Osteoporosis is characterized by decreased bone mass and deteriorated bone structure; which subsequently leads to increased bone fragility and fracture risk. It typically detected as low bone mineral density (BMD). Detecting low bone density is an important determinant of hip fracture; as one standard deviation decrease in femoral bone density increases the fracture risk by a factor of two to three.
Patients with a fragility fracture are almost twice as likely to suffer another fragility fracture compare; to their age-matched peers with no previous fractures. Hip fracture is the most serious outcome of osteoporosis; when considering mortality and morbidity. During the first year after a hip fracture, more than 24% of the patients aged 65 years or older will die.
Treatment for osteoporosis
However, approximately 50% of patients who have suffered a hip fracture had a previous fragility fracture. But a large study in Spain showed 18% of patients with a hip fracture had receive; treatment for osteoporosis and 26% were receiving pharmacological treatment after being discharge; from the hospital.
But it is common for orthopaedic surgeons to encounter patients with low-energy fractures. This has led to increasing interest in prevention of secondary fractures among orthopaedic surgeons. Hip fractures are the most serious outcome of osteoporosis and increase the mortality; and morbidity among older patients. An evidence-based method is available that estimates bone mineral density at the hip; providing vital, early information on the patient’s bone density.
Orthopaedic surgeons routinely encounter patients with low energy fractures; which has led to more interest in the prevention of secondary fractures among orthopaedists. From 2016 to 2019, an EU funded project in the Baltic Sea Region aimed to address the challenges related; to fractures and the health disorders linked to them.
Diagnostics of hip fracture patients
Due to an ageing society, those challenges are increasing. Over the course of the project; the Tartu University Hospital in Estonia and their Department of Traumatology and Orthopedics participate; in a pilot to increase the diagnostics of hip fracture patients. In the pilot study, a mobile diagnostic device Bindex (Bone Index Finland Ltd.) was used. Bindex estimates the BMD at the hip and provides 90% sensitivity; and specificity compared to DXA-based osteoporosis diagnostics.
However, use of this method enables osteoporosis diagnostics to take place at the patient’s bedside in the hospital ward; and the method could potentially also be used prior to surgery. In the short pilot study, 26 patients measured and Bindex show; 100% sensitivity and 80% specificity when compared to DXA diagnostics at the hip.