In a study of the 68,730 patients, these authors found that the prevalence of an osteoporosis diagnosis at the time of surgery was 14.3% for anatomic TSA patients and 26.2% of reverse TSA patients.
Anatomic TSA patients with osteoporosis experienced significantly higher rates of periprosthetic fracture (odds ratio [OR], 1.49; P = 0.017) and revision shoulder arthroplasty (OR, 1.21; P = 0.009) within 2 years of surgery compared with matched controls without osteoporosis.
Patients in the reverse TSA group with osteoporosis also had significantly higher rates of periprosthetic fracture (OR, 1.86; P = 0.001) and revision shoulder arthroplasty (OR, 1.42; P = 0.005) within 2 years of surgery compared with matched controls.
Comment: The risk of periprosthetic fracture cannot be eliminated in patients with osteoporosis. However, the risk may be lowered by attention to fall prevention, as discussed in this link. Certain surgical techniques may be effective in making the shoulder more resistant to fracture, such as impaction grafting of the humeral stem (see this link and this link).
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