focus Ageing & Health - A Global Priority
According to the American Academy of Orthopaedic Surgeons, by 2050 there will be an estimated 650,000 hip fractures annually in the US.
multimorbidity – that is, the presence of multiple chronic conditions at the same time. Predictably, multimorbidity is also associated with higher rates of healthcare utilization and higher costs. One large systematic review of studies in seven high-income countries concluded that more than half of all older people are affected by multimorbidity, with the prevalence increasing sharply in very old age. One large study from Scotland found that the onset of multimorbidity occurred 10–15 years earlier in people living in the most deprived areas compared with the most affluent. It is also more prevalent in people with low socioeconomic status. This reinforces the theme that good health in older age is closely related to high socioeconomic position. Despite the large numbers of older people experiencing multimorbidities, most health systems are not equipped to provide the comprehensive care needed to manage these complex health states. Clinical care guidelines typically focus on a single condition, rarely incorporating information on potential comorbidities and frequently contradicting recommended treatment or lifestyle changes for other conditions.
society and its healthcare system. As it is becoming increasingly important to keep older adults functional and independent, societies are struggling to find ways to provide high-quality, cost-effective care. This demographic tsunami will drive the need for more research and innovation in the care of the elderly orthopaedic patients. Today, more than ever, many geriatric patients lead active and productive lives. Unfortunately, such a lifestyle can be dramatically changed by an inadvertent slip or fall that causes an orthopaedic injury. According to the American Academy of Orthopaedic Surgeons, by 2050 there will be an estimated 650,000 hip fractures annually in the US. At a cost of USD 26,912 per patient, these injuries represent a staggering economic burden. Only 25% of these patients will make a full recovery, 30% will require nursing-home care and 50% will need either a cane or a walker. Within approximately 1 year, 30% of these elderly patients will die. Data from Europe indicate that hip fractures are a similarly serious problem. Such statistics point out the need for expert and efficient musculoskeletal care.
The Prevalence of Orthopaedic Injuries
One of the major contributing factors to the occurrence of musculoskeletal injuries is osteoporosis. Osteoporosis is a systemic disorder characterized by decreased bone mass and an increased vulnerability to pathological fractures. Fractures in osteoporotic
As the older population continues to increase, musculoskeletal injuries can be expected to become more prevalent and have a profound effect on both
Vertebral Compression Fractures (VCFs) Vertebroplasty or kyphoplasty should be considered for patients in whom a progressive kyphotic deformity or intractable pain develops.
Magnetic resonance imaging of the spine is probably the single most useful test for evaluating a fracture 26
Calcium and vitamin D supplementation, antiresorptive and anabolic agents and weight-bearing exercises are helpful in preventing secondary VCFs
VCFs are common but often silent consequences of osteoporosis the risk of death is increased several-fold during the year following a VCF