Bone Defects and Osteoporosis

Osteoarthritis (OA) patients are increasing with the ageing population. It is not unusual to perform bilateral total knee replacements (TKA) in patients over 90 due to advances in preoperative and perioperative medical care. Therefore, there are needs for treating severe deformities, contractures and defects in these patients. The first part of this section focuses on the evaluation and treatment of bone defects. The latter section highlights the importance of identifying and treating osteoporosis as it reduces the rate of revision arthroplasties, and reduces the risk of peri-prosthetic fractures. The section describes how therapeutic agents affect bone mineral density and metabolic markers as well as their effects on implant fixation. There is an increasing need to consider bone quality especially in the elderly to ensure a good long-term outcome of joint replacement surgeries.