Prevalence of Osteopenia and Osteoporosis in Orthopaedic Outpatients in Southern India

Introduction: Osteoporosis is a common metabolic bone disorder. Yet it is underdiagnosed and undertreated in clinical settings. Many studies have shown that, as part of the treatment of fragility fractures, early osteoporosis screening by orthopaedic surgeon, can lead to better management. Even better would be if orthopaedic surgeons could prevent these fragility fractures by routine Bone Mineral Density (BMD) screening in indicated patients to diagnose it early and treat them before fracture occurs. Aim: To find out the age-related prevalence of osteopenia and osteoporosis in patients who attend orthopaedic outpatient clinics in southern India, using quantitative calcaneal ultrasound. Materials and Methods: This was a multicentric cross-sectional study conducted between January 2017 to September 2017 in seven centres in the union territory of Puducherry and one centre in the state of Tamil Nadu. The patients were divided into young (<35 years), middle age (36-55 years) and elderly (>55 years) groups and screened using quantitative calcaneal ultrasound and then BMD was grouped as normal, osteopenia and osteoporosis according to WHO T-score criteria. Statistical analysis were done using SPSS version 23.0. Analysis were carried out at 5% level of significance and p <0.05 (2-sided) was considered statistically significant. Results: The overall prevalence of osteopenia and osteoporosis in present study were found to be (48.4%) and (6.6%) respectively in all the age groups. Women had more prevalence of osteoporosis (9.3%), while men had only (3.5%). But osteopenia was more prevalent in men (51.2%) than women (45.9%). The main finding of the present study was the high prevalence of osteopenia in the middle age group (35-55 years) men and women; (54%) in men and (51%) in women. In the present study even (39%) of men and (34%) women in the young age group were found to be osteopenic while (1%) of men and (3%) of women in the same age group were osteoporotic. Conclusion: We found a high prevalence of osteopenia in the age group of 35-55 years. Hence, we recommend extending routine screening for BMD in middle aged orthopaedic outpatients. And the common understanding that low BMD is mainly a disease of the elderly needs to be reconsidered.