Evidence-based joint statement position of perioperative bone optimization in the arthroplasty candidate, from FEMECOT, AMMOM, ACOMM, SCCOT, SECOT, SEFRAOS, SEIOMM

Patients scheduled for elective arthroplasty should undergo a bone health assessment (BHA).

If poor bone quality is observed during surgery and a BHA has not been conducted promptly, a complete BHA, including a DXA scan, is imperative.

In the arthroplasty candidate with low bone mineral density (LBMD) or osteoporosis, bone loss-related factors should be corrected and appropriate osteoporosis treatment started before or right after arthroplasty; anti-resorptive and bone anabolic agents have been shown to reduce periprosthetic bone loss, complications and non-septic revision rates.

In arthroplasty candidates, the diagnosis of osteoporosis or LBMD should not delay the surgery.

Monitoring central and periprosthetic BMD through DXA protocols can help identify bone loss in central and periprosthetic areas in patients with risk factors or osteoporosis.