ABSTRACT
Total knee replacement (TKR) is a successful procedure for end-stage osteoarthritis (OA) of the knee, which is predicted to be performed with increasing frequency. The relationship between OA of the knee and osteoporosis (OP) is complex and controversial. The presence of OA may inhibit the effective diagnosis of OP. OP is of particular significance in the context of a TKR as it increases the risk of implant failure, impaired function, and periprosthetic fracture. Dual-energy x-ray absorptiometry studies have estimated the degree of bone mineral density (BMD) after TKR. To mitigate against the complications of a reduction in BMD around a TKR, there has been much interest in the use of bisphosphonates (BP) and teriparatide following TKR, with the aim of decreasing BMD loss through the inhibition of bone resorption. Future research is needed to clarify protocols to effectively diagnose OP in patients requiring TKR and identify those who may be at risk of a poor outcome as a result of this. These patients may then benefit from pharmacologic treatment to improve peri-implant BMD.
