How do you approach perioperative management of anabolic therapies such as romosozumab and PTH analogues in patients undergoing joint replacement?

Although there is no good human data, there is some pre-clinical data that shows increased screw purchase in the setting of tptd use. It makes good common sense that an anabolic (both PTH types and romosozumab) would likely increase the purchase of an implant.

In addition, if the patient had signifi...