title: [Endoprosthetic treatment of osteoporosis-related coxarthrosis : aspects of safe patient treatment].
abstract: BACKGROUND
  With increasing life expectancy the prevalence of osteoarthritis is also substantially rising. Patients aged between 65 and 75 years scheduled for total joint arthroplasty suffer from undetected osteoporosis in 20-25% of cases.
  
  
  OBJECTIVE
  How to determine osteoporosis during preoperative workup? Which conclusions can be drawn for the operation treatment and the postoperative course?
  
  
  METHODS
  The literature dealing with the prevalence of osteoporosis, perioperative complications of total hip arthroplasty, selected register informations, guidelines for diagnostics and treatment of osteoporosis and for the postoperative treatment are summarized and discussed.
  
  
  RESULTS
  The fracture risk is determined according to the guidelines of the Dachverband Osteologie (DVO, Governing Body on Osteology). The implant and the anchorage are selected based on the risk of suffering from osteoporosis. An intraoperative fracture and early aseptic loosening are the main operative risk factors. For the postoperative course in addition to education about arthroplasty, adequate support for prevention of falls is mandatory. Continuous physiotherapy with muscular strengthening is advisable. The long-term medication should be checked for risks in the PRISCUS list of potentially inappropriate medication in the elderly and non-steroidal anti-inflammatory drugs (NSAIDs) should not be prescribed in patients with cardiac comorbidities. Patients with confirmed osteoporosis should be treated with antiresorptive agents.
authors.affiliation: UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Carl-Gustav Carus, Technische Universität Dresden AöR, Fetscherstr. 74, 01307, Dresden, Deutschland, Stephan.Kirschner@uniklinikum-dresden.de.
authors.forename: S
authors.initials: S
authors.lastname: Kirschner
authors.forename: A
authors.initials: A
authors.lastname: Hartmann
authors.forename: K-P
authors.initials: KP
authors.lastname: Günther
authors.forename: C
authors.initials: C
authors.lastname: Hamann
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation / Q000592:standards*; D006801:Humans; D009985:Orthopedics / Q000592:standards; D015207:Osteoarthritis, Hip / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D061214:Patient Safety / Q000592:standards; D017410:Practice Guidelines as Topic; D011292:Premedication / Q000592:standards*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents