The Orthopaedic Surgeon and the Diseases of Skeletal Metabolism

  • George Kapetanos Emeritus Professor of Orthopaedics
Keywords: Osteoporosis; Fragility fractures; Fracture liaison services


Fragility fractures, namely fractures from low-energy mechanisms that would not produce fracture in a healthy bone, are most commonly caused by osteoporosis, and constitute a major financial burden worldwide. The effectiveness of systems for the prevention of fragility fractures, also known as fracture liaison services (FLS) has been investigated by numerous programs. The FLS is a coordinated care paradigm where several providers work together to help the patient manage their osteoporosis following a fragility fracture in order to help prevent subsequent fractures. FLS offers a thorough method for not only identifying individuals who are at risk for secondary fracture but also for putting into practice evidence-based therapies to stop further fractures. For the FLS to be successful, doctors, nurses, administration and national healthcare systems must work together toward the common objective of protecting patients aged 50 and older from fragility fractures. This review article discusses the current FLS programs, their pros and cons, and emphasizes on the Greek FLS model.


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1. Knowledge to Practice(K2P). How much knowledge Do Physicians Lose over the time? July 18,2018
2. Lyritis, G. Metabolic Bone Diseases. Hylonome ed.6th ed., Athens 2021
3. Kapetanos G. Metabolic Diseases of Bone, University Studio Press, Thessaloniki,2010
4. Makras P, Vaiopoulos G, Lyritis G. Greek National Medicine Agency. Guidelines for diagnosis and treatment of osteoporosis in Greece. J. Musculoskel. Neuronal Interactions 2012; 12:38-42
5. Milat F, Eballing PR. Osteoporosis treatment: a missed opportunity. The Medical j. of Australia 2016; 205:185-190
6. Figliomeni A, Signorini V, Mazantini T. One year in review 2018: progress in osteoporosis treatment. Clinical and Experimental Rheumatology 2018;948-958
7. Compston JE, Papapoulos SE, Blackhard F. Report on osteoporosis in the European community: current status and recommendation for the future. Osteoporosis Int. 1998; 8:531-534
8. Cummings SR, Melton LJ Epidemiology and outcomes of osteoporotic fractures. Lancet 2002; 359:1761-1767.
9. NIH Consensus development panel on osteoporosis. JAMA 2001; 285:785-795
10. World Health Organization Assessment of osteoporosis at the primary health care level/WHO Scientific meeting, Geneva 2997
11. Kapetanos G. Educating physicians for osteoporosis Common Meeting of Greek and Dutch metabolic bone societies, Athens,10=12 Oct.2019
12. Kapetanos G, Osteoporosis and Orthopedic surgeon. University Studio Press Thessaloniki,2012