2011, Number 5
<< Back Next >>
Acta Ortop Mex 2011; 25 (5)
Diagnosis and treatment of osteoporosis. Position of the Mexican College of Orthopedics and Traumatology
Cymet-Ramírez J, Cisneros-Dreinhofer FA, Álvarez-Martínez MM, Cruz-González I, de la Fuente-Zuno JC, Figueroa-Cal y Mayor FJ, García-López OF, Gómez-García F, Mirassou-Ortega M, Legorreta-Cuevas JG, Medinaveitia A, Nájera-Castro MA, Sierra-Martínez O, Ojeda-Padilla EA, Suárez-Espinosa VF, Vallejo-Almada J, Valles-Figueroa JF, Villalobos-Garduño FE, Vázquez-Camacho L
Language: Spanish
References: 47
Page: 303-312
PDF size: 85.11 Kb.
ABSTRACT
Our current in Mexico is that it represents a serious health problem not yet recognized as low-energy fractures in older adults account for approximately 10% of subjects over 65 years (compared with 29% in Japan ) about 4.4 million fractures in patients over 70 years, taking into account that we are a nation of 112 million, the problem is minor compared with other diseases in this and other population groups. In the Mexican health system, orthopedic services instead share with other health priorities, so that the authorities do not understand osteoporosis as a health problem, not observe increased morbidity and mortality that implicitly leads, there are few centers to support the diagnosis of osteoporosis (densitometers do not have), and recruitment, diagnosis and management of patients who have suffered a broken ground mechanically compromised. Have increased the frequency of fractures in osteoporotic ground, and institutional level has only treatments based on calcitriol and calcium to maintain bone mineral density. In the Mexican health system, orthopedic services instead share with other health priorities, so that the authorities do not understand osteoporosis as a health problem, not observe increased morbidity and mortality that implicitly leads, there are few centers to support the diagnosis of osteoporosis (we don´t count with densitometers), and recruitment, diagnosis and management of patients who have suffered a broken ground mechanically compromised. Have increased the frequency of fractures in osteoporotic ground, and institutional level has only treatments based on calcitriol and calcium to maintain bone mineral density.
REFERENCES
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy: Osteoporosis prevention, diagnosis and therapy. JAMA 2001; 285: 785-95.
Tortolani PJ, McCarthy EF, Sponseller PD: Bone mineral density deficiency in children: J Am Acad Orthop Surg 2002; 10: 57-66.
Gómez GF: Morbimortalidad de fracturas de cadera en el Hospital de Traumatología Magdalena de las Salinas. IMSS. Rev Mex Ortop Traum 1998; 2: 48-52.
Clark P, Lavielle P, Franco-Marina F, Ramírez E, Salmerón J, Kanis JA, et al: Incidence rates and life-time risk of hip fractures in mexicans over 50 years of age: a population-based study. Osteoporos Int 2005; 16(12): 2025-30.
Gómez GF, Figueroa GF y cols: Osteoporosis. Rev Mex Ortop y Traum 1988; l2(4): 114-8.
Martín NP: La osteoporosis. Actualizaciones en Osteología 2007; 3(2): 117-36.
Clark PF, Cons-Molina M, Deleze, et al: Prevalence of radiographic vertebral fractures in Latin American countries. Osteoporosis Int 2008; DOI 10.1007/s00198-008-0657-4.
Álvarez-Mon S, et al: Osteoporosis. Medicine 2006: 2-76.
Nájera-Castro MA: El tejido óseo, un análisis desde su formación hasta su destrucción. Capítulo 5: Trauma y Cirugía de Cadera, Editorial Prado, 1ª. Ed. México 1998.
Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster JY, et al: European guidance for diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2008; 19: 399-428.
Kanis JA: Diagnosis of osteoporosis and assessment of fracture risk. Lancet 2002; 359(9321): 1929-36.
World Health Organization: Assessment of osteoporosis at the primary health care level. Summary Report of the WHO Scientific Group. WHO Geneva 2007.
Gómez GF: Densitometría clínica “por una salud ósea”. Disponible en: www.densitometria.com.mx 14-03-2010
National Osteoporosis Fundation: Physician’s Guide to prevention and treatment of osteoporosis. Available in: http://www.nof.org 14-03-11
Kanis JA: Behalf of the World Health Organization Scientific Group Assessment of osteoporosis at the primary health care level. Technical Report WHO Collaborating Centre, University of Sheffield, Sheffield 2007.
Cons M: Densitometría ósea. En: Reza A, Mendoza V, editores. Enfermedades del metabolismo óseo y mineral. 1ª ed. México: Prado, 2006: 17-70.
WHO Scientific Group Technical Report: Assessment of osteoporosis at the primary health care level. Available in: www.shef.ac.uk/FRAX 14-03-11
Benjamin MP, Tang MD, et al: Use of calcium or calcium. Lancet 2007; 370: 657-66.
Bonaiuti D, Shea B, Iovine R, Negrini S, Robinson V, Kemper HC, et al: Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 2002; 3: CD000333.
Kannus P, Sievanen H, Palvanen M, Jarvinen T, Parkkari J: Prevention of falls and consequent injuries in elderly people. Lancet 2005; 366: 1885-93.
Oliver D, Connelly JB, Victor CR, Shaw FE, Whitehead A, Genc Y, et al: Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review. Cochrane Database Syst Rev 2002; 3: CD000347.
Sawka AM, Boulos P, Beattie K, Thabane L, Papapioannou A, Gafni A, et al: Do hip protectors decrease the risk of hip fractures in institutional and community-dwelling elderly? A systematic review and meta-analysis of randomized controlled trials. Osteoporos Int 2005; 16: 1461-74.
Kiel DP, Magaziner J, Zimmerman S, Ball L, Barton BA, Brown KM, et al: Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized controlled trial. JAMA 2007; 298: 413-22.
Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, et al: Randomized trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 1996; 348: 1535-41.
Chesnut CH, Azria M, Silverman S, Engehardt OM, Mindeholm L: Salmon calcitonin: a review of current and future therapeutic indications. Osteoporos Int 2008; 19: 479-91.
Chesnut CH, et al: A randomized trial of nasal spray salmon calcitonin in post-menopausal woman with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study Group. Am J Med 2000; 109: 267-76.
Delmas P: Treatment of postmenopausal osteoporosis. Lancet 2002; 359: 2018-26.
Torgerson DJ, Bell-Syer SE: Hormone replacement therapy and prevention of non-vertebral fractures: a meta-analysis of randomized trials. JAMA 2001; 285: 2891-7.
Cauley JA, Robbins J, Chen Z, Cummings SR, Jackson RD, La Croix AZ, et al: Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women´s Health Initiative randomized trial. JAMA 2003; 290: 1729-38.
Sornay-Rendu E, Garnero P, Muñoz F, Duboeuf F, Delmas PD: Effect of withdrawal of hormone replacement therapy on bone mass and bone turnover: the OFELY study. Bone 2003; 33: 159-66.
Bagger YZ, Tanko LG, Alexandersen P, Hansen HB, Mollgaard A, Ravn P, et al: Two to three years of hormone replacement treatment in healthy women have long-term preventive effects on bone mass and osteoporotic fractures: The PERF study. Bone 2004; 34: 728-35.
Ettinger B, Black DM, Mitlak BH, Knickerbrocker RK, Nickelsen T, Genant HK, et al: Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3 year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 1999; 282: 637-45.
CORE, Cummings SR, Eckert S, Krueger KA, Grady D, Powles TJ, Cauley JA, et al: The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation. JAMA 1999; 281: 2189-97.
Prince R, Sipos A, Hossain A, Syversen U, Ish-Shalom S, Marcinowska E, et al: Sustained non vertebral fragility fracture risk reduction after discontinuation of teriparatide treatment. J Bone Miner Res 2005; 20: 1507-13.
Finkelstein JS, Hayes A, Hunzelman JL, Wyland JJ, Lee H, Neer RM: The effects of parathyroid hormone, alendronate, or both in men with osteoporosis. N Engl J Med 2003; 349: 1216-26.
Black DM, Greenspan SL, Ensrud KE, Palermo L, McGowan JA, Lang TF, et al: The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N Engl J Med 2003; 249: 1207-15.
Ettinger B, San Martin J, Crans G, Pavo I: Differential effects of teriparatida on BMD after treatment with raloxifene or alendronate. J Bone Min Res 2004; 19: 745-50.
Meunier PJ, Roux C, Seeman E, Ortolani S, Baduski JE, Spector TD, et al: The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004; 50: 459-68.
Reginster JY, Seeman E, De Vernejoul MC, Adami S, Compston J, Phenekos C, et al: Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: treatment of peripheral osteoporosis (TROPOS) study. J Clin Endocrinol Metab 2005; 90: 2816-22.
Rabenda V, Hanssens L, De Ceulaer F, Reginster JY: Is there any interest in combining treatments in osteoporosis? Curr Rheumatol Rev 2005; 1: 49-55.
Roussow JE, Anderson GL, Prentice RL, La Croix AZ, Kooperberg C, Stefanick ML, et al: Risk and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women´s Health Initiative randomized controlled trial. JAMA 2002; 288: 321-33.
ICF: Research Branch. I CF Core Set for Osteoporosis. Available in: http://www.icf-research-branch.org/icf-core-sets-projects/musculoskeletal-conditions/icf-core-set-for-osteoporosis.html. 30-06-11.
Maricic, et al: Early effects of raloxifene on clinical vertebral fractures at 12 months in postmenopausal women with osteoporosis. Arch Intern Med 2002; 162: 1140-3.
Holick MF: Vitamin D. Am Soc Bone Mineral Res 2006: 129-37.
El ranelato de estroncio en el tratamiento de la osteoporosis. Seminarios de la Fundación Española de Reumatología 2005; 6(2): 43-52.
Heini PF: The current treatment-a survey of osteoporotic fracture treatment. Osteoporotic spine fractures: the spine surgeon´s perspective. Osteoporos Int 2005; 16: S85-S92.
Seebeck J, Goldhahn J, Morlock MM, Schneider E: Mechanical behavior of screws in normal and osteoporotic bone. Osteoporos Int 2005; 16: S107-S111.