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Page 6 of 6 (page number not for citation purposes) The identification of low bone mass in postmenopausal women should be emphasized because of the severe complications. Although some experts should give advice to their patients, most physicians and patients in our country are not aware of osteoporosis. It is only appropriately diagnosed and treated in a very small proportion of patients, even if they had a prior history of osteoporotic fracture. Up to now, BMD measurement is still the golden standard of osteoporosis diagnosis. We recommended that physicians should identify women who are likely to have low BMD according to much more factors than OSTA risk index. The limitation of this study is that not all patients measured femoral neck BMD, so the data did not compared with OSTA index. Although BMD measurements of total hip and femoral neck were easily influenced by body position, they could be alternative sites for identifying osteoporosis, especially when false high lumbar spine BMD were found because of vertebral fractures, hyperostosis, aortic calcification, and so on. 5. Conclusion A risk index of osteoporosis like OSTA has its characteristic of calculating simply and quickly. But the validation of its use in our hospital for postmenopausal women who underwent LS BMD measurements by DXA was somewhat disappointed. The OSTA risk index may not be a very good method in identifying postmenopausal women at high risk of osteoporosis, as measured by DXA, in Sichuan Osteoporosis in Indian Patients Undergoing Elective Arthroplasty and Spinal Procedures: An Observational Study Dipak Dave , Sujoy K. Bhattacharjee , Dilip D. Shah , Amrithlal Mascerhans , Paresh C. Dey , Subramanian Arumugan , Vikas Mehra , Vinod Agarwal , Sandeep Garg , Satish Chandra Gore , Rajiv Raj Choudhry , Manish Mahajan , Suyash Bharat 1. Orthopedics, Healthcare Global (HCG) Hospital, Ahmedabad, IND 2. Orthopedics, Sarvodaya Hospital and Research Centre, Faridabad, IND 3. Orthopedics, Dr. Dilip Shah Clinic, Mumbai, IND 4. Orthopedics, Vikram Hospital, Bengaluru, IND 5. Orthopedics, CARE Hospitals, Bhubaneswar, IND 6. Orthopedics, Bharathirajaa Hospital and Research Centre Pvt Ltd., Chennai, IND 7. Orthopedics, Dr. Vikas Mehra Orthopedic Centre, Chandigarh, IND 8. Orthopedics, Lilavati Hospital and Research Centre, Mumbai, IND 9. Orthopedics, Health City Hospital, Lucknow, IND 10. Orthopedics, Dr. Satishchandra Gore Spine Clinic, Pune, IND 11. Orthopedics, Asutosh Hospital, Surat, IND 12. Pharmacology and Therapeutics, Cadila Healthcare Ltd., Ahmedabad, IND 13. Pharmacology, Swami Rama Himalayan University (SRHU), Dehradun, IND Corresponding author: Sujoy K. Bhattacharjee, propesi2020@gmail.com Abstract Background This is an observational study conducted to determine the prevalence of osteoporosis and osteopenia in patients undergoing elective arthroplasty and spinal procedures in India. Methods This observational, multicentre study included both male and female patients. Their bone mineral density and fracture risk were measured using dual-energy x-ray absorptiometry (DEXA) and Fracture Risk Assessment Tool (FRAX ®: Centre for Metabolic Bone Diseases, University of Sheffield, UK), respectively, in compliance with the guidelines for Good Epidemiological Practice (ISRCTN: 14543098). Results The study revealed that majority (76.4%; 97/127) of the patients had low BMD; over one-third had osteoporosis (39.4%; 50/127) or osteopenia (37%; 47/127). Among those undergoing total knee replacement (TKR)/total hip replacement (THR), majority (75.6%; 59/78) had low BMD (osteoporosis: 38.5% {30/78}; osteopenia: 37.2% {29/78}). Among the patients undergoing spinal procedures, all except two (93.10%; 27/29) had low BMD, two-thirds had osteoporosis (65.5%; 19/29), and around one-fourth had osteopenia (27.6%; 8/29). Radial BMD measurements showed higher prevalence of osteoporosis and osteopenia. Based on FRAX score, nearly 30% of patients were at a high risk of hip fracture in the next 10 years. As per National Osteoporosis Foundation (NOF) guidelines, most (59.79%; 58/97) patients with osteoporosis/osteopenia met criteria for pharmacological treatment. Conclusions Regular preoperative bone health evaluation should be adopted and osteoporosis/osteopenia patients should be adequately managed pharmacologically in India. Categories: Internal Medicine, Orthopedics, Osteopathic Medicine Keywords: india, fractures, bone density, arthroplasty, osteoarthritis, osteoporosis Introduction Osteoporosis, a skeletal disorder characterized by reduced bone strength, increased bone fragility, and a greater predisposition to fractures, is a major global public health problem [1,2]. Over 200 million people worldwide suffer from osteoporosis [3,4]. Factors contributing to vitamin D deficiency, such as genetics, darker skin, vegetarianism, and lactose intolerance, have led to a high prevalence of osteoporosis in India [5]. Approximately 50 million people in India have either osteoporosis or osteopenia, with a greater prevalence among men and postmenopausal women [6-8]. As osteoporosis and osteopenia are known to occur at a relatively young age in the Indian population [9], increasing longevity in Indians may further escalate this mounting threat to wellbeing [1,10].
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