Wednesday, December 17, 2008

Aggressive Osteoporosis Approach To Curb Hip Fractures

Osteoporosis screening and treatment could cut U.S. hip fractures by 25% or more, according to a new study by researchers who work at Kaiser Southern California, a branch of the Kaiser Permanente health maintenance organization (HMO).

The new study shows that the aggressive three-pronged approach to osteoporosis can go a long way toward preventing hip fractures.

In the first step, bone scans using dual X-ray absorptiometry, which is the gold standard for bone density tests, were given to the following patients:

  • All patients over age 50 with a history of fragility fractures or fractures not due to trauma
  • All women over age 65
  • All men over age 70
  • All patients on high doses of corticosteroids and certain other drugs
The second step focuses on osteoporosis education and treatment. Those with poor bone density or previous fragility fractures were included in the osteoporosis education program. In addition to bone drugs, patients who needed osteoporosis treatment also got home safety checks to help prevent falls.

The third step is a fall-reduction program, including physical therapy, for at-risk patients.

From 2002 to 2006, more than 620,000 patients were included in those programs at 11 Kaiser Southern California centers. Based on statistics, hip fractures dropped by 37% overall, ranging from 23% to nearly 61% across the 11 centers during that time.

According to Kaiser researchers, who included Richard Dell, MD, the difference among the centers may be due to the fact that some centers had a longer history of treating osteoporosis aggressively.

Dell and his colleagues reported that achieving that result didn’t require experimental drugs or a radical change in screening. However, it did require a coordinated, aggressive approach.

In the November edition of The Journal of Bone & Joint Surgery, Dell’s team wrote that the first step must be a more active role by orthopedic surgeons in osteoporosis disease management.

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