Miki Roberto A, Oetgen Matthew E, Kirk Jessica, Insogna Karl L, Lindskog Dieter M
Department of Orthopaedics, Miller School of Medicine, University of Miami, 900 N.W. 17th Street, Miami, FL 33136, USA.
J Bone Joint Surg Am. 2008 Nov;90(11):2346-53. doi: 10.2106/JBJS.G.01246.
Although osteoporosis is strongly associated with hip fractures, the initiation of osteoporosis treatment following hip fractures occurs at surprisingly low rates of between 5% and 30%. Currently, most patients receiving treatment have been referred back to their primary care physician for osteoporosis management. The purpose of this study was to compare the effect of osteoporosis management initiated by the orthopaedic team and osteoporosis management initiated by the primary care physician on the rates of treatment at six months.
A prospective randomized trial was conducted to assess the difference in the rate of osteoporosis treatment when an in-house assessment of osteoporosis was initiated by the orthopaedic surgeon and follow-up was conducted in a specialized orthopaedic osteoporosis clinic compared with osteoporosis education and "usual" care.
Sixty-two patients were enrolled in the study. Thirty-one patients each were in the control and intervention groups. The percentage of patients who were on pharmacologic treatment for osteoporosis at six months after the fracture was significantly greater when the evaluation was initiated by the orthopaedic surgeon and was managed in a specialized orthopaedic osteoporosis clinic (58%) than when treatment was managed by a primary care physician (29%) (p = 0.04).
An active role by orthopaedic surgeons in the management of osteoporosis improves the rate of treatment at six months following a hip fracture.
尽管骨质疏松症与髋部骨折密切相关，但髋部骨折后开始骨质疏松症治疗的比例低得出奇，仅为5%至30%。目前，大多数接受治疗的患者已被转回其初级保健医生处进行骨质疏松症管理。本研究的目的是比较骨科团队启动的骨质疏松症管理与初级保健医生启动的骨质疏松症管理在六个月时的治疗率效果。
进行了一项前瞻性随机试验，以评估由骨科医生进行骨质疏松症内部评估并在专门的骨科骨质疏松症诊所进行随访时的骨质疏松症治疗率差异，与骨质疏松症教育和“常规”护理相比。
62名患者纳入研究。对照组和干预组各有31名患者。骨折后六个月接受骨质疏松症药物治疗的患者百分比，由骨科医生进行评估并在专门的骨科骨质疏松症诊所管理时（58%）显著高于由初级保健医生管理时（29%）（p = 0.04）。
骨科医生在骨质疏松症管理中发挥积极作用可提高髋部骨折后六个月的治疗率。
