Changes in Periprosthetic Bone Mineral Density Following Arthroplasty: An In-Depth Review and Current Perspectives.

IF 5.3 2区医学

Current Osteoporosis Reports Pub Date : 2025-06-27 DOI:10.1007/s11914-025-00921-6

Daizhi Li, Feiyang Liu, Yilin Hou, Yi Zeng

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引用次数: 0

Abstract

Purpose of review: Arthroplasty (e.g., TKA, UKA, THA) is a gold-standard treatment for end-stage joint diseases, yet it often leads to periprosthetic bone mineral density (BMD) loss, increasing risks of implant loosening and fractures. This review aims to (1) evaluate current methods for measuring periprosthetic BMD, (2) analyze factors contributing to BMD reduction, and (3) discuss pharmacological interventions to mitigate bone loss, thereby improving postoperative outcomes.

Recent findings: Recent studies highlight three primary BMD assessment tools: DEXA (widely used but limited by artifact interference), QCT (3D precision but higher cost/radiation), and HRpQCT (high-resolution yet restricted to peripheral sites). Key contributors to BMD loss include stress shielding, surgical technique, patient-specific factors (e.g., age, osteoporosis), and postoperative management gaps. Pharmacological agents like teriparatide (anabolic), denosumab (anti-resorptive), and TCM (e.g., Epimedium-derived compounds) show efficacy in preserving periprosthetic BMD. Periprosthetic BMD loss remains a critical challenge post-arthroplasty. While current monitoring tools and pharmacological strategies offer promising solutions, limitations in accessibility and standardization persist. Future research should focus on personalized BMD management protocols, cost-effective monitoring technologies, and long-term outcomes of combined therapies to optimize implant longevity and patient quality of life.

查看原文本刊更多论文

关节置换术后假体周围骨矿物质密度的变化：深入回顾和当前观点。

综述目的：关节置换术（如TKA、UKA、THA）是终末期关节疾病的金标准治疗方法，但它经常导致假体周围骨矿物质密度（BMD）下降，增加假体松动和骨折的风险。本综述旨在(1)评估目前测量假体周围骨密度的方法，(2)分析导致骨密度降低的因素，(3)讨论减轻骨质流失的药物干预，从而改善术后预后。最近的发现：最近的研究强调了三种主要的BMD评估工具：DEXA（广泛使用，但受伪影干扰的限制），QCT （3D精度，但成本/辐射较高）和HRpQCT（高分辨率，但仅限于外周部位）。造成骨密度损失的主要因素包括应力屏蔽、手术技术、患者特异性因素（如年龄、骨质疏松症）和术后管理差距。药物制剂如特立帕肽（合成代谢）、地诺单抗（抗再吸收）和中药（如epimedium衍生化合物）显示出保存假体周围骨密度的功效。假体周围骨密度损失仍然是关节置换术后的一个关键挑战。虽然目前的监测工具和药理学策略提供了有希望的解决方案，但在可及性和标准化方面的限制仍然存在。未来的研究应该集中在个性化的BMD管理方案，成本效益的监测技术，以及联合治疗的长期结果，以优化种植体的寿命和患者的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Osteoporosis Reports ENDOCRINOLOGY & METABOLISM-

CiteScore

8.40

自引率

2.30%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.