背景:骨质疏松症是一个普遍关注的问题,特别是在老龄化人群中,导致骨折风险增加,包括与髋关节和膝关节置换术相关的手术。骨质疏松症筛查,尤其是双X射线吸收法(DXA)扫描,对于早期发现和管理至关重要。
目的:本研究旨在评估65岁及以上在单一健康网络中接受选择性全髋关节置换术(THA)或全膝关节置换术(TKA)的患者对骨质疏松症筛查指南的依从性。还探讨了影响筛查依从性的因素。
方法:对2019年1月至2023年1月期间接受选择性THA或TKA的2,160例患者进行了回顾性图表回顾。人口统计数据,骨质疏松症筛查状态,并对假体周围骨折的发生情况进行分析。统计分析包括描述性统计和卡方检验。
结果:只有24.1%的合格患者在手术前接受了DXA扫描。女性比男性更有可能接受筛查,种族也与筛查状态相关.共发现45例假体周围骨折,骨质疏松状态之间没有显著的相关性,DXA筛查,和骨折的发生。
结论:在所研究的健康网络中,接受选择性全关节置换术的老年患者对骨质疏松症筛查指南的依从性仍然很低。尽管在这项研究中,筛查和骨折发生之间缺乏相关性,强调高危患者筛查和潜在优化的重要性.需要进一步的研究来评估与选择性老年全关节患者骨健康筛查和管理中不同护理途径相关的结果。
BACKGROUND: Osteoporosis is a prevalent concern, particularly among aging populations, leading to increased risk of fractures, including those related to hip and knee arthroplasty procedures.
Screening for osteoporosis, especially with dual X-ray absorptiometry (DXA) scans, is crucial for early detection and management.
OBJECTIVE: This study aimed to assess adherence to osteoporosis
screening guidelines among patients aged 65 and older undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) within a single health network. Factors influencing
screening adherence were also explored.
METHODS: A retrospective chart review of 2,160 patients undergoing elective THA or TKA between January 2019 and January 2023 was conducted. Demographic data, osteoporosis screening status, and occurrence of periprosthetic fractures were analyzed. Statistical analysis included descriptive statistics and chi-square tests.
RESULTS: Only 24.1 % of eligible patients underwent a DXA scan prior to surgery. Females were more likely to undergo
screening than males, and race was also associated with
screening status. A total of 45 periprosthetic fractures were identified, with no significant correlation between osteoporosis status, DXA screening, and fracture occurrence.
CONCLUSIONS: Adherence to osteoporosis screening guidelines among geriatric patients undergoing elective total joint arthroplasty remains low within the studied health network. Despite the lack of correlation between screening and fracture occurrence in this study, the importance of
screening and potential optimization in high-risk patients is emphasized. Further research is needed to assess outcomes associated with different care pathways in bone health screening and management for elective geriatric total joint patients.