Osteoporosis: An Update on Screening, Diagnosis, Evaluation, and Treatment

Abstract

Osteoporosis screening, diagnosis, and treatment have gained much attention in the health care community over the past 2 decades. During this time, creation of multispecialty awareness programs (eg, “Own the Bone,” American Orthopedic Association; “Capture the Fracture,” International Osteoporosis Foundation) and improvements in diagnostic protocols have been evident. Significant advances in technology have elucidated elements of genetic predisposition for decreased bone mineral density in the aging population. Additionally, several novel drug therapies have entered the market and provide more options for primary care and osteoporosis specialists to medically manage patients at risk for fragility fractures. Despite this, adherence to osteoporosis screening and treatment protocols has been surprisingly low by health care practitioners, including orthopedic surgeons. Continued awareness and education of this skeletal disorder is crucial to effectively care for our aging population. [ Orthopedics . 2023;46(1):e20–e26.]

Evidence-based education to mitigate osteoporosis through diet and exercise

“…A person acquires bone during growth, reaching peak BMD in early adulthood. 9 Nonpharmacologic means of preventing and mitigating bone loss include adequate vitamin D intake, fall prevention, smoking cessation, and remaining active using weight-bearing exercise, among other therapies.…”

“…Evidence demonstrates the ongoing need for continuous education to maintain awareness and reinforce bone loss prevention strategies throughout the aging process. A person acquires bone during growth, reaching peak BMD in early adulthood 9. Nonpharmacologic means of preventing and mitigating bone loss include adequate vitamin D intake, fall prevention, smoking cessation, and remaining active using weight-bearing exercise, among other therapies.…”

Bone density estimation using tissue heat capacity

“…Chronic health problems such as cerebrovascular disease, dementia, frailty, and sarcopenia become more prevalent with increasing age (Sanford et al, 2020). Osteoporosis is a serious condition with a greater frequency among the elderly (Sabri et al, 2023). It causes bone loss, which increases risks of fractures, but the disease progression is relatively asymptomatic before serious complications arise.…”

Osteoporosis: Spotlight on current approaches to pharmacological treatment

“…Pharmacological treatment includes a wide range of drug groups such as antiresorptive and anabolic agents. [ 5 , 10 , 14 ] Fracture risk assessment in drug selection is of utmost importance for guiding treatment. [ 13 ] In accordance with the recommendations of the current guidelines, antiresorptive agents are the first choice to reduce the fracture risk in patients with moderate-to-high fracture risk in the treatment of OP.…”

“…To address this gap, strategies should be developed including applying combined pharmacological and non-pharmacological treatments, informing general practitioners, increasing the use of Fracture Liaison Services, improving communication on reminder systems (e.g., appointment/medication follow-up), and improving adherence to treatment. [ 10 , 14 , 18 , 19 , 25 , 30 , 54 , 78 ]…”