Improving Patients' Outcomes After Osteoporotic Fractures

Rozalia Dimitriou; Giorgio Maria Calori; Peter V Giannoudis


Int J Clin Rheumatol. 2012;7(1):109-124. 

In This Article

Future Perspective

Advances that are made in implant technology, operative and anesthetic techniques as well as rehabilitation strategies and their effectiveness on improving outcomes in patients after osteoporotic fractures will be evaluated in the years to come. Moreover, with the increased understanding of the pathophysiology of osteoporosis at the molecular level, research is ongoing to develop novel and more effective therapeutic targets for osteoporosis, in an effort to overcome side-effects and limitations of current treatments, and inadequate compliance and to improve outcome and possibly reverse osteoporosis in the future. The most promising novel treatments include odanacatib (a specific inhibitor of the osteoclast protease cathepsin K), and antibodies against the proteins sclerostin and dickkopf-1 (two endogenous inhibitors of bone formation).[123] In the future, the role of the genetic susceptibility to bone fragility and osteoporosis will be further elucidated,[124] allowing early identification of patients at risk for osteoporosis or poor outcome, identification of genes and pathways as molecular targets for the design of novel more efficacious treatments and the development of individualized treatment modalities to improve outcomes.

Physicians and all healthcare professionals need to be actively educated about the existing guidelines, and the 'barriers' for adequate postfracture care need to be identified and addressed within the different medical, rehabilitative, nursing home and home-care services.[125] Finally, further efforts should be made on the secondary prevention following the first osteoporotic fracture[84] and a standardized discharge plan may help to achieve long-term adherence to treatment.[29]