{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:56:06Z","timestamp":1793235366698,"version":"4.5.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Osteoporosis is a well-recognized risk factor for complications after total knee arthroplasty (TKA). However, the effect of pre-TKA osteoporosis on healthcare utilization and patient-reported outcomes is poorly understood. Here, we characterize the association between pre-TKA osteoporosis and (1) healthcare utilization and patient-reported pain and function outcome measures; and (2) dual X-ray absorptiometry (DEXA) scan\n                      <jats:italic>T<\/jats:italic>\n                      -scores and the aforementioned outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective cohort of primary elective TKA patients between July 2015 and January 2020 was obtained (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096318), of which 4922 (77.9%) completed 1-year follow-up. Outcomes included healthcare utilization (prolonged length of stay (LOS)\u2009\u2265\u20093D, discharge disposition (DD), 90-day readmission, and 1-year reoperation) as well as Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain, KOOS-function (PS) and satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of pre-TKA osteoporosis was 66.8%, of which 28.7% had a DEXA scan and 66.3% were on osteoporosis medications. Medicated osteoporotic patients were independently associated with higher odds of prolonged LOS (Odds Ratio (OR): 1.21 (95% Confidence Interval (CI) 1.02\u20131.43)) and non-home DD (OR:1.56 (95%CI 1.25\u20131.95)). Medicated and non-medicated osteoporosis patients were associated with higher odds of 90-day readmission. The odds of failing to achieve MCID or satisfaction were not associated with preoperative OP diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Two-thirds of primary TKA recipients had osteoporosis. Among these patients, two-thirds were on medication and one-third had a DEXA scan. Osteoporotic patients are at a higher risk of 90-day hospital readmission, longer hospital stays and non-home discharge. Interestingly, osteoporosis status was not associated with failure to achieve clinically significant improvements or satisfaction at 1\u00a0year following TKA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-025-04418-x","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T20:19:04Z","timestamp":1754338744000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence and impact of preoperative osteoporosis on healthcare utilization and patient-reported outcomes in primary total knee arthroplasty"],"prefix":"10.1007","volume":"35","author":[{"given":"Alvaro","family":"Ibaseta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed K","family":"Emara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin E","family":"Jevnikar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujaa T","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Pasqualini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oguz","family":"Turan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cleveland Clinic","family":"Adult Reconstruction Research","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas S","family":"Piuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"4418_CR1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm4.10192","volume":"3","author":"EM Lewiecki","year":"2019","unstructured":"Lewiecki EM, Ortendahl JD, Vanderpuye-Orgle J et al (2019) Healthcare policy changes in osteoporosis can improve outcomes and reduce costs in the United States. 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Nicolas Santiago Piuzzi, MD American Association of Hip and Knee Surgeons: Board or committee member ISCT: Board or committee member Journal of Hip Surgery: Editorial or governing board Journal of Knee Surgery: Editorial or governing board Orthopaedic Research Society: Board or committee member Osteal Therapeutics: Research support Pacira: Paid consultant Peptilogics: Research support RegenLab: Research support Signature Orthopaedics: Research support Stryker: Paid consultant Zimmer: Research support  Trevor G Murray, MD, FAAOS Biomet: Paid consultant Prichard Medical: Paid consultant Stryker: Research support Zimmer: Paid consultant  Robert M Molloy, MD American Association of Hip and Knee Surgeons: Board or committee member Stryker: Paid consultant; Paid presenter or speaker; Research support Zimmer: Research support  Kim L Stearns, MD, FAAOS Molnlycke: Paid consultant  Viktor Erik Krebs, MD, FAAOS Journal of Arthroplasty: Editorial or governing board Stryker: IP royalties; Paid presenter or speaker Stryker Orthopaedics: Paid consultant  Michael R Bloomfield, MD, FAAOS AAOS: Board or committee member American Association of Hip and Knee Surgeons: Board or committee member Stryker: Paid consultant  John McLaughlin, DO, FAAOS Smith & Nephew: Paid consultant Zimmer: Paid consultant  Matthew Edward Deren, MD, FAAOS Brasseler: Paid presenter or speaker RomTech: Stock or stock Options  Wael K Barsoum, MD, FAAOS Beyond Limits: Stock or stock Options Capsico Health: Stock or stock Options Cleveland Clinic: Employee Custom Orthopaedic Solutions: Stock or stock Options Florida Board of Medicine: Board or committee member Health XL: Stock or stock Options Healthcare Outcomes Performance Company (HOPCo): Employee PeerWell: Stock or stock Options PT Genie: Stock or stock Options Sight Medical: Stock or stock Options Stryker: IP royalties.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"339"}}