Periprosthetic fractures are osteoporotic fractures: missed opportunities for osteoporosis diagnosis
Authors' conclusion
Periprosthetic fractures are osteoporosis-related. They occur in older adults, often female, and result from falls; BMD, when assessed, is low. Data available at the time of PPFx often allows osteoporosis diagnosis
Study context
- Population
- Patients with periprosthetic fractures seen over 4 years in a university orthopedic practice115 F/41 M
- Participants
- 156 patients
- Outcome
- Clinical osteoporosis diagnosable from existing data at the time of PPFx (prior diagnosis, osteoporosis treatment, T-score ≤ - 2.5, HU ≤ 100, or prior fracture)
- Follow-up
- At the time of PPFx
Methodological detailssingle-centre, electronic medical record (EMR) review
- Single-centre
- EMR review
Main finding
As reported in the abstract
Clinical osteoporosis diagnosable from existing data
Clinical osteoporosis could have been diagnosed
104
67%
Observational data: associations, not effects.
Further findings
Age
- Mean (SD) age
- 75.4 (11.9)
Femoral fractures
- Femoral
- 153/156 (98%)
Fracture mechanism
- Falls
- 139 (89%)
- Spontaneous
- 12 (8%)
Time post-arthroplasty
- Mean (SD) years
- 7.9 (6.3)
Prior fragility fracture(s)
- Prior fragility fracture(s)
- 72 (46%)
- Prior fractures that were PPFx
- 14
Prior osteoporosis diagnosis and treatment
- Previously diagnosed
- 45 (29%)
- Medications prescribed
- 41 (26%)
DXA lowest T-score before PPFx (DXA available in 62)
- Mean (SD) lowest T-score
- - 1.9 (0.9)
- T-score ≤ - 2.5
- 19
L1 Hounsfield unit (HU) on CT within 2 years before PPFx (CT available in 46)
- Mean (SD) L1 HU
- 79.0 (29.4)
- HU ≤ 100
- 35
Original publication
Periprosthetic fractures are osteoporotic fractures: missed opportunities for osteoporosis diagnosis. Osteoporos Int. Published 1 April 2024. doi:10.
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