Guidelines For Management Of Osteoporosis Research Articles

The patient with a fragility fracture: an evolving role for the orthopaedic surgeon.

Osteoporosis can now be diagnosed readily, and treatments that increase bone mineral density and decrease fracture risk, even after fragility fracture has occurred, are now available. Clinical guidelines for management of osteoporosis unanimously recognize that fracture risk is highest among those who have already sustained a fracture, and encourage prompt evaluation and treatment of these individuals. Despite these guidelines, most women who experience fragility fractures remain untreated (for osteoporosis) by any of the physicians involved in their care. Barriers to diagnosis and treatment have been identified, including uncertainty about the responsibility for such management. The orthopaedic surgeon has a unique opportunity to initiate definitive osteoporosis evaluation and treatment in patients who present with fractures, and recent guidelines support the evolution of the role of the orthopaedist in this direction.

Department of Health is fair to patients with osteoporosis

The Advisory Group on Osteoporosis1 was not established to advise ministers on health technology; machinery for that purpose is in place and a separate group has been set up to review this rapidly advancing topic. The remit given to the advisory group was to summarise current knowledge about osteoporosis, to detail ongoing research into the subject, and to identify research priorities. The final version was submitted to wide ranging consultation, including review by several representatives of purchasers and providers of health care, by the Standing Medical Advisory Committee of the Department of Health, and by the NHS Management Executive. The recommendations of the report were: (a) better coordination of services in osteoporosis management, (b) greater availability of bone densitometry facilities for defined clinical indications, (c) provision of these facilities at the discretion of purchasers at a local level, and (d) the development of guidelines for osteoporosis management through the royal colleges. Of the 86 pages covering this diverse and often complex agenda, Professor Sheldon and colleagues have taken exception to the conclusions articulated in the seven which refer to a clinical bone density service. We infer that they are in broad agreement with …