How to Prevent a Feared Complication After Joint Replacement

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How to Prevent a Feared Complication After Joint Replacement
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Knee and hip replacements significantly improve a patient's QoL. But a periprosthetic fracture can be a major setback for the patient's mobility, and the consequences can be life-threatening. BoneHealth MedTwitter

, the bone surrounding the new joint is weaker than the metal of the prosthesis, and the metal can rip out of the bone, Bukata toldA periprosthetic fracture should be recognized as an osteoporotic fracture, too, although these fractures have not typically been categorized that way, she said.

A patient's initial visit to their primary care doctor because of joint pain is an opportunity to check on and promote their bone health, given that they might be a candidate for surgery in the future, Bukata said. Strengthening, maintaining, and protecting bone should be seen as a long-term investment in the patient's success after a joint replacement. That said,"There is no clear evidence or protocol for us to follow," she said."The mantra at UCSD now is, let's keep it simple. Get the patient on track. And then we can always refine things as we continue to treat the patient."

"It's a big deal to try to repair it," Russell said."Sometimes you need to revise the joint, or sometimes you need to put lots more hardware in." Surgeons increasingly appreciate the need to pay attention to the quality of the bone before they operate, she said. For Matzkin, a fragility fracture is a red flag that the patient's bone density is probably not optimal. In such cases, she prepares for various scenarios during surgery, such as a screw not holding in a low-density bone.

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