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Osteoporotic fractures have become an increasing burden in orthopaedics
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As our elderly population becomes more physically active, the incidence of low bone density fractures among that group increases. This has been a common occurrence for the past few decades – and it remains a growing issue.
The lifetime risk of sustaining an osteoporotic fracture has been estimated to be 50%, and the corresponding hospitalization, morbidity and treatment costs are significant, particularly for vertebral and hip fractures. Each year, many persons older than 90 years of age are hospitalized for osteoporotic fractures, making the cost of managing osteoporotic fractures quite high.
Orthopaedists: Get involved
While it is vital to have rheumatologists or family/general physicians actively participating in the care of osteoporotic patients, it is imperative that we also get involved not only in the treatment of osteoporotic fractures, but also in their diagnosis and prevention. This process involves educating our young orthopaedic colleagues and updating established specialists as new scientific information about osteoporosis care surfaces.
We must therefore include a focus on osteoporotic fractures and their treatment and prevention in our national and international conferences. Moreover, as a way of combining energy and force, national orthopaedic societies must establish an orthopaedic task force that collaborates with the internal medical specialties who normally make the diagnosis and establish treatment plans.
EFORT has decided to focus on osteoporosis in the coming years, making it a main topic at their annual congresses. At the EFORT congresses in Madrid in 2010 and Copenhagen in 2011, there will be sessions dealing with all aspects surrounding osteoporotic fractures. In addition, EFORT has organized a basic instructional course on “Osteoporotic Fractures in the Elderly” in Copenhagen next autumn.
Wolfhart Puhl, MD, past president of EFORT, confirmed this escalating focus during the EFORT congress in Vienna in June.
“Osteoporosis will remain an important theme on the EFORT agenda because of its increasing significance,” he said in a press release.
For the congress in Madrid in 2010, EFORT is planning with patient organizations to conduct a debate with European political decision makers to help sensitize the public and policy makers about this disease. This awareness will be a decisive factor in finally providing care corresponding to the current medical knowledge to those suffering from osteoporosis, according to Puhl.
Daunting numbers
Unfortunately, only half of those with osteoporosis will be diagnosed correctly, “and not even a quarter of them will get proper treatment” unless the public’s understanding of osteoporosis improves, Puhl noted.
The consequences of osteoporosis are severe: In Germany, there are 12,000 femoral neck fractures due to osteoporosis. Throughout the European Union, that figure climbs to more than 1 million patients, according to the EFORT press release.
It is clear that we will need to address this clinical challenge at the organizational, national and international levels. A failure to do so will result in continued underdiagnosing and undertreatment of the condition, which will plague our society for decades to come.
For more information:
- Per Kjaersgaard-Andersen, MD, is an assistant professor of orthopaedic surgery, Vejle Hospital at South Danish University, Vejle, Denmark, and is the president of the Danish Orthopaedic Association. He is also the chief medical editor of Orthopaedics Today Europe. He can be reached at ote@slackinc.com.