Trends in screening and treatment of osteoporosis after periprosthetic fractures from 2010 to 2020.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Osteoporosis International Pub Date : 2025-01-15 DOI:10.1007/s00198-025-07385-5

Jackson W Durbin, Amy Y Zhao, Eric Cui, Amil R Agarwal, Andrew Smith, Alex Gu, Gregory J Golladay, Savyasachi C Thakkar

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Abstract

Osteoporosis is often underrecognized and undertreated following periprosthetic fractures (PPF). Our study found that between 2010 and 2020, there has been no significant change in the rates of osteoporosis screening or treatment within 1 year following PPF. Orthopedic surgeons can play an integral role in helping to curtail the osteoporosis epidemic.

Purpose: Periprosthetic fractures (PPF) typically occur from low-energy mechanisms and are pathognomonic for osteoporosis. However, osteoporosis is often underrecognized and undertreated. The aim of this study was to examine trends in dual energy X-ray absorptiometry (DXA) scans and treatment of osteoporosis after PPF between 2010 and 2020.

Methods: Patients older than 40 who experienced a lower extremity PPF between 2010 and 2020 and had no prior history of osteoporosis screening or treatment were identified utilizing a large national administrative database. Rates of bone mineral density (BMD) measurement using DXA and anti-osteoporotic treatment with pharmacotherapy, or either intervention within 1 year following experiencing a PPF were determined. The rate of change for these interventions was calculated using the compounded annual growth rate (CAGR), with linear regression used to determine whether trends were statistically significant.

Results: In total, 5.7% and 3.6% of patients were screened and treated for osteoporosis, respectively. Between 2010 and 2020, there was no significant change in rates of osteoporosis screening (CAGR + 0.1%; p = 0.13), treatment (CAGR - 2.4%; p = 0.29), or either intervention (CAGR - 1.1%; p = 0.77) within 1 year following PPF. Factors associated with intervention included older age, female sex, and increased comorbidities.

Conclusion: Our study found that there has been no significant change in the rates of osteoporosis screening or treatment within 1 year following PPF. Orthopedic surgeons and allied healthcare workers can play an integral role in helping to curtail the osteoporosis epidemic.

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2010 - 2020年假体周围骨折后骨质疏松筛查与治疗趋势

假体周围骨折（PPF）后，骨质疏松症往往得不到充分认识和治疗。我们的研究发现，从 2010 年到 2020 年，骨质疏松症筛查率或 PPF 发生后 1 年内的治疗率没有明显变化。目的：假体周围骨折（PPF）通常发生于低能量机制，是骨质疏松症的病理标志。然而，骨质疏松症往往得不到充分认识和治疗。本研究旨在探讨 2010 年至 2020 年间双能 X 射线吸收测量（DXA）扫描和 PPF 后骨质疏松症治疗的趋势：利用一个大型全国性行政数据库，对 2010 年至 2020 年间 40 岁以上、下肢 PPF 患者进行了识别，这些患者之前没有接受过骨质疏松症筛查或治疗。研究人员确定了使用 DXA 测量骨矿密度 (BMD) 的比率、使用药物疗法进行抗骨质疏松治疗的比率或在发生 PPF 后 1 年内采取其中任何一种干预措施的比率。这些干预措施的变化率采用复合年增长率（CAGR）计算，并通过线性回归确定趋势是否具有统计学意义：共有 5.7% 和 3.6% 的患者接受了骨质疏松症筛查和治疗。2010 年至 2020 年间，骨质疏松症筛查率（CAGR + 0.1%；p = 0.13）、治疗率（CAGR - 2.4%；p = 0.29）或 PPF 后 1 年内的干预率（CAGR - 1.1%；p = 0.77）均无明显变化。与干预相关的因素包括年龄偏大、女性和合并症增多：我们的研究发现，骨质疏松症筛查率或治疗率在 PPF 实施后 1 年内没有明显变化。矫形外科医生和相关医护人员在帮助遏制骨质疏松症流行方面可以发挥不可或缺的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoporosis International 医学-内分泌学与代谢

CiteScore

8.10

自引率

10.00%

发文量

224

审稿时长

3 months

期刊介绍： An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.