Osteoporosis is a major health issue worldwide with considerable economic consequences and adverse effects on quality of life.
In arthroplasties, poor bone quality (i.e., poor bone structure) and low bone mineral density, eventually weak bone strength is crucial for the survival of implants. For longer durability of the implants, these factors should be assessed further and efforts should be made to resolve them.
The rates of bone production and destruction can be evaluated through a meticulous assessment of the bone matrix components released in the bloodstream and excreted in the urine. Biomarkers of formation include bone-specific alkaline phosphatase, osteocalcin and biomarkers of resorption: N-terminal and C-terminal cross-linking telopeptide of type I collagen.
Cement fixation of the implants is recommended to minimize the risk of peri-prosthetic fracture and aseptic loosening.
In Medicare patients, cemented femoral fixation outperformed cementless fixation in terms of the length of hospital stay, readmission, cost of care, and reoperation.