More than 1 million total joint arthroplasties (TJAs) are performed in the United States each year, and much higher demand is projected. Most TJAs are successful, but aseptic loosening of implants remains a problem that limits long-term success. Aseptic osteolysis, an inflammatory reaction, occurs in up to 10% of patients at 10 years postsurgery.

ABSTRACT: The aging process is difficult, involving multisystem functional decline, and the pharmacokinetics of medications are altered in the older population, resulting in increased risks. Concerns associated with biologic therapy are demonstrated in case reports.

Following the release of revised National Osteoporosis Foundation guidelines and of the World Health Organization’s fracture risk assessment tool, several pharmacological therapies have become available to help improve outcomes in patients with osteoporosis.