Metabolic bone disease care practice patterns and the correlation between computed tomography and fracture risk assessment tool score in patients undergoing total shoulder arthroplasty
Abstract
Background: Periprosthetic fracture following total shoulder arthroplasty (TSA) is a devastating complication. Metabolic bone disease has been shown to increase the incidence of fracture. However, the state of metabolic bone care in this population is poorly studied. The purpose of this study is to elucidate the state of metabolic bone care in patients undergoing TSA. We also aim to study the association between computed tomography (CT)‑derived Hounsfield unit (HU) measurements and Fracture Risk Assessment Tool (FRAX) scores in this population.
Materials and methods: Consecutive adult patients who underwent primary TSA between January 1, 2019, and December 31, 2023, at a single institution were included in the study. Demographic variables, medical and surgical history, medications, pre-operative and post-operative dual-energy X-ray absorptiometry scans, and post-operative follow-up data were collected retrospectively. FRAX scores were calculated for each patient. Patients with FRAX major score >20 or FRAX hip score >3 were classified as "high-risk" for metabolic bone disease‑related complications. HU measurements for the humeral head and glenoid from pre-operative CT were collected for patients with available CT scans. T-tests were used to compare high-risk vs. low-risk patients. Logistic and linear regression analyses were used to examine factors associated with higher metabolic bone disease‑associated risk.
Results: Overall, 831 patients were included in the study, with…
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