Ishikura Hisatoshi, Moro Toru, Tanaka Takeyuki, Kaminaga Naoto, Kato Kenichi, Iiboshi Mayu, Tanaka Sakae
Department of Orthopedics, The University of Tokyo, Tokyo, JPN.
Department of Orthopedic Surgery, The University of Tokyo, Tokyo, JPN.
Cureus. 2025 Jul 6;17(7):e87396. doi: 10.7759/cureus.87396. eCollection 2025 Jul.
Total hip arthroplasty (THA) alleviates pain and improves walking ability and quality of life in patients with hip osteoarthritis (OA). However, its effect on systemic bone mineral density (BMD) remains unclear. In this study, we investigated the effect of THA on systemic BMD in postmenopausal women with hip OA using an artificial intelligence (AI)-assisted osteoporosis diagnostic support system that estimates BMD solely using posteroanterior chest radiographs.
This retrospective observational study included postmenopausal Japanese women aged 50-59 years who underwent bilateral THA on separate occasions at our institution between 2007 and 2023. BMD was estimated using our AI-assisted osteoporosis diagnostic system that uses posteroanterior chest radiographs obtained approximately one month before each THA. The rate of change was compared with age-specific BMD reference values for the Japanese population.
A total of 59 patients were included, with a mean age of 54.9 years and an average interval between unilateral THA of 2.1 years. Among those who underwent an initial THA at ages 50-54 years, the estimated BMD decreased by 1.52% and 0.81% annually in the lumbar spine and proximal femur, respectively. For patients who underwent an initial THA at ages 55-59 years, the estimated BMD decreased by 0.00% and 0.80% annually in the lumbar spine and proximal femur, respectively. These rates were lower than the reported rates of annual BMD decline in Japanese women aged 50-54 years (1.77%, lumbar spine; 1.27%, proximal femur) and 55-59 years (1.28%, lumbar spine; 0.88%, proximal femur).
THA has the potential to attenuate age-related BMD decline in postmenopausal women with hip OA.
全髋关节置换术（THA）可缓解髋骨关节炎（OA）患者的疼痛，提高其行走能力和生活质量。然而，其对全身骨密度（BMD）的影响仍不明确。在本研究中，我们使用仅通过后前位胸部X线片估算骨密度的人工智能（AI）辅助骨质疏松症诊断支持系统，调查了THA对绝经后髋OA女性全身骨密度的影响。
这项回顾性观察研究纳入了2007年至2023年期间在我们机构分阶段接受双侧THA的50 - 59岁绝经后日本女性。使用我们的AI辅助骨质疏松症诊断系统估算骨密度，该系统使用每次THA前约一个月获得的后前位胸部X线片。将变化率与日本人群的年龄特异性骨密度参考值进行比较。
共纳入59例患者，平均年龄54.9岁，单侧THA的平均间隔时间为2.1年。在50 - 54岁接受初次THA的患者中，腰椎和股骨近端的估算骨密度每年分别下降1.52%和0.81%。对于55 - 59岁接受初次THA的患者，腰椎和股骨近端的估算骨密度每年分别下降0.00%和0.80%。这些比率低于报道的50 - 54岁（腰椎1.77%；股骨近端1.27%）和55 - 59岁（腰椎1.28%；股骨近端0.88%）日本女性的年骨密度下降率。
THA有可能减缓绝经后髋OA女性与年龄相关的骨密度下降。
