{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:15:07Z","timestamp":1790201707243,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Am Acad Orthop Surg","JAAOS"],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Osteoporosis is a widespread and growing medical condition, with significant orthopaedic implications. However, the effect of osteoporosis on outcomes after total shoulder arthroplasty (TSA) is not well understood. The goal of the present study was to characterize the incidence of osteoporosis in patients undergoing shoulder arthroplasty and to examine whether patients with osteoporosis undergoing anatomic and reverse TSA are at an increased risk of prosthetic-related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Complication rates were calculated for patients with osteoporosis who underwent anatomic and reverse TSA as separate cohorts within 2 years of surgery including loosening\/osteolysis, periprosthetic fracture, periprosthetic dislocation, and revision shoulder arthroplasty and compared using a multivariable logistic regression analysis to control for patient demographics and comorbidities during comparisons, including the indication for reverse TSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The prevalence of an osteoporosis diagnosis at the time of surgery was 14.3% for anatomic TSA patients and 26.2% of reverse TSA patients. Anatomic TSA patients with osteoporosis experienced significantly higher rates of periprosthetic fracture (odds ratio [OR], 1.49;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.017) and revision shoulder arthroplasty (OR, 1.21;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009) within 2 years of surgery compared with matched controls without osteoporosis. Patients in the reverse TSA group with osteoporosis also had significantly higher rates of periprosthetic fracture (OR, 1.86;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) and revision shoulder arthroplasty (OR, 1.42;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005) within 2 years of surgery compared with matched controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>A significant number of patients undergoing both anatomic and reverse TSA have a concurrent diagnosis of osteoporosis. Osteoporosis represents a significant independent risk factor for periprosthetic fracture and revision shoulder arthroplasty within 2 years of surgery, regardless of the type of implant. Patients with osteoporosis should be counseled on their increased risk of complications after shoulder arthroplasty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5435\/jaaos-d-18-00537","type":"journal-article","created":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T23:24:12Z","timestamp":1559258652000},"page":"121-127","source":"Crossref","is-referenced-by-count":83,"title":["Osteoporosis and Implant-Related Complications After Anatomic and Reverse Total Shoulder Arthroplasty"],"prefix":"10.5435","volume":"28","author":[{"given":"Aaron J.","family":"Casp","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Montgomery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jourdan M.","family":"Cancienne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen F.","family":"Brockmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230714","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1007\/s00264-014-2317-y","article-title":"Osteoporosis and the orthopaedic surgeon: Basic concepts for successful co-management of patients' bone health","volume":"38","author":"Farmer","year":"2014","journal-title":"Int Orthop"},{"key":"R2-20230714","doi-asserted-by":"crossref","first-page":"171","DOI":"10.5312\/wjo.v7.i3.171","article-title":"Major osteoporotic fragility fractures: Risk factor updates and societal impact","volume":"7","author":"Pisani","year":"2016","journal-title":"World J Orthop"},{"key":"R3-20230714","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/BF01623184","article-title":"Hip fractures in the elderly: A world-wide projection","volume":"2","author":"Cooper","year":"1992","journal-title":"Osteoporos Int"},{"key":"R4-20230714","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1016\/S0140-6736(02)08657-9","article-title":"Epidemiology and outcomes of osteoporotic fractures","volume":"359","author":"Cummings","year":"2002","journal-title":"Lancet"},{"key":"R5-20230714","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/PL00004148","article-title":"World-wide projections for hip fracture","volume":"7","author":"Gullberg","year":"1997","journal-title":"Osteoporos Int"},{"key":"R6-20230714","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s001980200069","article-title":"A new approach to the development of assessment guidelines for osteoporosis","volume":"13","author":"Kanis","year":"2002","journal-title":"Osteoporos Int"},{"issue":"suppl 2","key":"R7-20230714","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1007\/s00198-004-1702-6","article-title":"Epidemiology of osteoporotic fractures","volume":"16","author":"Johnell","year":"2005","journal-title":"Osteoporos Int"},{"key":"R8-20230714","doi-asserted-by":"crossref","first-page":"e982","DOI":"10.3928\/01477447-20170925-01","article-title":"Increasing use of reverse total shoulder arthroplasty for proximal humerus fractures in elderly patients","volume":"40","author":"Rajaee","year":"2017","journal-title":"Orthopedics"},{"key":"R9-20230714","doi-asserted-by":"crossref","first-page":"271","DOI":"10.11138\/mltj\/2017.7.2.271","article-title":"Reverse total shoulder versus angular stable plate treatment for proximal humeral fractures in over 65 years old patients","volume":"7","author":"Giardella","year":"2017","journal-title":"Muscles Ligaments Tendons J"},{"key":"R10-20230714","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.2106\/JBJS.L.01115","article-title":"Comparison of hemiarthroplasty and reverse arthroplasty for treatment of proximal humeral fractures","volume":"95","author":"Namdari","year":"2013","journal-title":"J Bone Joint Surg"},{"key":"R11-20230714","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2106\/JBJS.F.01351","article-title":"Fracture displacement and screw cutout after open reduction and locked plate fixation of proximal humeral fractures [corrected]","volume":"90","author":"Owsley","year":"2008","journal-title":"J Bone Joint Surg Am"},{"key":"R12-20230714","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1302\/0301-620X.93B1.25087","article-title":"The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement","volume":"93","author":"Meek","year":"2011","journal-title":"J Bone Joint Surg Br"},{"key":"R13-20230714","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1177\/2151458512462870","article-title":"A review of periprosthetic femoral fractures associated with total hip arthroplasty","volume":"3","author":"Marsland","year":"2012","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"R15-20230714","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/ageing\/afp222","article-title":"The prevalence of osteoporosis in patients with severe hip and knee osteoarthritis awaiting joint arthroplasty","volume":"39","author":"Lingard","year":"2010","journal-title":"Age Ageing"},{"key":"R16-20230714","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.bone.2006.11.013","article-title":"The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement","volume":"40","author":"M\u00e4kinen","year":"2007","journal-title":"Bone"},{"key":"R17-20230714","first-page":"247","article-title":"Total hip replacement in osteoarthritis: The role of bone metabolism and its complications","volume":"12","author":"Bottai","year":"2015","journal-title":"Clin Cases Miner Bone Metab"},{"key":"R18-20230714","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.2106\/JBJS.H.00331","article-title":"Intraoperative periprosthetic fractures during total hip arthroplasty","volume":"90","author":"Davidson","year":"2008","journal-title":"J Bone Joint Surg Am"},{"key":"R19-20230714","first-page":"68","article-title":"Total hip arthroplasty periprosthetic femoral fractures: A review of classification and current treatment","volume":"71","author":"Schwarzkopf","year":"2013","journal-title":"Bull Hosp Joint Dis"},{"key":"R20-20230714","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jor.2018.01.006","article-title":"Periprosthetic hip fractures: A review of the economic burden based on length of stay","volume":"15","author":"Lyons","year":"2018","journal-title":"J Orthop"},{"key":"R21-20230714","doi-asserted-by":"crossref","first-page":"2734","DOI":"10.1016\/j.arth.2018.05.015","article-title":"The \u201cBundle Busters\u201d: Incidence and costs of postacute complications following total joint arthroplasty","volume":"33","author":"Luzzi","year":"2018","journal-title":"J Arthroplasty"},{"key":"R22-20230714","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3109\/17453674.2012.678798","article-title":"Low BMD affects initial stability and delays stem osseointegration in cementless total hip arthroplasty in women: A 2-year RSA study of 39 patients","volume":"83","author":"Aro","year":"2012","journal-title":"Acta Orthop"},{"key":"R23-20230714","doi-asserted-by":"crossref","first-page":"98","DOI":"10.3109\/10929088.2010.515419","article-title":"Stress concentration near pin holes associated with fracture risk after computer navigated total knee arthroplasty","volume":"15","author":"Kim","year":"2010","journal-title":"Comput Aided Surg"},{"key":"R24-20230714","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s12306-016-0409-0","article-title":"Reverse total shoulder arthroplasty for the management of fractures of the proximal humerus: A systematic review","volume":"100","author":"Longo","year":"2016","journal-title":"Musculoskelet Surg"},{"key":"R25-20230714","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S1058-2746(02)86804-5","article-title":"A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: Results of a multicenter study","volume":"12","author":"Edwards","year":"2003","journal-title":"J Shoulder Elbow Surg"},{"key":"R26-20230714","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1016\/j.jse.2016.02.012","article-title":"Reverse shoulder arthroplasty for proximal humeral fractures: Outcomes comparing primary reverse arthroplasty for fracture versus reverse arthroplasty after failed osteosynthesis","volume":"25","author":"Shannon","year":"2016","journal-title":"J Shoulder Elbow Surg"},{"key":"R27-20230714","doi-asserted-by":"crossref","first-page":"3324","DOI":"10.1007\/s11999-011-2055-z","article-title":"Is reverse shoulder arthroplasty appropriate for the treatment of fractures in the older patient?: Early observations","volume":"469","author":"Lenarz","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"R29-20230714","doi-asserted-by":"crossref","first-page":"743","DOI":"10.2106\/JBJS.I.00919","article-title":"The assessment of fracture risk","volume":"92","author":"Unnanuntana","year":"2010","journal-title":"J Bone Joint Surg Am"}],"container-title":["Journal of the American Academy of Orthopaedic Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.5435\/JAAOS-D-18-00537","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:47:57Z","timestamp":1787669277000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.5435\/JAAOS-D-18-00537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,1]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.5435\/jaaos-d-18-00537","relation":{},"ISSN":["1067-151X","1940-5480"],"issn-type":[{"value":"1067-151X","type":"print"},{"value":"1940-5480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,1]]}}}