Baseline bone mineral density and boneturnover in pre-operative hip and knee arthroplasty patients.
| Autor: | James SJ; Southampton University Hospital, Departmentof Trauma and Orthopaedic Surgery, TremonaRoad, Southampton SO16 6YD, UK., Mirza SB, Culliford DJ, Taylor PA, Carr AJ, Arden NK |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Bone & joint research [Bone Joint Res] 2014 Jan 17; Vol. 3 (1), pp. 14-9. Date of Electronic Publication: 2014 Jan 17 (Print Publication: 2014). |
| DOI: | 10.1302/2046-3758.31.2000218 |
| Abstrakt: | Aims: Osteoporosis and abnormal bone metabolism may prove to be significant factors influencing the outcome of arthroplasty surgery, predisposing to complications of aseptic loosening and peri-prosthetic fracture. We aimed to investigate baseline bone mineral density (BMD) and bone turnover in patients about to undergo arthroplasty of the hip and knee. Methods: We prospectively measured bone mineral density of the hip and lumbar spine using dual-energy X-ray absorptiometry (DEXA) scans in a cohort of 194 patients awaiting hip or knee arthroplasty. We also assessed bone turnover using urinary deoxypyridinoline (DPD), a type I collagen crosslink, normalised to creatinine. Results: The prevalence of DEXA proven hip osteoporosis (T-score ≤ -2.5) among hip and knee arthroplasty patients was found to be low at 2.8% (4 of 143). Spinal osteoporosis prevalence was higher at 6.9% (12 of 175). Sixty patients (42% (60 of 143)) had osteopenia or osteoporosis of either the hip or spine. The mean T-score for the hip was -0.34 (sd 1.23), which is within normal limits, and the mean hip Z-score was positive at 0.87 (sd 1.17), signifying higher-than-average BMD for age. The median urinary DPD/creatinine was raised in both female patients at 8.1 (interquartile range (IQR) 6.6 to 9.9) and male patients at 6.2 (IQR 4.8 to 7.5). Conclusions: Our results indicate hip and knee arthroplasty patients have higher BMD of the hip and spine compared with an age-matched general population, and a lower prevalence of osteoporosis. However, untreated osteoporotic patients are undergoing arthroplasty, which may negatively impact their outcome. Raised DPD levels suggest abnormal bone turnover, requiring further investigation. Cite this article: Bone Joint Res 2014;3:14-19. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|