• Roberto A Miki, Matthew E Oetgen, Jessica Kirk, Karl L Insogna, and Dieter M Lindskog.
• Department of Orthopaedics, Miller School of Medicine, University of Miami, 900 N.W. 17th Street, Miami, FL 33136, USA. rmiki2@med.miami.edu
• J Bone Joint Surg Am. 2008 Nov 1; 90 (11): 2346-53.

BackgroundAlthough 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.MethodsA 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.ResultsSixty-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).ConclusionsAn active role by orthopaedic surgeons in the management of osteoporosis improves the rate of treatment at six months following a hip fracture.

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