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Prevalence and Predictors of Osteoporosis Risk in Orthopaedic Patients

  • Symposium: Gender-specific Issues in Orthopaedic Surgery
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Current physician practices are not effective in adequately evaluating and treating patients for osteoporosis. While dual-energy xray absorptiometry is the gold standard in evaluating bone mineral density, calcaneal quantitative ultrasound has emerged as a low-risk and low-cost alternative.

Questions/purposes

We estimated the prevalence of abnormal bone mineral density with calcaneal quantitative ultrasound and developed criteria for risk stratification in female and male orthopaedic patients.

Methods

We enrolled 500 patients (331 women, 169 men) with a mean age of 67 years (range, 55–94 years) and screened them for osteoporosis with calcaneal quantitative ultrasound. Multivariate logistic regression was used to identify predictors of low bone mineral density and a risk model was developed.

Results

Quantitative ultrasound identified 154 patients with low bone mineral density at the time of enrollment. The prevalence of abnormal bone mineral density was 31% (women: 38%, men: 17%). Multivariate analysis demonstrated age, female gender, smoking, wrist fracture, and spinal deformities independently predicted low bone mineral density. The probability of low bone mineral density among patients with more than one risk factor was greater than 50% among women and greater than 30% among men.

Conclusions

Low bone mineral density is common among orthopaedic outpatients. Age, female gender, smoking, wrist fractures, and spinal deformities are independent risk factors for osteoporosis. We present a probability model designed to assist orthopaedic surgeons in identifying high-risk patients and initiating adequate preventative measures.

Level of Evidence

Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA, 02215, USA

    Tamara D. Rozental MD & Aron T. Chacko BS

  2. Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL, USA

    Jalaal Shah BS

  3. Department of Anesthesiology and Surgery, Childrens’ Hospital Boston, Harvard Medical School, Boston, MA, USA

    David Zurakowski PhD

Authors
  1. Tamara D. Rozental MD
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  2. Jalaal Shah BS
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  3. Aron T. Chacko BS
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  4. David Zurakowski PhD
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Corresponding author

Correspondence to Tamara D. Rozental MD.

Additional information

One or more of the authors (TDR) have received funding from Procter and Gamble, Cincinnati, OH.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Beth Israel Deaconess Medical Center.

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Rozental, T.D., Shah, J., Chacko, A.T. et al. Prevalence and Predictors of Osteoporosis Risk in Orthopaedic Patients. Clin Orthop Relat Res 468, 1765–1772 (2010). https://doi.org/10.1007/s11999-009-1162-6

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  • DOI: https://doi.org/10.1007/s11999-009-1162-6

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