Tom Murphy
RedwoodAge.com

Boomers who get hip to proactive bone care can expect longer, healthier lives, according to a study that found ways to reduce hip fractures by more than a third in the people most at risk.

The study is the largest-ever of its kind and focused on proactive measures that can be taken to avoid broken bones. It included 625,000 people over 50 who faced a risk of osteoporosis and/or hip fractures, according to Kaiser Permanente, which conducted the study in Southern California.

Hip fracture rates fell by an average of 37.2 percent among the participants, and as much as half, according to the five-year study, which was published in The Journal of Bone & Joint Surgery.

The results are highly significant, given that life expectancy drops dramatically for people who suffer hip fractures. A quarter of people who suffer hip fractures die within a year.

About 44 million Americans have osteoporosis, resulting in about 1.5 million fractures a year, including 300,000 hip fractures. 

"One-half of all women and one-third of all men will sustain a fragility fracture in their lifetime," said Dr. Richard Dell, an orthopedic surgeon who was the lead author. "The mortality rate due to osteoporosis-related fractures is greater than the rates for breast cancer and cervical cancer combined."

Society has long taken such fractures as an unfortunate reality of old age. But Dell said "it's a misconception" to think nothing can be done to prevent osteoporosis.

"It is possible to achieve at least a 25 percent reduction in the hip fracture rate in the United States if a more active role is taken by all orthopedic surgeons in osteoporosis disease management," he said.

Doctors in the study increased the use of bone-density tests and medications used to treat osteoporosis. They also added education and home health programs and followed standardized guidelines for managing the disease.

"Significant improvements in hip fracture rates are achievable wherever orthopedic surgeons and treatment teams are willing to take a more active role in osteoporosis disease management," Dell said.

Tips for Doctors
Dr. Laura Tosi of the American Orthopaedic Association published steps for doctors as part of that group's "Own the Bone" campaign."  They include:

Be a champion. Remember that addressing the problem of fragility fractures is multifaceted and will require a multidisciplinary solution. Identify potential partners in your community.

Don't Wait. Identify high-risk patients and don't wait until your patient has a fragility fracture.

Be a teacher. Teach patients about osteoporosis and falls.

Make it Easy. Develop pre-printed admission sheets and orders.

Parting Shots. Develop a discharge checklist for fragility fracture patients, and improve your discharge documentation.

Measure Up. Set realistic goals and measure what you've done.

Use the Right Tool. Use the new fracture risk assessment tool called FRAX.