Efficacy of orthopaedic-inspired osteoporosis management: a secondary fracture prevention program after a fracture of the hip in a prospective randomized study

Zinger, Gershon; Sylvetsky, Noa; Levy, Yedin; Steinberg, Kobi; Bregman, Alexander; Yudkevich, Genady; Peyser, Amos

doi:10.1097/oi9.0000000000000122

Cited by 6 publications

(7 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, there were 40 patients (20%) with complications including 12 (6%) with surgical complications, 22 (11%) with medical complications and 6 (3%) with both surgical and medical complications. Surgical complications included deep wound infection (7), super cial wound infection (3), hardware failure (4) and artery perforation or pseudoaneurysm requiring interventional radiology coiling (2).…”

Section: Complicationsmentioning

confidence: 99%

“…Medical complications (some with more than one complication in a patient) included pulmonary embolism (1), urinary tract infection (5), renal failure (12), stroke (1), heart failure exacerbation (12), pneumonia (7), other (6) including gallstones, atrial brillation, GI bleed, intra-cranial bleed, terminal ileitis, general deterioration, and death (6), Hospital Perspective -cost of treating hip fracture:…”

Section: Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Cost analysis of a Fracture Liaison Service: a prospective randomized study for secondary prevention after fragility fractures of the hip

Zinger

Davidson

Sylvetsky

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Fracture liaison services (FLS) have proven to be effective in treating osteoporosis associated with fragility fractures. For patients with fragility fractures of the hip, FLS programs are expected to be cost-effective because of the high risk of re-fracture and the high cost of fracture treatment. In this study we evaluate the essential factors in determining whether the FLS saves or loses more than it costs. Methods: A prospective-randomized study was done in patients with hip fragility fractures using a hospital-based FLS program in parallel with a cost analysis. Data was generated from a cohort of patients using actual data for FLS effectiveness, individual costs of hip fracture treatment, and medication costs based on an accepted treatment algorithm. Results: There were 200 patients randomized and 180 analyzed for costs. Results showed that the cost-benefit of the FLS was dependent on the medication used for osteoporosis. Specifically, using the medication algorithm in this study, the loss per patient enrolled in the FLS was $671 for a 2-year period. If intravenous zoledronic acid had been used, then the loss would have been $221. If only oral bisphosphonates had been used, then the FLS would have saved $109 per patient for a 2-year period. Conclusions: The analysis done here shows that medication cost is the critical component in cost-effectiveness of a FLS program. Additional work needs to be done refining the medication algorithm considering medication costs but individualized to patient needs based on fracture risk. Trial Registration: NCT02239523

show abstract

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Cost analysis of a Fracture Liaison Service: a prospective randomized study for secondary prevention after fragility fractures of the hip

Zinger

Davidson

Sylvetsky

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…One advantage of having a baseline DEXA is to follow effectiveness of treatment. Another advantage was in identifying patients with unusually low bone densities that are at higher risk and therefore warrant treatment with more effective and expensive medications [7].…”

Section: Fls Costsmentioning

confidence: 99%

“…Overall, there were 40 patients (20%) with complications including 12 (6%) with surgical complications, 22 (11%) with medical complications, and 6 (3%) with both surgical and medical complications. Surgical complications included deep wound infection (7), superficial wound infection (3), hardware failure (4) and artery perforation or pseudoaneurysm requiring interventional radiology coiling (2). Cost Analysis of an FLS Service J Curr Surg.…”

Section: Complicationsmentioning

confidence: 99%

“…Medical complications (some with more than one complication in a patient) included pulmonary embolism (1), urinary tract infection (5), renal failure (12), stroke (1), heart failure exacerbation (12), pneumonia (7), other (6) including gallstones, atrial fibrillation, gastrointestinal (GI) bleed, intra-cranial bleed, terminal ileitis, general deterioration, and death (6).…”

Section: Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Cost Analysis of a Fracture Liaison Service: A Prospective Study for Secondary Prevention After Fractures of the Hip

Zinger¹,

Davidson²,

Sylvetsky³

et al. 2022

J Curr Surg

View full text Add to dashboard Cite

Background: Fracture liaison services (FLSs) have proven to be effective in treating osteoporosis associated with fragility fractures. For patients with fragility fractures of the hip, FLS programs are expected to be cost-effective because of the high risk of re-fracture and the high cost of fracture treatment. In this study, we evaluated the essential factors in determining whether the FLS saves or loses more than it costs. Methods:A prospective-randomized study was done in patients with hip fragility fractures using a hospital-based FLS program in parallel with a cost analysis. Data were generated from a cohort of patients using actual data for FLS effectiveness, individual costs of hip fracture treatment, and medication costs based on an accepted treatment algorithm.Results: There were 200 patients randomized and 180 analyzed for costs. Results showed that the cost-benefit of the FLS was dependent on the medication used for osteoporosis. Specifically, using the medication algorithm in this study, the loss per patient enrolled in the FLS was $671 for a 2-year period. If intravenous zoledronic acid had been used, then the loss would have been $221. If only oral bisphosphonates had been used, then the FLS would have saved $109 per patient for a 2-year period. Conclusions:The analysis done here shows that medication cost is the critical component in cost-effectiveness of an FLS program. Additional work needs to be done refining the medication algorithm considering medication costs but individualized to patient needs based on fracture risk.

show abstract

Advances in Osteoporosis Therapy: Focus on Osteoanabolic Agents, Secondary Fracture Prevention, and Perioperative Bone Health

Kostenuik

Binkley

Anderson

2023

Curr Osteoporos Rep

View full text Add to dashboard Cite

Purpose of Review This review summarizes recently published data and other developments around osteoanabolic osteoporosis therapies in patients with very high fracture risk, including those undergoing bone-related surgery. Recent Findings Two osteoanabolic agents, abaloparatide and romosozumab, were recently approved for treatment of patients with osteoporosis at high fracture risk. These agents, along with teriparatide, are valuable for primary and secondary fracture prevention. Orthopedic surgeons are well positioned to facilitate secondary fracture prevention via referrals to fracture liaison services or other bone health specialist colleagues. This review aims to help surgeons understand how to identify patients with sufficiently high fracture risk to warrant consideration of osteoanabolic therapy. Recent evidence around the perioperative use and potential benefits of osteoanabolic agents in fracture healing and other orthopedic settings (e.g., spinal fusion and arthroplasty) in individuals with osteoporosis is also discussed. Summary Osteoanabolic agents should be considered for patients with osteoporosis at very high fracture risk, including those with prior osteoporotic fractures and those with poor bone health who are undergoing bone-related surgery.

show abstract

Efficacy of orthopaedic-inspired osteoporosis management: a secondary fracture prevention program after a fracture of the hip in a prospective randomized study

Abstract: Supplemental Digital Content is available in the text

Cited by 6 publications

References 17 publications

Cost analysis of a Fracture Liaison Service: a prospective randomized study for secondary prevention after fragility fractures of the hip

Cost analysis of a Fracture Liaison Service: a prospective randomized study for secondary prevention after fragility fractures of the hip

Cost Analysis of a Fracture Liaison Service: A Prospective Study for Secondary Prevention After Fractures of the Hip

Advances in Osteoporosis Therapy: Focus on Osteoanabolic Agents, Secondary Fracture Prevention, and Perioperative Bone Health

Contact Info

Product

Resources

About