Indian Orthopaedics Association Guidelines for Osteoporosis
Ramesh Sen1, Shiva Shankar Jha2, S S Amarnath3
1General Orthopaedics and Trauma, Institute of Orthopaedics, MAX Hospital, Mohali, India.
Introduction:
These guidelines provide a comprehensive and practical framework for preventing osteoporosis. They are designed for use by healthcare professionals, including orthopaedic surgeons, primary care physicians, specialists, nurses, and allied health providers, as they work with patients at risk of or already diagnosed with osteoporosis.
Methodology:
This iterative process involved multiple questionnaires sent to a panel of 62 osteoporosis and bone health experts. Experts, including clinicians, researchers, and academicians, were selected based on their recognised expertise and contributions to the field of osteoporosis.
Observations:
There were 62 medical personnel with experience. The protocol was to get consensus from experts for each round. The set of questions was divided into six rounds. This structured Delphi methodology ensured that the resulting osteoporosis guidelines were evidence based and reflective of expert consensus, providing a robust clinical practice framework.
Results:
The guidelines were put up in sections with titles as: prevention of osteoporosis, Screening for osteoporosis, diagnosing osteoporosis, calcium and vitamin D in osteoporosis, microbiome, obesity in osteoporosis, postmenopausal osteoporosis, male osteoporosis. Chronic kidney disease and osteoporosis, glucocorticoid-induced osteoporosis (GIOP), therapeutics in osteoporosis, monitoring osteoporosis therapy and osteosarcopenia. Ultimately, all the details obtained in various meetings were analysed, and responses were sought from all the participant members. All such reactions were again grouped back sequentially.
Conclusions:
osteoporosis is a significant problem, and many protocols exist in the literature. These guidelines were created by consensus among experts using the Delphi method. They have been developed until current knowledge is available and may be changed in the next 5-6 years, depending on the new research accumulated by that time.
Related Concept Videos
Osteoclasts in Bone Remodeling
Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Role of Vitamins in Maintaining Bone Health
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
Bone Remodeling
Essential Minerals for Bone Health
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...


