{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:20Z","timestamp":1787755280471,"version":"build-2784847793"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Fragility fractures are often sentinel events in documenting new cases of osteoporosis. Numerous analyses have demonstrated low rates of adequate osteoporosis evaluation and treatment following primary fragility fractures. The purpose of this study was to quantify the incidence of primary fragility fractures in America and the rates of osteoporosis screening and management before and after fracture.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A retrospective review of the PearlDiver database was conducted using the International Classification of Diseases, Ninth Revision (ICD-9) and ICD, Tenth Revision (ICD-10) and Current Procedural Terminology codes. Patients who were 60 to 80 years of age and had primary fragility fractures of the hip, wrist, spine, pelvis, humerus, and other unspecified locations were included. The rates of dual x-ray absorptiometry (DXA) screening and osteoporosis pharmacotherapy were assessed for 2 years before and 2 years after the primary fracture.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n In this study, 48,668 patients with a primary fragility fracture were identified. Within this cohort, 25.8% (12,573 of 48,668) had received osteoporosis screening or treatment in the prior 2 years. In the 36,095 patients with no management before the fracture, 19% (6,799 patients) were diagnosed with osteoporosis and 18.4% (6,653 patients) received a DXA scan and\/or filed claims for pharmacotherapy in the following 2 years. Patients with an osteoporosis diagnosis were more likely to receive both types of management (odds ratio [OR], 11.55 [95% confidence (CI), 10.31 to 12.95]), and male patients were less likely to receive both types of management (OR, 0.23 [95% CI, 0.17 to 0.27]). Secondary fragility fractures within the next 2 years were diagnosed in 8.4% (3,038 of 36,095) of patients at a mean of 221 days following the primary fracture.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The rates of appropriate osteoporosis evaluation, diagnosis, and management following primary fragility fractures remain unacceptably low. Less than one-third of patients with primary fragility fractures had been evaluated or treated for osteoporosis in the 2 years prior to fracture. Furthermore, among patients without pre-fracture management, <20% received osteoporosis screening or treatment within the next 2 years.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Prognostic\n Level IV<\/jats:underline>\n . See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.oa.20.00142","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T14:08:07Z","timestamp":1623679687000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":29,"title":["Rates of Osteoporosis Management and Secondary Preventative Treatment After Primary Fragility Fractures"],"prefix":"10.2106","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3977-9467","authenticated-orcid":false,"given":"Bailey J.","family":"Ross","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1024-9729","authenticated-orcid":false,"given":"Olivia C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7003-6138","authenticated-orcid":false,"given":"Mitchel B.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6826-3075","authenticated-orcid":false,"given":"Thomas C.","family":"Dowd","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, San Antonio Uniformed Services Health Education Consortium Orthopaedic Residency Program, Fort Sam Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1064-8428","authenticated-orcid":false,"given":"Felix H.","family":"Savoie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4097-5668","authenticated-orcid":false,"given":"William F.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,4]]},"reference":[{"issue":"2","key":"R1-20240801","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1016\/j.bone.2005.11.024","article-title":"Osteoporosis: a still increasing prevalence","volume":"38","author":"Reginster","year":"2006","journal-title":"Bone"},{"issue":"11","key":"R2-20240801","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.1002\/jbmr.2269","article-title":"The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine","volume":"29","author":"Wright","year":"2014","journal-title":"J Bone Miner Res"},{"key":"R3-20240801","article-title":"Osteoporosis and bone health","author":"Wright","year":"2020","journal-title":"The Burden of Musculoskeletal Diseases in the United States (BMUS): Prevalence, Societal and Economic Cost. 4th ed. 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