Title

Geriatric orthopaedics:Management of osteoporosis-fragility of the pelvis and femur

Document Type

Journal Article

Publication Date

9-1-2011

Journal

Current Orthopaedic Practice

Volume

22

Issue

5

DOI

10.1097/BCO.0b013e31822b38ba

Keywords

Management; Osteoporosis; Risk; Treatment

Abstract

Osteoporosis (OP) and its critical outcome, fragility fracture, already represent a major health care burden in the United States. It is estimated that the US population aged 50 years and older will increase by 60% by 2025. Thus, an increase in fractures and OP is expected. This report reviews current efforts to address OP diagnosis, treatment, and prevention. Although there is no consensus on when to screen for OP, most clinical societies recommend bone density screening with a DXA scan for all women over the age of 65 and for all men and women over the age of 50 with risk factors for osteoporosis. Screening for men remains controversial. The new Fracture Risk Assessment Calculator (FRAX) tool, easily accessed on the Internet, can be useful both in choosing which patients to screen and in helping patients understand their risk factors for fracture. Bisphosphonates continue to be the mainstay of pharmacologic treatment for OP, although a wide range of new therapies are coming into use. Concerns regarding long-term bisphosphonate use (atypical fractures and osteonecrosis) are reviewed. Finally, new approaches to improving fracture outcomes using multidisciplinary care teams and care pathways are reviewed. © 2011 Wolters Kluwer Health.

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