Osteoporosis: management and densitometry for orthopaedic surgeons.

Osteoporosis is a metabolic condition that is increasing in prevalence as people live longer. A fracture is a sentinel event. Despite all the advances in technology, a history of low-energy fracture in adulthood is the best predictor of future fracture-an even better predictor than low bone mineral density. Osteoporosis and the risk of fracture go hand in hand. The orthopaedic surgeon is often viewed as an expert in managing and treating bone disorders. Given that the orthopaedic surgeon is often the first and only physician to evaluate a patient with a fracture, he or she may be in the ideal position to initiate patient evaluation and therapy. However, many times the orthopaedic surgeon is concerned about the adverse effects of the pharmacologic treatment of osteoporosis to the extent that prescribing these drugs is avoided. A treatment approach incorporating nonpharmacologic agents is an effective strategy in the prevention and treatment of osteoporosis.