Osteoporosis -: a neglected issue in orthopaedics?: Results of a nation-wide survey amongst orthopaedic surgeons

Aim: Patients with fragility fractures have a significantly increased risk of sustaining additional fractures. Therefore one should consider avoidance of further fractures as the primary treatment principle. Since orthopaedic surgeons manage most of fragility fractures, but might not be well attuned to osteoporosis itself, it was the aim of the Bone and joint Decade (BJD) and the International Osteoporosis Foundation (IOF) to survey orthopaedic surgeons in order to assess their knowledge of prevention, diagnosis, and treatment of osteoporosis. Material and Methods: The multinational survey questionnaire was developed by a working group of national project co-ordinators in France, Germany, Italy, Spain, the United Kingdom, and New Zealand and based to some extent on an American survey. Following translation into the national language it was distributed in 2002 to the members of the orthopaedic societies to assess the management of prevention, diagnosis, and therapy of osteoporosis and fragility fractures, comparing both different health-care systems and different working environments. 5 700 questionnaires were distributed in Germany with a 20 percent response rate. Results: As the main result of the German survey - independent of the working environment - a substantial deficit concerning training and knowledge about the management of prevention, diagnosis, and treatment of osteoporosis and fragility fractures was seen. In addition, the majority of participants requested educational opportunities to become qualified for a better disease control. Conclusion: In order to satisfy the increasing need for adequate management of prevention, diagnosis, and therapy of osteoporosis and fragility fractures, structured educational opportunities have to be offered to the German orthopaedic community. In the mean time first steps have been initiated: training courses to qualify as "Osteologe DVO" and the "White Book Osteoporosis", which was initiated by BJD and IOF and developed by several German medical societies and patient organisations it is based on the German DVO guidelines providing an evidence-based and structured overview concerning all relevant aspects of osteoporosis and fragility fractures.