Role of DEXA-derived bone mineral density in orthopaedic surgical planning: A cross-sectional study

Abstract

Objective: This study aims to clarify the role of site-specific bone density measurement in surgical decision-making by comparing BMD in the spine and bilateral femurs of males and females.

Method: Cross-sectional comparative study of two hundred consenting individuals consisting of 100 osteoporotic patients and 100 healthy controls (in terms of the total spine and femur (left and right femurs)), matched for age and sex. The volunteers aged between 40 and 75, with heights between 158 and 180 cm, and weights between 63 and 87 kg.

Results: There were no significant differences in the mean values of the normal BMDs between the lumbar spine and right femur, or between the lumbar spine and left femur. There were statistically significant (P ˂ 0.001) differences in the mean BMD for the normal lumbar spine and osteoporosis of the left and right femurs in both male and female cases, separately.

Conclusion: The significant reduction in femoral BMD among osteoporotic patients underscores the need to focus on bones other than the lumbar vertebrae and hip bones, which are traditionally assessed without taking into consideration the affected bone(s). Further, routine DEXA screening plus the bone(s) of interest (other than the lumbar spines and hip bones) should be integrated into orthopaedic practice to optimise patient outcomes, reduce the risk of fractures, and enhance surgical success rates in osteoporotic individuals. Osteoporotic patients requiring fracture fixation should undergo site-specific DEXA screening of the affected bone to guide fixation feasibility and procedure selection.