Women want answers, but what questions should be asked?

One in two women in the United States will have an osteoporosis-related fracture in her lifetime (1). However, according to a review article published in the May 2010 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), only a few of these women will be tested and treated for osteoporosis, which if identified and treated, could dramatically decrease their risk of future fractures. "Less than 10 percent of patients who sustain a fracture receive information about osteoporosis treatment, yet these are the same group of patients who are at a very high risk for future hip, spine or wrist fractures," said lead author Evan F. Ekman, MD, president of Southern Orthopaedic Sports Medicine and medical director of the Palmetto Health Alliance/Parkridge Surgery Center in Columbia, S.C. "Because orthopaedic surgeons are the physicians who treat these fractures, we have a tremendous opportunity to educate these patients about their bone health, and urge them to get tested for osteoporosis and receive treatment for the disease to avoid future fractures."

According to the National Osteoporosis Foundation:

• An estimated 10 million people in the United States have osteoporosis, and nearly 34 million more are at a higher risk due to low bone mass.
• The cost of fractures in the United States was $17 billion in 2005, with 2.5 million medical office visits, 430,000 hospital admissions and 180,000 nursing home admissions.
• There is a high mortality rate for patients who have experienced a hip fracture. The 1-year mortality rate following a hip fracture is estimated to be between 15 percent and 33 percent.

Dr. Ekman added that post-surgical patients who receive information about appropriate osteoporosis management and who are given questions they can ask their primary care physicians, see improved treatment rates.

"Women should not be afraid to walk into their doctors' offices armed with a list of questions about their bone health," said Dr. Ekman. "What many people don't realize is that hip fractures have a high mortality rate. Asking questions and being educated about your bone health not only can help you save the time, money and pain that comes along with fractures, it can help save your life."

Dr. Ekman suggests women ask their physicians the following questions:

• I've recently had a fracture—do I have osteoporosis? Should I be tested for it?
• How much calcium and vitamin D should I take daily?
• How can I prevent falls?
• What medications are available that can help me strengthen my bones?
• Are any of the medications I'm currently taking affecting my bone health?

Lisa Cannada, MD, an orthopaedic trauma surgeon at St. Louis University Hospital, agrees that women should be their own advocates when it comes to preventing fractures. "Women need to be a squeaky wheel to get the information and treatment they need," said Dr. Cannada. "Don't wait to ask questions until you have experienced a fracture or until you think you're 'old enough' to start worrying. It's never too early to begin educating yourself, your sister or your daughter about how you can prevent the disease."

Dr. Cannada recommends the following tips to improve bone health and prevent fractures:

• Learn about your risk factors. Aging, heredity, nutrition, lifestyle, medications and other illnesses can increase your risk of developing the disease.
• Maintain a diet rich in calcium with foods like yogurt, cheese and green leafy vegetables.
• Make sure you're taking in enough vitamin D, a minimum of 2,000 IU per day is recommended, and this will help your body absorb calcium.
• Quit smoking, and drink alcohol in moderation.
• Participate in at least 30 minutes of weight-bearing activity three to four times a week.
• Prevent falls by improving your motor skills through exercise and physical therapy. Also, examine the furniture in your house and rearrange it if necessary to reduce the risk of tripping.

Source: American Academy of Orthopaedic Surgeons