From Repair to Prevention: The Emerging Role of Preventive Orthopedics

Musculoskeletal (MSK) conditions are leading causes of global disability and major drivers of healthcare utilization, surgeries, and productivity loss, with low back pain, osteoarthritis, and fragility fractures contributing most to the burden and expected to rise due to aging, obesity, and sedentary lifestyles. Work-related MSK disorders remain highly prevalent and are costly. This narrative review aimed to synthesize current preventive orthopedic strategies across the life course. Evidence was drawn from systematic reviews, meta-analyses, clinical guidelines, economic evaluations, and targeted searches, following best-practice standards for transparent narrative reviews. Preventive orthopedics integrates risk stratification; neuromuscular and ergonomic interventions; lifestyle-first osteoarthritis management; fall and fracture prevention, including osteoporosis screening and fracture liaison services; workplace MSK programs; perioperative prehabilitation; digital health technologies; and emerging pharmacologic strategies such as glucagon-like peptide-1 (GLP-1)-based weight management. These interventions demonstrate reductions in injury rates, improvements in pain and function, and meaningful health system efficiencies. Persistent challenges include adherence, implementation fidelity, reporting quality, and equitable access. Future priorities include pragmatic and equity-focused trials and clearer operationalization of prevention across musculoskeletal care pathways.