Bone Health Optimization: Beyond Own the Bone: AOA Critical Issues.

Area of Science:

• Orthopaedic Surgery
• Endocrinology
• Geriatrics

Background:

• Osteoporosis management faces global challenges, including inconsistent care, conflicting guidelines, and poor patient compliance.
• Poor bone health is often undiagnosed or untreated, leading to adverse outcomes, particularly in patients undergoing elective orthopaedic procedures.
• Secondary fracture prevention programs have shown success in improving post-fracture diagnosis and management.

Purpose of the Study:

• To define bone health optimization as a process for assessing and treating bone status in patients.
• To advocate for orthopaedic surgeons to play a more active role in bone health management.
• To outline key principles for bone health optimization applicable to all orthopaedic surgeons.

Main Methods:

• Assessment of osteoporosis risk in patients aged 50 years and older.
• Bone density measurement for high-risk individuals.
• Counseling on adequate vitamin D and calcium intake and cessation of toxins (tobacco, excessive alcohol).
• Consideration of delaying surgery for at least 3 months to initiate pharmaceutical therapy for eligible patients.

Main Results:

• Bone health optimization principles are adaptable from secondary fracture prevention strategies.
• Early assessment and intervention can improve bone health in at-risk patients.
• Integration of bone health management into orthopaedic practice is feasible and beneficial.

Conclusions:

• Orthopaedic surgeons must assume a greater responsibility in managing their patients' bone health.
• Bone health optimization is crucial for improving surgical outcomes and preventing fractures.
• A proactive approach to bone health can address the current crisis in osteoporosis management.