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Osteoporosis Treatment Rates Rise With Orthopedic Surgeon Playing Active Role

Hip fractures, a very serious injury for the elderly, often occur because the person has thinning bones due to osteoporosis. The other most commonly broken bones in this group of people are the wrist and the vertebrae, the little bones in the spine.

Doctors and researchers have been working on ways to strengthen the bones of patients who had had a hip fracture as a result of thinning bones and studies are finding that treatment with a bisphosphonate, a medication that is given by intravenous in this case, reduces the risk of another fracture.

The authors of this study wanted to compare the rates of osteoporosis treatment, how often it was prescribed, by the orthopedic team and by the primary doctor. To do this, the researchers recruited 62 patients who had surgery for hip fractures. Thirty-one patients were in the intervention group that received medications and 31 were in the control group that didn't receive medications. The patients all filled out questionnaires and they and their families or caregivers were given a 15 minute class on hip fractures, fracture prevention, and osteoporosis.

Patients in the intervention group had an osteoporosis evaluation while they were in the hospital. They were also given calcium and vitamin D3 to take daily when they were discharged. They had follow-up visits scheduled with an orthopedic surgeon for two to four weeks after surgery. There, the patients were evaluated again and then started on a medication called risedronate for osteoporosis. The patients in the control group also took the calcium and vitamin daily, but when they were discharged, they were only given instructions to call their own doctor for follow up and an osteoporosis evaluation.

The results of the study showed that the patients who saw the orthopedic surgeon were much more likely to receive osteoporosis treatment than if they went to a primary care doctor. All the patients in the control group (24 by the end of the study) did see their primary doctor within six months of the fracture and 95 percent went to see their orthopedic surgeon. But only 39 percent of the patients remembered the primary doctor talking about osteoporosis. None of the control group remembers discussing osteoporosis with their orthopedic surgeon.

Still with the control group, one patient had another within the six months but didn't begin osteoporosis treatment until after the second break. Seven patients had a dual x-ray absorbtiometry scan, a test that measure bone density and eight began bisphosphonate medication. At the end of six months, only seven of the control group were taking the medications.

Things were quite different in the intervention group. None of the patients in this group (26 by study end) had another fracture within the six months, 26 had the bone density measuring test. Twenty began taking medication for osteoporosis following the fracture and the remaining six couldn't because of transportation issues. Five stopped taking the medications. At the end of six months, 15 of the group were still taking the medications.

In conclusion, the authors pointed out that the patients who were followed by orthopedic surgeons had a higher osteoporosis treatment rate than those who were followed by their primary physicians. This shows that this evaluation and treatment may improve the overall rate of recurrent hip fractures due to osteoporosis


Roberto A. Miki, et al. Orthopaedic Management Improves the Rate of Early Osteoporosis Treatment After Hip Fracture. A Randomized Clinical Trial. In The Journal of Bone and Joint Surgery. November 2008. Vol. 90. Pp. 2346-2353.

11/26/2008

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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