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Study: Hip Fracture Rate Could Drop 25%
Prevention is rather the other end of the OR...the latter being where most orthopedists like to spend a majority of their time. But, says a new study from Kaiser Permanente, the country’s hip fracture rate could be reduced by 25% if at risk patients are managed aggressively.
The research, published in the November issue of the Journal of Bone & Joint Surgery, indicates that the first step must be a more active role by orthopedic surgeons in osteoporosis disease management. It is the largest study to date to examine osteoporosis management in men and women over 50 years old—650,000 men and women in Kaiser Permanente’s osteoporosis management program were included. The researchers found that hip fractures dropped by 38%, preventing 970 hip fractures in 2007.
The prospective observational study examined the effectiveness of the Kaiser Permanente Southern California’s Healthy Bones Program from 2002 to 2007. Kaiser Permanente indicates that its HealthConnect, the world's largest civilian electronic health record database, was used to collect data on patients that included anti-osteoporosis medication usage, bone density scans and fragility fractures.
“Currently in the United States, the rate of treatment after a fragility fracture is only 20%. Treatment after a fragility fracture at Kaiser Permanente in Southern California is now 68%. Health care would be drastically improved if this model of osteoporosis care were adapted for the rest of America, said the study’s lead author. Richard M. Dell, M.D., in the news release. Dr. Dell is an orthopedic surgeon at Kaiser Permanente in Downey, California.
When asked about the U.S. rate of treatment after a fragility fracture, Dr. Dell told OTW that it was previously noted by,
Several articles over the last few years and the HEDIS (Healthcare Effectiveness Data and Information Set) average treatment score.
In this study, the Kaiser researchers found that annual bone density screening rates increased by 263% from 2002 to 2007. The number of people on anti-osteoporosis medications increased by 153% from 33,208 in 2002 to 84,155 a year in 2007.
“The most important thing an orthopedic surgeon should know about osteoporosis/fracture prevention is that we can take action that helps to prevent hip and other fragility fractures,” Dr. Dell said in the news release. “Simple steps like suggesting calcium and vitamin D for all your patients and bone mineral density testing in patients at higher risk for osteoporosis should be considered part of your daily practice.”
“After a fracture, you need treatment, and in America, most people are not getting the treatment they need,” Dr. Dell added. “The lesson here is if you are over 50 years old and have a fragility fracture, ask your doctor about getting a bone density scan, and if needed, osteoporosis treatment.”
Dr. Dell also mentioned that understanding the pathophysiology of osteoporosis and fragility fractures helps to develop a treatment strategy.
To this point, Dr. Dell told OTW,
Knowing who gets osteoporosis and why is crucial in determining who gets the correct treatment, when to treat, for how long to treat, and all your treatment options. These treatment decision points were the main focus of the article and that by treating correctly you can see a huge drop in the fracture rate.