Evidence map›Paper›PMID 38561550›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024

Periprosthetic fractures are osteoporotic fractures: missed opportunities for osteoporosis diagnosis.

Paul S Whiting, Kristyn Hare, Diane Krueger, Gretta Borchardt, Kristina Parvanta-Johnson, James Bernatz, Neil Binkley, Paul A Anderson

Abstract read
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In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
8.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Evidence-based joint statement position of perioperative bone optimization in the arthroplasty candidate, from FEMECOT, AMMOM, ACOMM, SCCOT, SECOT, SEFRAOS, SEIOMM.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Guideline
  2. Review
  3. Article
  4. Patients with periprosthetic femoral fractures are older adults who are commonly diagnosed with osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Observational
  5. Review
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Paul S WhitingDepartment of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, MFCB 6227, Madison, WI, 53705, USA. whiting@ortho.wisc.edu.
Kristyn HareDepartment of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, MFCB 6227, Madison, WI, 53705, USA.
Diane KruegerOsteoporosis Clinical Research Program, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Gretta BorchardtOsteoporosis Clinical Research Program, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Kristina Parvanta-JohnsonDepartment of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, MFCB 6227, Madison, WI, 53705, USA.
James BernatzDepartment of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, MFCB 6227, Madison, WI, 53705, USA.
Neil BinkleyOsteoporosis Clinical Research Program, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Paul A AndersonDepartment of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, MFCB 6227, Madison, WI, 53705, USA.
University of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Joint replacement surgery is common in older adults, leading to increasing periprosthetic fracture (PPFx) occurrence. We reviewed all PPFx seen over a 4-year period at an academic hospital. Clinical osteoporosis could be diagnosed based on existing data in 104 (67%) at the time of PPFx. Periprosthetic fractures are generally osteoporosis-related. PURPOSE: Periprosthetic fractures (PPFx) cause morbidity, mortality, and cost. This study's purpose was to describe osteoporosis-related data available at the time of PPFx.

methodsThe electronic medical record (EMR) of PPFx patients seen over 4 years in a university orthopedic practice were reviewed. Demographic data and osteoporosis relevant parameters were collected. Prior DXA studies were reviewed, and L1 Hounsfield unit (HU) measurements were performed on CT scans obtained within 2 years before PPFx. Clinical osteoporosis was defined as prior diagnosis, prescribed osteoporosis treatment, T-score ≤  - 2.5, HU ≤ 100, or prior fracture.

resultsRecords of 156 PPFx patients (115 F/41 M), mean (SD) age 75.4 (11.9), were reviewed. Almost all 153/156 (98%) of these fractures were femoral. Falls caused 139 (89%); 12 (8%) were spontaneous. Mean time post-arthroplasty was 7.9 (6.3) years. Prior fragility fracture(s) occurred in 72 (46%); 14 were PPFx. Osteoporosis was previously diagnosed in 45 (29%) and medications prescribed in 41 (26%). Prior to PPFx, DXA data were available in 62, mean (SD) lowest T-score was - 1.9 (0.9) and was ≤  - 2.5 in 19. CT data were available in 46; mean (SD) L1 HU was 79.0 (29.4) and was ≤ 100 in 35. Based on existing data, clinical osteoporosis could have been diagnosed in 104 (67%) at the time of PPFx.

conclusionPeriprosthetic fractures are osteoporosis-related. They occur in older adults, often female, and result from falls; BMD, when assessed, is low. Data available at the time of PPFx often allows osteoporosis diagnosis; this should prompt evaluation and pharmacologic treatment consideration.

Indexed as

Absorptiometry, PhotonOsteoporosisOsteoporotic FracturesPeriprosthetic FracturesAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeBone DensityBone Density Conservation AgentsFemaleHumansMaleMiddle AgedMissed DiagnosisRetrospective StudiesBone Density Conservation AgentsArthroplastyOpportunistic CTOsteoporosisPeriprosthetic fracture

Identifiers

PMID38561550
OpenAlexW4393377489

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.