 (10%) patients had preoperative osteoporosis.
According to the study, outcome measures included 5-year incidence of revision surgery for all-causes, periprosthetic fracture (PPF), aseptic loosening and periprosthetic joint infection (PJI). Researchers also performed a subgroup analysis comparing outcomes in patients with vs. without obesity.
After controlling for age, sex and comorbidities, researchers found patients who had osteoporosis had a two-fold increased risk for 5-year revision for PPF (HR = 1.8) and a mildly increased risk for revision for all-causes (HR = 1.1), aseptic loosening (HR = 1.2) and PJI (HR = 1.2). Researchers also noted osteoporosis was independently associated with PJI and aseptic loosening in patients with obesity.
“As with other modifiable factors, future studies should observe the efficacy of bone health optimization via screening and treatment in patients undergoing TKA to reduce the incidence and burden of these postoperative sequalae,” the researchers wrote in the study.
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