Osteoporosis is common in people undergoing knee replacement surgery. However, the condition can increase the risk of complications. Proper management can help reduce these risks.
Weakened bones with osteoporosis can make knee replacement surgery more challenging.
Proper preoperative and postoperative care, as well as long-term follow-up, can help promote successful knee replacement surgery with osteoporosis.
Osteoporosis weakens the bones, making knee replacement more challenging and
A surgeon may need to make certain adjustments to the procedure to perform a successful knee replacement.
How common is osteoporosis in those who have knee replacement surgery?
Osteoporosis is common in people undergoing knee replacement surgery. Around
According to a 2024 research article, the national administrative database that researchers gathered data from showed that 10% of the 418,054 people listed who were undergoing total knee replacement surgery between 2010 and 2021 had osteoporosis.
A 2022 review of research indicated that osteoporosis in people undergoing total joint replacement of the knee or hip is more common in females, including a small percentage of postmenopausal females.
Osteoporosis
Fragility fractures are fractures that occur due to a fall or injury that would not usually cause healthy bones to break. These fractures are a feature of osteoporosis.
A 2024 literature review highlighted older research noting that a fragility fracture
Postoperative measures, such as antiresorptive medication which helps reduce bone loss, may help reduce the risk of complications.
According to a small 2020 study, there are concerns about whether implants that do not use medical cement to hold them in place are suitable for people with low bone mineral density (BMD).
Cementless implants rely on the surrounding bone to hold them in place. Weakened bones due to osteoporosis may not be able to provide enough stability for the implant. Generally, surgeons use cementless implants in younger people with higher BMD.
The small-scale study indicated that cementless implants may be safe in people with osteoporosis and osteopenia and may have similar outcomes to those with typical BMD.
However, researchers require further, large-scale studies to confirm these findings. Until further evidence is available, surgeons may choose to use cement implants for people with osteoporosis.
A 2019 case series review showed that one-quarter of the medical charts reviewed showed that people undergoing total joint replacement met the criteria for getting osteoporosis medication, but only 5% had preoperative or postoperative management.
Preoperative screening and treatment may help reduce the risk of periprosthetic fractures following surgery.
Certain factors may increase the risk of negative outcomes following joint replacement surgery, including:
- having obesity
- diabetes
- tobacco use
- malnutrition
- vitamin D deficiency
- opioid use
- irregular dentition, which is the development and arrangement of teeth
- anemia
Addressing any of these risk factors before surgery may help to improve outcomes. Preoperative management may include:
- Preoperative screening: Preoperative screening to assess BMD
may helpTrusted Source identify people who require medical management for low BMD around the period of surgery and help reduce risks. - Taking vitamin D supplements: Vitamin D is an important component in bone health. Preoperative vitamin D supplementation in people with a vitamin D deficiency may help improve outcomes.
- Quit smoking: If people smoke, quitting can help reduce the risk of delayed healing and infections following surgery.
- Weight-bearing exercise to strengthen bones: People can talk with a doctor to discuss exercises, if any, they can do before their knee replacement. Isometric exercises contract certain muscles, which can help strengthen the legs. Building upper body strength can also help people use walking aids in the recovery period.
- Lose weight: Your care team may recommend weight loss if they feel it’s necessary to help reduce extra stress on the new joint.
Before undergoing knee replacement, people can talk with a doctor about the best ways to help reduce risks and improve the outcome of the procedure.
After surgery, taking precautions to help prevent fractures is important. Examples may include:
- removing trip hazards in the home, such as rugs or loose cables
- using a walking aid, such as crutches, to help move around
- modifying rooms for easier use, such as rearranging furniture or adding a shower chair to the bathroom
People may also undergo a rehabilitation program, which may involve exercises to help restore balance, range of motion, and function. Postoperative rehabilitation may help people heal more quickly and improve their quality of life after knee replacement surgery.
Osteoporosis medications
Attending follow-up appointments is an important part of long-term care after a knee replacement. Your check-in appointments may follow the schedule below:
- 2-to-3-week follow-up: wound check
- 6 weeks: check recovery and implant surveillance with X-rays
- 3 to 6 months: general follow-up
- 1 year: typical stage of full recovery
- Past 1 year: may be a need for follow-ups every year or every 2, 5, or 10 years
- Past 10 years: follow-ups every year or every other year after this post-recovery milestone
This is a general timeframe. It may vary for people with osteoporosis. Doctors
Further research is necessary to understand which osteoporosis treatments may help improve the postoperative outlook for knee replacement.
Osteoporosis can make knee replacement surgery more challenging, but it is common for people with osteoporosis to undergo the procedure.
Optimizing bone health, taking fracture prevention steps, rehabilitation, and long-term follow-ups may all help improve outcomes for knee replacement surgery.