Saturday, March 16, 2013

Osteoporosis and shoulder arthritis

Osteoporosis and shoulder osteoarthritis: incidence, risk factors, and surgical implications

This study compared computed tomography (CT)-derived Hounsfield unit (HU) measurements and bone mineral density (BMD) in 230 patients who underwent total shoulder arthroplasty. 

Significant correlations between HU and hip BMD and T score were identified (P < .001). HU value ranges were identified that may alert the surgeon of metabolic bone disease. 

These authors found that, in their practice, age at time of surgery was a predictor of cemented stem fixation (P = .024) and that patients with a lower BMD were statistically more likely to receive a larger-diameter humeral stem (P = .016).
While we agree that it is important to diagnose and treat osteoporosis, we are reluctant to cement humeral prostheses in weak bone because of fear of periprosthetic fracture at the point of transition of structural property. Instead we use impaction grafting to help strengthen the bone.

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