Comparison of Teriparatide and Denosumab in Patients Switching From Long-Term Bisphosphonate Use

Abstract Context Teriparatide and denosumab are effective treatments for osteoporosis and typically reserved as second-line options after patients have used bisphosphonates. However, limited head-to-head comparative effectiveness data exist between teriparatide and denosumab. Objective We compared changes in bone mineral density (BMD) between groups treated with teriparatide or denosumab after using bisphosphonates, focusing on the change in BMD while on either drug over 2 years. Design Observational cohort study using electronic medical records from two academic medical centers in the United States. Participants The study population included osteoporotic patients >45 years who received bisphosphonates >1 year before switching to teriparatide or denosumab. Outcome Measures Annualized BMD change from baseline at the lumbar spine, total hip, and femoral neck. Results Patients treated with teriparatide (n = 110) were compared with those treated with denosumab (n = 105); the mean (SD) age was 70 (10) years and median duration (interquartile range) of bisphosphonate use was 7.0 (5.6 to 9.7) years. Compared with denosumab users, teriparatide users had higher annualized BMD change at the spine by 1.3% (95% CI 0.02, 2.7%) but lower at the total hip by −2.2% (95% CI −2.9 to −1.5%) and the femoral neck by −1.1% (95% CI −2.1 to −0.1%). Those who switched to teriparatide had a transient loss of hip BMD for the first year, with no overall increase in the total hip BMD over 2 years. Conclusions Among patients who use long-term bisphosphonates, the decision of switching to teriparatide should be made with caution, especially for patients at high risk of hip fracture.

Download Full-text

A Model of BMD Changes After Alendronate Discontinuation to Guide Postalendronate BMD Monitoring

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-1193 ◽

2014 ◽

Vol 99 (11) ◽

pp. 4094-4100 ◽

Cited By ~ 8

Author(s):

Brian McNabb ◽

Eric Vittinghoff ◽

Richard Eastell ◽

Ann V. Schwartz ◽

Douglas C. Bauer ◽

...

Keyword(s):

Multicenter Clinical Trial ◽

Intervention Trial ◽

Mineral Density ◽

Management Change ◽

Total Hip ◽

T Score ◽

Hip Bmd ◽

The Given

Context: Women stopping alendronate are commonly monitored with serial bone mineral density (BMD) measurements, yet no information exists on how frequently or for whom these measurements should be performed. Objective: The objective of the study was to develop a tool to guide post-alendronate BMD monitoring. Design: A predictive model was constructed to estimate the time until a given percentage of women's BMD T-scores drop below a given threshold that indicates a management change (such as retreatment) would be considered. This model was then used to estimate the time it would take for groups of women defined by their baseline BMDs to drop below the given threshold. Setting: Data were derived from the Fracture Intervention Trial Long Term Extension (FLEX), the largest multicenter clinical trial of its type to date. Participants: Four hundred four women who had received an average of 5.1 years of alendronate during the Fracture Intervention Trial and were subsequently observed for 5 treatment-free years (on placebo) during the FLEX trial were used to estimate the change in BMD over time. Results: If a management change such as alendronate reinitiation would be considered when BMD T-score drops below −2.5, the model shows that women with total hip BMD greater than −1.9 T-scores at the time of alendronate discontinuation have less than a 20% probability that at follow-up, monitoring BMD will be below the threshold within 5 years. The model performed similarly, and results are provided over a range of management change thresholds from −1.75 to −3 T-scores. Conclusions: Using the tool developed in this analysis, it is possible to estimate when BMD repeat measurement after alendronate discontinuation could potentially be useful. Measuring BMD within 5 years after alendronate discontinuation is unlikely to change management for women with total hip BMD 0.6 T-scores above a prespecified retreatment threshold within the range of −1.75 to −3 T-scores.

Download Full-text

Reduction in femoral neck and total hip bone mineral density following hospitalisation for diabetes-related foot ulceration

Scientific Reports ◽

10.1038/s41598-021-02233-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Marcel M. Nejatian ◽

Salar Sobhi ◽

Blake N. Sanchez ◽

Kathryn Linn ◽

Laurens Manning ◽

...

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Fat Mass ◽

Mineral Density ◽

Contralateral Limb ◽

Foot Ulceration ◽

Total Hip ◽

Hip Bmd

AbstractManagement of diabetes-related foot ulceration (DFU) includes pressure offloading resulting in a period of reduced activity. The metabolic effects of this are unknown. This study aims to investigate changes in bone mineral density (BMD) and body composition 12 weeks after hospitalisation for DFU. A longitudinal, prospective, observational study of 22 people hospitalised for DFU was conducted. Total body, lumbar spine, hip and forearm BMD, and total lean and fat mass were measured by dual-energy X-ray absorptiometry (DXA) during and 12 weeks after hospitalisation for DFU. Significant losses in total hip BMD of the ipsilateral limb (− 1.7%, p < 0.001), total hip BMD of the contralateral limb (− 1.4%, p = 0.005), femoral neck BMD of the ipsilateral limb (− 2.8%, p < 0.001) and femoral neck BMD of the contralateral limb (− 2.2%, p = 0.008) were observed after 12 weeks. Lumbar spine and forearm BMD were unchanged. HbA1c improved from 75 mmol/mol (9.2%) to 64 mmol/mol (8.0%) (p = 0.002). No significant changes to lean and fat mass were demonstrated. Total hip and femoral neck BMD decreased bilaterally 12 weeks after hospitalisation for DFU. Future research is required to confirm the persistence and clinical implications of these losses.

Download Full-text

Rates of Bone Loss Among Women Initiating Antidepressant Medication Use in Midlife

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-1971 ◽

2013 ◽

Vol 98 (11) ◽

pp. 4355-4363 ◽

Cited By ~ 26

Author(s):

Susan J. Diem ◽

Kristine Ruppert ◽

Jane A. Cauley ◽

YinJuan Lian ◽

Joyce T. Bromberger ◽

...

Keyword(s):

Lumbar Spine ◽

Bone Loss ◽

Femoral Neck ◽

Serotonin Reuptake ◽

The United States ◽

Community Dwelling ◽

Mineral Density ◽

Total Hip ◽

Antidepressant Medications ◽

Rate Of Bone Loss

Context: Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. Objective: The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. Design and Setting: We conducted a prospective cohort study at five clinical centers in the United States. Participants: The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). Exposure: The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. Main Outcome Measures: BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. Results: BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (<16 vs ≥16). Conclusions: In this cohort of middle-aged women, use of SSRIs and TCAs was not associated with an increased rate of bone loss at the spine, total hip, or femoral neck.

Download Full-text

Urinary Phthalate Biomarkers and Bone Mineral Density in Postmenopausal Women

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab189 ◽

2021 ◽

Author(s):

Katherine W Reeves ◽

Gabriela Vieyra ◽

Nydjie P Grimes ◽

Jaymie Meliker ◽

Rebecca D Jackson ◽

...

Keyword(s):

Femoral Neck ◽

Postmenopausal Women ◽

Endocrine Disrupting Chemicals ◽

Estimating Equation ◽

Mineral Density ◽

Cross Sectional ◽

Total Hip ◽

Physiologic Function ◽

Hip Bmd ◽

Nested Case Control

Abstract Background Phthalates are endocrine-disrupting chemicals that could disrupt normal physiologic function, triggering detrimental impacts on bone. We evaluated associations between urinary phthalate biomarkers and BMD in postmenopausal women participating in the prospective Women’s Health Initiative (WHI). Methods We included WHI participants enrolled in the BMD substudy and selected for a nested case-control study of phthalates and breast cancer (N=1255). We measured thirteen phthalate biomarkers and creatinine in 2-3 urine samples per participant collected over 3 years, when all participants were cancer-free. Total hip and femoral neck BMD were measured at baseline and year 3, concurrent with urine collection, via dual energy x-ray absorptiometry. We fit multivariable generalized estimating equation models and linear mixed effects models to estimate cross-sectional and longitudinal associations, respectively, with stratification on postmenopausal hormone therapy (HT) use. Results In cross-sectional analyses, mono-3-carboxypropyl phthalate and the sum of di-isobutyl phthalate metabolites were inversely associated with total hip BMD among HT non-users, but not among HT users. Longitudinal analyses showed greater declines in total hip BMD among HT non-users and with highest concentrations of mono-3-carboxyoctyl phthalate (-1.80%, 95% CI -2.81 – -0.78%) or mono-carboxynonyl phthalate (-1.84%, 95% CI -2.80 – -0.89%); similar associations were observed with femoral neck BMD. Among HT users, phthalate biomarkers were not associated with total hip or femoral neck BMD change. Discussion Certain phthalate biomarkers are associated with greater percent decreases in total hip and femoral neck BMD. These findings suggest that phthalate exposure may have clinically important effects on BMD, and potentially fracture risk.

Download Full-text

AB0617 BISPHOSPHONATES DANS L’OSTÉOPOROSE ET LE RISQUE D’OSTÉONÉCROSE DE LA MÂCHOIRE, ENVIRON 896 CAS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2399 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1343.1-1343

Author(s):

A. R. Halidou ◽

K. Nassar ◽

S. Janani

Keyword(s):

Lumbar Spine ◽

Femoral Neck ◽

Corticosteroid Therapy ◽

Osteonecrosis Of The Jaw ◽

Mineral Density ◽

Duration Of Treatment ◽

Treatment Of Osteoporosis ◽

Total Hip ◽

T Score

Background:Bisphosphonates (BF) are used in the treatment of osteoporosis, Paget’s disease of bone, hypercalcemia and in patients with cancer. When used to treat osteoporosis, the optimal duration of treatment is 3 to 5 years; however, their long-term use has been rarely associated with osteonecrosis of the jaw.Objectives:To assess the risk of developing osteonecrosis of the jaw in patients followed for osteoporosis and on bisphosphonates (BP).Methods:Type of study: retrospective study conducted at the rheumatology department of the IBN ROCHD CHU in Casablanca.Duration: from October 2013 to October 2020 (7 years).Inclusion criteria: all patients followed for osteoporosis in the weakening osteopathies unit of the bone and treated with oral or intravenous bisphosphonates.Exclusion criteria: patients followed for other than osteoporosis.Results:896 patients were treated during this period. The average age was 62.74 years (28 to 90 years), of which 85.16% were women and 14.84% were men, for a sex ratio (F / M) of 5.74. As a history, 18.75% of patients are diabetic, 26.56% followed for breast neoplasm, 14.06% of patients had received long-term corticosteroid therapy for various pathologies such as chronic inflammatory rheumatism. Osteoporosis was postmenopausal in 687 patients, ie 76.67% of cases, 14.06% after long-term corticosteroid therapy, 8.15% following hormone therapy (anti-aromatases) and 6.92% following chemotherapy; note that 18.16% of these patients were found in at least two of the situations. The mean bone mineral density (BMD), T-score pair considered in all [T-score (BMD)] is -3 (0.736) in the lumbar spine (L1-L4), -2.9 (0.658) at the femoral neck, -2.6 (0.804) at the total hip before the start of treatment. 69.97% of the patients were put on Alendronic acid, 12.50% on Residronic acid, 10.93% on Zolidronic acid, 3.46% on Pamidronic acid and 3.14% received Strontium Ranelate, note that before the start of the treatment all the patients benefited from a dental consultation followed by care of any lesions, the bisphosphonates were only introduced after having ruled out all their dental contraindications, the average duration of treatment for all the molecules was 4.71 years (2 to 5 years) and no patient developed osteonecrosis of the jaw. The change in control BMD on average after 2 years of treatment was -2.7 (0.782) at the lumbar spine, -2.6 (0.749) at the femoral neck and -2.4 (0.713) at the hip total, after 5 years -2.4 (0.874) at the spine, -2.1 (0.809) at the femoral neck and -1.93 (861) at the total hip.Conclusion:The occurrence of ONJ in the treatment of osteoporosis with the use of BFs is rare, and appears to be unpredictable; but maintaining therapeutic caution, consisting in diagnosing and treating any dental lesions before starting treatment, can considerably reduce or even cancel the risk of occurrence; especially in patients treated with long-term intravenous pamidronate.References:[1]Dr Halidou Idrissa Abdoul-Rahamane, Pr Kawtar Nassar, PR Saadia Janani.[2]Rheumatology department of the IBN ROCHD CHU in CASABLANCA. Casablanca Faculty of Medicine and Pharmacy. Hassan II University. MoroccoDisclosure of Interests:None declared.

Download Full-text

ESR1 polymorphism (rs2234693) influences femoral bone mass in patients with Turner syndrome

Endocrine Connections ◽

10.1530/ec-19-0398 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1513-1519 ◽

Cited By ~ 1

Author(s):

Renata C Scalco ◽

Ericka B Trarbach ◽

Edoarda V A Albuquerque ◽

Thais K Homma ◽

Thais H Inoue-Lima ◽

...

Keyword(s):

Femoral Neck ◽

Turner Syndrome ◽

Hormone Replacement ◽

Estrogen Therapy ◽

Tertiary Hospital ◽

Breast Development ◽

Mineral Density ◽

Total Hip ◽

Individual Outcomes ◽

Hip Bmd

Most patients with Turner syndrome (TS) need hormone replacement therapy because of hypergonadotropic hypogonadism; individual outcomes, however, are highly variable. Our objective was to assess the influence of five estrogen receptor 1 gene (ESR1) polymorphisms (rs543650, rs1038304, rs2046210, rs2234693 and rs9340799) on adult height, breast development, uterine volume and bone mineral density (BMD). We studied 91 TS patients from a tertiary hospital using adult estrogen dose. In our group, ESR1 rs2234693 was associated with femoral neck and total hip BMD, and it accounted for around 10% of BMD variability in both sites (P < 0.01). Patients homozygous for C allele in this polymorphism had significantly lower femoral neck BMD (0.699 ± 0.065 g/cm2 vs 0.822 ± 0.113 g/cm2, P = 0.008) and total hip BMD (0.777 ± 0.118 g/cm2 vs 0.903 ± 0.098 g/cm2, P = 0.009) than patients homozygous for T allele. The other four ESR1 polymorphisms were not able to predict any of the above estrogen therapy outcomes in an isolated manner. Patients homozygous for the haplotype GCG formed by polymorphisms rs543650, rs2234693 and rs9340799 had an even more significantly lower femoral neck BMD (0.666 ± 0.049 vs 0.820 ± 0.105 g/cm2, P = 0.0047) and total hip BMD (0.752 ± 0.093 vs 0.908 ± 0.097 g/cm2, P = 0.0029) than patients homozygous for haplotypes with a T allele in rs2234693. In conclusion, homozygosity for C allele in ESR1 rs2234693 and/or for GCG haplotype appears to be associated with lower femoral neck and total hip BMD. We believe that the identification of polymorphisms related to estrogen outcomes may contribute to individualization of treatment in TS.

Download Full-text

Impact of androgen deprivation therapy (ADT) on bone mineral density (BMD) over 3 years in men with nonmetastatic prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.193 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 193-193

Author(s):

Shabbir M.H. Alibhai ◽

Hassanabbas Z. Mohamedali ◽

Abbas H. Panju ◽

Narhari Timilshina ◽

Henriette Breunis ◽

...

Keyword(s):

Prostate Cancer ◽

Vitamin D ◽

Lumbar Spine ◽

Femoral Neck ◽

Control Group ◽

First Year ◽

Mineral Density ◽

Prospective Longitudinal Study ◽

Total Hip ◽

Prospective Longitudinal

193 Background: Decreased BMD is a common side effect of ADT, leading to increased fracture risk. Although loss of BMD appears to be greatest within the first 12 months of starting ADT, few data on BMD changes exist beyond 12 months, and other risk factors for bone loss in men on ADT are not well-characterized. Methods: Men age 50+ with non-metastatic prostate cancer and starting continuous ADT were enrolled in a prospective longitudinal study. BMD was determined by dual-energy x-ray absorptiometry at baseline and yearly for 3 years. A matched control group of men with prostate cancer but not on ADT was also enrolled. Medication use was recorded at each visit. Multivariable regression analyses were done to examine predictors of BMD loss. Results: 80 ADT users and 80 controls were enrolled (mean age 69.4 y); 49.7% had osteopenia and 4.6% had osteoporosis at baseline. ADT was associated with significant losses in lumbar spine BMD in year 1 compared to controls (p=0.004) and trends towards greater declines at femoral neck and total hip sites. Changes in year 2 and 3 were much smaller and not statistically different from controls (Table). Vitamin D use but not calcium use was associated with improved BMD at the lumbar spine in year 1 (+5.77%, p=0.006) with positive trends at other sites (+2.19% femoral neck, +1.76% total hip) primarily in year 1. Age was not associated with changes in BMD. Conclusions: Losses in BMD with ADT use are greatest at the lumbar spine and in the first year compared to years 2 and 3 and are independent of age. Vitamin D appears to be protective particularly in the first year of ADT use. [Table: see text]

Download Full-text

Dose-dependent effects of inhaled corticosteroids on bone mineral density in postmenopausal women with asthma or COPD: A registry-based cohort study

10.1101/184937 ◽

2017 ◽

Author(s):

Wenjia Chen ◽

Kate M. Johnson ◽

J. Mark FitzGerald ◽

Mohsen Sadatsafavi ◽

William D. Leslie

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Postmenopausal Women ◽

Bone Mineral ◽

Mineral Density ◽

Cross Sectional ◽

Total Hip ◽

Hip Bmd ◽

Sectional Analysis

ABSTRACTBackgroundThe effect of long-term inhaled corticosteroid (ICS) therapy on the bone health of older adults remains unclear due to its possible impact on bone mineral density (BMD).ObjectiveTo evaluate, cross-sectionally and longitudinally, the impact of ICS use on BMD in postmenopausal women with asthma or chronic obstructive pulmonary disease (COPD).MethodsWe used a population-based bone densitometry registry linked with administrative health data of the province of Manitoba, Canada (1999–2013), to identify women with diagnosed asthma or COPD. ICS use was defined as cumulative dispensed days prior to baseline BMD (cross-sectional analysis), and medication possession ratio (MPR) between two BMD measurements (longitudinal analysis). Results were adjusted for multiple covariates including the underlying respiratory diagnosis and its severity.ResultsIn the cross sectional analysis, compared with non-users, women with the highest tertile of prior ICS exposure had lower baseline BMD at the femoral neck (-0.09 standard deviations [SD] below a healthy young adult, 95% CI: −0.16, −0.02) and total hip (-0.14 SD, 95% CI: −0.22, −0.05), but not at the lumbar spine. Longitudinally, the highest tertile of ICS exposure was associated with a slight decline in total hip BMD relative to non-users (-0.02 SD/year, 95% CI: −0.04, −0.01), with no significant effect at the femoral neck and lumbar spine. Middle and lower tertiles of ICS use had no significant effects.ConclusionHigh exposure to ICS was associated with a small adverse effect on baseline hip BMD and total hip BMD loss in post-menopausal women with asthma or COPD.

Download Full-text

Effects of Teriparatide in Postmenopausal Women with Osteoporosis on Prior Alendronate or Raloxifene: Differences between Stopping and Continuing the Antiresorptive Agent

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2008-2719 ◽

2009 ◽

Vol 94 (10) ◽

pp. 3772-3780 ◽

Cited By ~ 110

Author(s):

Felicia Cosman ◽

Robert A. Wermers ◽

Christopher Recknor ◽

Karen F. Mauck ◽

Li Xie ◽

...

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Turnover ◽

Postmenopausal Women ◽

Bone Mineral ◽

Mineral Density ◽

Total Hip ◽

Hip Bmd ◽

Switch Group

Objective: The aim of the study was to assess adding vs. switching to teriparatide 20μg/d in patients on alendronate or raloxifene. Design: We conducted a randomized, open-label trial. Patients and Interventions: Postmenopausal women with osteoporosis on alendronate or raloxifene for at least 18 months added teriparatide (Add groups) or switched to teriparatide (Switch groups) for 18 months. Main Outcome Measures: We measured bone turnover markers (BTM) and bone mineral density (BMD). Results: In the alendronate stratum, increases in BTM were smaller in the Add vs. Switch group [6-month PINP (64 vs. 401%); bone ALP (15 vs. 71%); βCTX (27 vs. 250%); all P < 0.001]. However, at 6 months, total hip BMD increased more in the Add vs. Switch group (1.4 vs. −0.8%; P = 0.002). In the Add vs. Switch group, 18-month BMD increments were higher in lumbar spine (8.4 vs. 4.8%; P = 0.003) and total hip (3.2 vs. 0.9%; P = 0.02), but not in femoral neck (2.7 vs. 2.3%; P = 0.75). In the raloxifene stratum, increases in BTM were also smaller in the Add vs. Switch group [6-month PINP (131 vs. 259%; P < 0.001), bone ALP (31 vs. 44%; P = 0.035), and βCTX (67 vs. 144%; P = 0.001)]. At 6 months, total hip BMD increase was greater in the Add vs. Switch group (1.8 vs. 0.5%; P = 0.028). At 18 months, increases in lumbar spine (9.2 vs. 8.1%), total hip (2.8 vs. 1.8%), and femoral neck (3.8 vs. 2.2%) were not significantly different between groups. Conclusions: In women with osteoporosis treated with antiresorptives, greater bone turnover increases were achieved by switching to teriparatide, whereas greater BMD increases were achieved by adding teriparatide. In patients treated with alendronate or raloxifene, adding teriparatide results in a greater bone mineral density response, and appears to be at least as safe as switching to teriparatide.

Download Full-text

The association between bone mineral density and postoperative drainage volume following cruciate-substituting primary total knee arthroplasty: a cross-sectional study

Knee Surgery and Related Research ◽

10.1186/s43019-021-00107-1 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Yuthasak Peerakul ◽

Jirapong Leeyaphan ◽

Karn Rojjananukulpong

Keyword(s):

Blood Loss ◽

Primary Total Knee Arthroplasty ◽

Cross Sectional Study ◽

Postoperative Blood Loss ◽

Mineral Density ◽

Cross Sectional ◽

Total Hip ◽

Drainage Volume ◽

Hip Bmd ◽

Postoperative Drainage

Abstract Background The prevalence of osteoporosis in patients who undergo a primary total knee arthroplasty (TKA) is increasing. Low bone mineral density (BMD) is related to unfavorable outcomes following TKA such as migration of uncemented tibial components. Postoperative blood loss in TKA is an important complication. Non-modifying predicting factors for postoperative blood loss in patients undergoing primary TKA need further elucidation. Studies on the association between BMD and blood loss after TKA are limited. We aimed to demonstrate the relationship between BMD and postoperative drainage volume following primary TKA. Methods A cross-sectional study was conducted between January 2014 and August 2020. A total of 119 primary varus osteoarthritis knees with BMD results were included in the study. Patients with secondary causes of osteoporosis were excluded. Results The median postoperative drainage volume of participants in the normal total hip BMD group and the normal trochanter BMD group was higher than that of patients in the low total hip BMD group and the low trochanter BMD group (285.0 ml vs 230.0 ml, P = 0.003; 282.5 ml vs 240.0 ml, P = 0.013, respectively). Multivariate regression analyses showed that operative time, spinal anesthesia, and normal total hip BMD status were significant predictive factors associated with increased postoperative drainage volume (P = 0.014, 0.022, and 0.013, respectively). No association was identified between the lumbar spine BMD status and postoperative drainage volume. Conclusions The relationship between BMD and postoperative blood loss in primary TKA was identified in this study. Normal total hip BMD was found to be associated with an increased postoperative drainage volume after primary TKA compared with low BMD.

Download Full-text