Diagnosis and Treatment of Osteoporosis

What Orthopaedic Surgeons Need to Know

Elizabeth G. Matzkin, MD; Marlene DeMaio, MD; Julia F. Charles, MD, PhD; Corinna C. Franklin, MD


J Am Acad Orthop Surg. 2019;27(20):e902-e912. 

In This Article


An estimated almost 9 million osteoporotic fractures occur annually worldwide. Of these, 51% occurred in Europe and the United States with hip, forearm, and vertebral fractures being the most common. As noted earlier, one in three women and one in five men older than 50 years are at risk of an osteoporotic fracture. Sixty-one percent of osteoporotic fractures occur in women, and it has been shown that women older than 45 years spend more days in the hospital secondary to osteoporosis compared with breast cancer, diabetes, or myocardial infarction. Many of these women are not identified as having osteoporosis and therefore are not treated, consequentially resulting in an 86% increased risk of sustaining a second osteoporotic fracture.[3] Although the fracture rates are higher for women, the mortality rates tend to be higher for men. Approximately 25% of osteoporotic hip fractures occur in men, and the 1-year mortality in men is 20% higher compared with women. Also, the lifetime risk for men to experience an osteoporotic fracture is 27%, more than twice the lifetime risk of prostate cancer (11.3%). Lastly, Gullberg et al projected that compared with rates of osteoporotic fracture in 1990, by 2050, the incidence of osteoporotic hip fractures will increase 240% in women and 310% in men.[3,7] Given these astounding statistics, it is imperative that orthopaedic surgeons can recognize, help manage, and prevent the growing osteoporosis epidemic.