Prevalence and Risk Factors of Osteoporosis in Chinese Postmenopausal Women Awaiting Total Knee Arthroplasty

Yuzhang Tao,1 Siying Tang,2 Xiao Huang,1 Hongwei Wang,1 Aiguo Zhou,1 Jian Zhang1 1Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 2Department of Clinical Nutrition, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of ChinaCorrespondence: Jian ZhangDepartment of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of ChinaEmail zhangjian@hospital.cqmu.edu.cnBackground: Total knee arthroplasty (TKA) complications associated with low bone quality are challenging for orthopaedic surgeons to treat, but little is known about bone quality in Chinese postmenopausal women awaiting TKA. This study investigated the incidence of osteoporosis (OP) and explored the preoperative risk factors for OP in this population.Methods: We retrospectively reviewed the data of Chinese postmenopausal women who were indicated for TKA between May 2017 and June 2020. The bone mineral density (BMD) of the hip and lumbar spine and multiple preoperative parameters were collected and analyzed. Binary logistic regression analysis was performed to identify independent risk factors for OP in this population.Results: A total of 204 postmenopausal women with advanced knee OA were included in the study (age: 69.7± 8.5 years; body mass index [BMI]: 25.5± 4.0 kg/m2). The OP prevalence among all participants was 59.8%, and the patients aged 60– 80 years had a significantly lower BMD than did the age/ethnicity-adjusted population. An age ≥ 60 years, a BMI< 25, and the presence of a varus knee deformity were independent risk factors for preoperative OP in the postmenopausal women awaiting TKA.Conclusion: The prevalence of OP in Chinese postmenopausal women awaiting TKA is higher than that in the age/ethnicity-adjusted normal population. An age ≥ 60 years, a BMI< 25, and the presence of a varus knee deformity are independent risk factors that can be used to predict preoperative OP in this population.Keywords: osteoporosis, postmenopausal women, total knee arthroplasty, Chinese, bone mineral density