OSTEOPOROSIS AND JOINT REPLACEMENT
Over the past few decades, the number of implantation of endoprosthetic joint replacements has steadily increased. Many patients who need joint replacements are of older age and have a reduced bone quality due to osteoporosis. In patients with joint replacements and osteoporosis complications are...
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Grodno State Medical University
2018-08-01
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doaj-78f23a7f3c2b45309852c2b0c6dde49f2020-11-24T22:24:01ZbelGrodno State Medical University Žurnal Grodnenskogo Gosudarstvennogo Medicinskogo Universiteta2221-87852413-01092018-08-0116325125610.25298/2221-8785-2018-16-3-251-256OSTEOPOROSIS AND JOINT REPLACEMENTHolzer Gerold0Holzer Lukas A.1Medical University of ViennaAUVA Trauma Center Klagenfurt, Klagenfurt am WӧrtherseeOver the past few decades, the number of implantation of endoprosthetic joint replacements has steadily increased. Many patients who need joint replacements are of older age and have a reduced bone quality due to osteoporosis. In patients with joint replacements and osteoporosis complications are often seen: intraoperative periprosthetic fractures, periprosthetic osteolysis, increased implant migration or postoperative periprosthetic fractures. The evaluation of bone quality therefore seems an essential point in patient management to provide the best possible care and to optimize long term surgical outcomes. If necessary, patients should be educated about a possible calcium and vitamin D supplementation. In addition, it seems reasonable to aim for physiological vitamin D levels perioperatively. In postmenopausal women, men over 70 years and both women and men with an increased risk of osteoporosis within two years of implantation of a total joint replacement a bone mineral density measurement should be performed. In patients with reduced bone quality, treatment with bisphosphonates, denosumab or teriparatide should be considered in order to improve the osseous integration of cementless implants, to increase the lifespan of implants as well as to reduce periprosthetic fractures and fractures in general. In individual cases of patients with osteoporosis cementation of prosthetic components (especially in total hip replacements) may be required.http://journal-grsmu.by/index.php/ojs/article/view/2265/2069osteoporosisfracturesendoprosthetic joint replacementbisphosphonatesdenosumabteriparatide |
collection |
DOAJ |
language |
Belarusian |
format |
Article |
sources |
DOAJ |
author |
Holzer Gerold Holzer Lukas A. |
spellingShingle |
Holzer Gerold Holzer Lukas A. OSTEOPOROSIS AND JOINT REPLACEMENT Žurnal Grodnenskogo Gosudarstvennogo Medicinskogo Universiteta osteoporosis fractures endoprosthetic joint replacement bisphosphonates denosumab teriparatide |
author_facet |
Holzer Gerold Holzer Lukas A. |
author_sort |
Holzer Gerold |
title |
OSTEOPOROSIS AND JOINT REPLACEMENT |
title_short |
OSTEOPOROSIS AND JOINT REPLACEMENT |
title_full |
OSTEOPOROSIS AND JOINT REPLACEMENT |
title_fullStr |
OSTEOPOROSIS AND JOINT REPLACEMENT |
title_full_unstemmed |
OSTEOPOROSIS AND JOINT REPLACEMENT |
title_sort |
osteoporosis and joint replacement |
publisher |
Grodno State Medical University |
series |
Žurnal Grodnenskogo Gosudarstvennogo Medicinskogo Universiteta |
issn |
2221-8785 2413-0109 |
publishDate |
2018-08-01 |
description |
Over the past few decades, the number of implantation of endoprosthetic joint replacements has steadily increased.
Many patients who need joint replacements are of older age and have a reduced bone quality due to osteoporosis.
In patients with joint replacements and osteoporosis complications are often seen: intraoperative periprosthetic
fractures, periprosthetic osteolysis, increased implant migration or postoperative periprosthetic fractures. The evaluation of bone quality therefore seems an essential point in patient management to provide the best possible care and to optimize long term surgical outcomes. If necessary, patients should be educated about a possible calcium and vitamin D supplementation. In addition, it seems reasonable to aim for physiological vitamin D levels perioperatively.
In postmenopausal women, men over 70 years and both women and men with an increased risk of osteoporosis
within two years of implantation of a total joint replacement a bone mineral density measurement should be performed.
In patients with reduced bone quality, treatment with bisphosphonates, denosumab or teriparatide should be
considered in order to improve the osseous integration of cementless implants, to increase the lifespan of implants as
well as to reduce periprosthetic fractures and fractures in general. In individual cases of patients with osteoporosis
cementation of prosthetic components (especially in total hip replacements) may be required. |
topic |
osteoporosis fractures endoprosthetic joint replacement bisphosphonates denosumab teriparatide |
url |
http://journal-grsmu.by/index.php/ojs/article/view/2265/2069 |
work_keys_str_mv |
AT holzergerold osteoporosisandjointreplacement AT holzerlukasa osteoporosisandjointreplacement |
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1725762765808730112 |