Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip Arthroplasty

<b>Background:</b> Total hip arthroplasty (THA) is a widely used surgical intervention for hip osteoarthritis (HOA), with a rising demand driven by an aging population. Osteoporosis is associated with increased risks of bone loss and implant loosening after THA. While medications such as...

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Main Authors: Ryuichi Kanabuchi, Yu Mori, Kazuyoshi Baba, Hidetatsu Tanaka, Yasuaki Kuriyama, Hideki Fukuchi, Hiroki Kawamata, Toshimi Aizawa
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Medical Sciences
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Online Access:https://www.mdpi.com/2076-3271/13/1/10
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author Ryuichi Kanabuchi
Yu Mori
Kazuyoshi Baba
Hidetatsu Tanaka
Yasuaki Kuriyama
Hideki Fukuchi
Hiroki Kawamata
Toshimi Aizawa
author_facet Ryuichi Kanabuchi
Yu Mori
Kazuyoshi Baba
Hidetatsu Tanaka
Yasuaki Kuriyama
Hideki Fukuchi
Hiroki Kawamata
Toshimi Aizawa
author_sort Ryuichi Kanabuchi
collection DOAJ
description <b>Background:</b> Total hip arthroplasty (THA) is a widely used surgical intervention for hip osteoarthritis (HOA), with a rising demand driven by an aging population. Osteoporosis is associated with increased risks of bone loss and implant loosening after THA. While medications such as bisphosphonates and denosumab have shown promise in mitigating these risks, the impact of preoperative osteoporosis treatment on postoperative outcomes remains unclear. This study investigates the effect of preoperative osteoporosis treatment intervention on stress shielding and clinical outcomes in THA patients. <b>Methods:</b> This retrospective study included 107 patients who underwent cementless THA between April 2019 and March 2022. Patients under 60 years old, with a follow-up period of less than one year, or with prior hip surgery were excluded. Participants were divided into two groups: a treatment group receiving osteoporosis medication preoperatively and a non-treatment group. The outcomes assessed included preoperative bone metabolism markers, Bombelli classification, stress shielding grade, and clinical scores. Statistical analysis was performed using the Mann–Whitney U test and Chi-squared test, with significance set at <i>p</i> < 0.05. <b>Results:</b> The preoperative osteoporosis treatment intervention rate was 28.9%. Stress shielding grades were significantly lower in the treatment group (<i>p</i> = 0.001). However, no significant differences were observed in clinical scores one year postoperatively. <b>Conclusion:</b> Preoperative osteoporosis treatment significantly reduced stress shielding incidence, potentially influencing long-term outcomes by preventing bone atrophy-related pain and fractures. Preoperative bone density assessment and osteoporosis treatment intervention are recommended to improve THA outcomes. Larger studies are needed for further validation.
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spelling doaj-art-fa11e99b62b04c7aadc01b3fcca846922025-08-20T03:43:34ZengMDPI AGMedical Sciences2076-32712025-01-011311010.3390/medsci13010010Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip ArthroplastyRyuichi Kanabuchi0Yu Mori1Kazuyoshi Baba2Hidetatsu Tanaka3Yasuaki Kuriyama4Hideki Fukuchi5Hiroki Kawamata6Toshimi Aizawa7Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, JapanDepartment of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan<b>Background:</b> Total hip arthroplasty (THA) is a widely used surgical intervention for hip osteoarthritis (HOA), with a rising demand driven by an aging population. Osteoporosis is associated with increased risks of bone loss and implant loosening after THA. While medications such as bisphosphonates and denosumab have shown promise in mitigating these risks, the impact of preoperative osteoporosis treatment on postoperative outcomes remains unclear. This study investigates the effect of preoperative osteoporosis treatment intervention on stress shielding and clinical outcomes in THA patients. <b>Methods:</b> This retrospective study included 107 patients who underwent cementless THA between April 2019 and March 2022. Patients under 60 years old, with a follow-up period of less than one year, or with prior hip surgery were excluded. Participants were divided into two groups: a treatment group receiving osteoporosis medication preoperatively and a non-treatment group. The outcomes assessed included preoperative bone metabolism markers, Bombelli classification, stress shielding grade, and clinical scores. Statistical analysis was performed using the Mann–Whitney U test and Chi-squared test, with significance set at <i>p</i> < 0.05. <b>Results:</b> The preoperative osteoporosis treatment intervention rate was 28.9%. Stress shielding grades were significantly lower in the treatment group (<i>p</i> = 0.001). However, no significant differences were observed in clinical scores one year postoperatively. <b>Conclusion:</b> Preoperative osteoporosis treatment significantly reduced stress shielding incidence, potentially influencing long-term outcomes by preventing bone atrophy-related pain and fractures. Preoperative bone density assessment and osteoporosis treatment intervention are recommended to improve THA outcomes. Larger studies are needed for further validation.https://www.mdpi.com/2076-3271/13/1/10total hip arthroplastyosteoporosisstress shieldingloosening
spellingShingle Ryuichi Kanabuchi
Yu Mori
Kazuyoshi Baba
Hidetatsu Tanaka
Yasuaki Kuriyama
Hideki Fukuchi
Hiroki Kawamata
Toshimi Aizawa
Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip Arthroplasty
Medical Sciences
total hip arthroplasty
osteoporosis
stress shielding
loosening
title Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip Arthroplasty
title_full Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip Arthroplasty
title_fullStr Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip Arthroplasty
title_full_unstemmed Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip Arthroplasty
title_short Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip Arthroplasty
title_sort preoperative osteoporosis treatment reduces stress shielding in total hip arthroplasty
topic total hip arthroplasty
osteoporosis
stress shielding
loosening
url https://www.mdpi.com/2076-3271/13/1/10
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AT hidetatsutanaka preoperativeosteoporosistreatmentreducesstressshieldingintotalhiparthroplasty
AT yasuakikuriyama preoperativeosteoporosistreatmentreducesstressshieldingintotalhiparthroplasty
AT hidekifukuchi preoperativeosteoporosistreatmentreducesstressshieldingintotalhiparthroplasty
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