How do you approach peri-operative management of anti-resorptive therapies such as denosumab in patients undergoing joint replacement?  

This is a very practical question. I think it is fine to continue the denosumab on a regular 6-month schedule for patients undergoing joint replacement. The reduction in bone turnover should not affect the implant. In fact, with denosumab, there is a small anabolic effect with each treatment that mi...