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Treating Osteoporosis After Hip Fracture
Most patients who
suffer a hip fracture are referred to their primary care physicians for
osteoporosis follow-up care. However, according to a study published in the
November 2008 issue of The Journal of Bone and Joint Surgery
(http://www.ejbjs.org), an osteoporosis management program initiated by an
orthopaedic surgeon can result in much better care for hip fracture
patients.
Osteoporosis (http://orthoinfo.aaos.org/topic.cfm?topic=A00232)is a
disease of progressive bone loss affecting 28 million Americans. The
disease often develops unnoticed for many years, with no symptoms or
discomfort until a fracture occurs because of the decreased bone density.
Osteoporosis is associated with fractures, and contributes to an
estimated 1.5 million bone fractures each year. One in two women and one in
five men older than 65, will sustain fractures caused by osteoporosis. Many
of these are painful fractures of the hip, spine, wrist, arm, and leg,
which often occur as a result of a fall.
The most serious and debilitating osteoporotic fractures are of the
hip. Most patients who experience a hip fracture and previously lived
independently will require some type of home care after the injury. All
patients who experience a hip fracture will require walking aids for
several months, and nearly half will permanently need canes or walkers.
Although osteoporosis is strongly associated with hip fractures,
osteoporosis treatment following hip fractures occurs just 5 to 30 percent
of the time.
"This low rate is the result of a few different factors," says Roberto
Augusto Miki, M.D., assistant professor of clinical orthopaedics at
University of Miami Jackson Memorial Hospital. "Most of these patients are
older, and therefore may have a number of other health concerns. Their
primary care physician is looking at the heart, lungs, and other more
critical issues. Also, a lot of primary care physicians aren't that
comfortable prescribing the specialized osteoporosis medications."
"In addition, orthopaedic surgeons frequently aren't prepared to take
responsibility for osteoporosis management," Miki adds. "It's not a
surgical issue -- it's chronic disease management, and their practices
aren't set up for that type of care."
In the study, researchers randomly selected 31 hip fracture patients to
receive follow-up care at a specialized orthopaedic osteoporosis clinic and
31 to receive the usual type of treatment from their primary care
physician. Six months following the initial hip fracture:
-- 58 percent of patients in the orthopaedic clinic were still taking an
osteoporosis medication.
-- 29 percent of the patients in the primary care group were taking an
osteoporosis medication.
In addition:
-- 26 patients in the orthopedic group had undergone a bone mineral density
test compared with 7 patients in the primary care group
Researchers initially planned to continue the study until they had
enrolled 120 patients, but the early findings were so conclusive that the
study was discontinued.
"Hospitals need systems and processes in place so that orthopaedic
surgeons can refer osteoporosis patients to a specialist who can oversee
disease management," Miki said.
More information on Osteoporosis
Disclosure: The authors did not receive any outside funding or grants
in support of their research for or preparation of this work. Neither they
nor a member of their immediate families received payments or other
benefits or a commitment or agreement to provide such benefits from a
commercial entity. No commercial entity paid or directed, or agreed to pay
or direct, any benefits to any research fund, foundation, division, center,
clinical practice, or other charitable or nonprofit organization with which
the authors, or a member of their immediate families, are affiliated or
associated.
American Academy of Orthopaedic Surgeons
http://www.aaos.org
Dupã tratarea Osteoporoza Hip fracturã - Treating Osteoporosis After Hip Fracture - articole medicale engleza - startsanatate