{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:13Z","timestamp":1787755273874,"version":"build-2784847793"},"reference-count":153,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,12,19]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Orthopaedic surgeons must play an important role in the secondary prevention of fragility fractures; however, some surgeons are more aware than others of their responsibility regarding fracture prevention. The purpose of the present study was to identify which factors can lead to a higher sensitivity for fracture prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cross-sectional survey was distributed to orthopaedic surgeons via online invitation or at academic conferences in China from July through October 2015. A total of 452 surgeons responded. As the primary outcome measure, we created a sensitivity scoring system for fracture prevention based on the respondents\u2019 answers to 5 questions regarding behavior in the following areas: risk-factor evaluation, pharmacologic therapy, nonpharmacologic therapy, patient education, and follow-up. Multivariable linear regression and multivariable logistic regression analyses were used to identify factors related to surgeon sensitivity to fracture prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Very few surgeons reported having received adequate training regarding fracture prevention or reading guidelines or other fracture prevention literature (22% and 30%, respectively). Most respondents initiated pharmacologic or nonpharmacologic therapy (82% and 75%, respectively) for the treatment of confirmed osteoporosis among patients with fragility fractures, but only half performed a risk-factor evaluation, patient education, or timely patient follow-up (51%, 52%, and 48%, respectively). In the multivariable linear regression model, the orthopaedic surgeon\u2019s age (\u03b2 = 0.09, p = 0.003), self-rated knowledge level regarding osteoporosis or related issues (\u03b2 = 0.16, p &lt; 0.001), self-perceived effectiveness in using preventive measures for patients with a fragility fracture (\u03b2 = 0.62, p &lt; 0.001), and use of clinical pathways for fragility fractures in his or her workplace (\u03b2 = 1.24, p &lt; 0.001) were independently associated with sensitivity scores for fracture prevention. Similar results were obtained from a multivariable logistic regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In China, the sensitivity of orthopaedic surgeons to the secondary prevention of fragility fractures is relatively low. Implementation of a comprehensive prevention approach and targeted continuing medical education are required to encourage surgeons to take greater responsibility for screening, treating, educating, and following their patients with fragility fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.01297","type":"journal-article","created":{"date-parts":[[2019,1,26]],"date-time":"2019-01-26T09:20:07Z","timestamp":1548494407000},"page":"e153","source":"Crossref","is-referenced-by-count":9,"title":["The Sensitivity of Orthopaedic Surgeons to the Secondary Prevention of Fragility Fractures"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2084-8450","authenticated-orcid":false,"given":"Jian","family":"Mo","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People\u2019s Republic of China"},{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7697-167X","authenticated-orcid":false,"given":"Kangmao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-3900","authenticated-orcid":false,"given":"Xumeng","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0984-2592","authenticated-orcid":false,"given":"Xinyu","family":"Sheng","sequence":"additional","affiliation":[{"name":"School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5153-1707","authenticated-orcid":false,"given":"Qiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4500-8914","authenticated-orcid":false,"given":"Xiangqian","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1560-9065","authenticated-orcid":false,"given":"Shunwu","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,12,19]]},"reference":[{"key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s11657-011-0066-8","article-title":"A study of bone mineral density and prevalence of osteoporosis in Chinese people of Han nationality from Changchun","volume":"7","author":"Mengmeng","year":"2012","journal-title":"Arch 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