Study Finds High Rates of Undetected Osteoporosis in Knee Replacement Patients and a Simple Scan Can Catch It Early

If you’re thinking about or preparing for a total knee replacement, a recently published study in SICOT-J highlights an interesting and hopeful development that could affect you. The study is titled Prevalence of low bone mineral density in robotic-assisted TKA candidates: insights from quantitative CT analysis, by SORI’s Dr David Parker and Dr Jobe Shatrov. 

Here’s what the researchers did and why that matters for you...

Study design and findings: 

• The researchers looked at 637 patients (307 men, 330 women) who underwent robotic-assisted total knee arthroplasty (TKA) between January 2023 and December 2024.  

• As part of routine preoperative planning for the robotic-assisted TKA, all patients had a standard preoperative CT scan. The authors re-used those CT scans to assess bone density - using validated quantitative computed tomography (QCT) software.  

• Among 597 patients with usable data, only 41.0% had normal bone mass; 32.3% were osteopenic (bone density has reduced but less severe), and 26.6% were osteoporotic (Osteoporosis is present). 

• The problem was particularly prevalent in older women: 37.0% of female patients were osteoporotic, compared with 15.3% of male patients. 
  

Why this matters for patients 

• Better safety and risk-awareness before surgery. Osteoporosis (or low bone density) can increase the risk of complications like fractures or poor implant fixation after knee replacement. By using the same CT scan needed for implant planning, this study shows surgeons can also screen for bone weakness without extra radiation or extra appointments. 

• No extra radiation, time, or cost. Since the CT scan is already part of the surgical planning for robotic-assisted TKA, opportunistic bone-density screening is “free” from a patient’s standpoint.  

• More personalised surgical planning. If low bone density is detected, surgeons may adapt their approach - for example, selecting cemented fixation instead of cementless, or planning for extra bone support to reduce risk and improve long-term outcomes. 

• Long-term joint stability & bone health. Early detection of bone weakness gives a chance to treat or manage bone health (e.g. diet, medication, lifestyle) before and after surgery which could lead to a stronger, more stable knee replacement and fewer complications over time. 

  
  

What this means for you 

If you’re preparing for knee replacement, you could ask your surgeon whether they plan to assess bone mineral density using your preoperative CT scan. It’s a simple, low-cost screening that may spot hidden bone weakness and let you and your surgeon plan the safest surgery tailored to your bone health. 

At the end of the day, a knee replacement isn’t just about “replacing joint surfaces”, it’s also about making sure the bones that support that new knee are strong. This study shows that many patients - especially older women, may have undiagnosed bone-density issues. Detecting them early empowers you and your surgeon to make informed decisions for a safer, longer-lasting result. 

Read the full article HERE