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Clinical Management and Future Perspectives in Osteoporosis and Fractures
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Clinical Management and Future Perspectives in Osteoporosis and Fractures

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (25 July 2024) | Viewed by 2867

Special Issue Editor

Dr. Laura Tafaro

E-Mail Website
Guest Editor
Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
Interests: geriatrics

Special Issue Information

Dear Colleagues,

Osteoporosis is a common condition characterized by low bone density and an increased risk of fractures. Bone fracture may be the result of impact or stress, or could be a result of certain medical conditions that weaken the bones, such as osteoporosis.

This Special Issue covers a range of topics related to the clinical management of osteoporosis, including the latest advancements in diagnosis, treatment, and prevention strategies. It also explores the impact of osteoporosis on fracture risk and the management of orthopedic trauma in elder patients. Additionally, this Special Issue delves into future perspectives in the field, including emerging therapies, novel diagnostic techniques, and potential advancements in personalized medicine.

We look forward to receiving submissions from medical practitioners from a wide range of backgrounds to provide a comprehensive overview of this important topic.

Dr. Laura Tafaro
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • osteoporosis
  • fracture
  • aging
  • bone loss and fracture risk
  • prevention strategies
  • bone metabolism
  • vitamin D deficiency

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Published Papers (3 papers)

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Research

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53 pages, 1398 KiB  
Article
Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune–Inflammatory–Metabolic Markers and Related Conceptual Issues
by Alexander Fisher, Leon Fisher and Wichat Srikusalanukul
J. Clin. Med. 2024, 13(13), 3969; https://doi.org/10.3390/jcm13133969 - 7 Jul 2024
Viewed by 688
Abstract
Objectives: This study, based on the concept of immuno-inflammatory–metabolic (IIM) dysregulation, investigated and compared the prognostic impact of 27 indices at admission for prediction of postoperative myocardial injury (PMI) and/or hospital death in hip fracture (HF) patients. Methods: In consecutive HF [...] Read more.
Objectives: This study, based on the concept of immuno-inflammatory–metabolic (IIM) dysregulation, investigated and compared the prognostic impact of 27 indices at admission for prediction of postoperative myocardial injury (PMI) and/or hospital death in hip fracture (HF) patients. Methods: In consecutive HF patient (n = 1273, mean age 82.9 ± 8.7 years, 73.5% females) demographics, medical history, laboratory parameters, and outcomes were recorded prospectively. Multiple logistic regression and receiver-operating characteristic analyses (the area under the curve, AUC) were used to establish the predictive role for each biomarker. Results: Among 27 IIM biomarkers, 10 indices were significantly associated with development of PMI and 16 were indicative of a fatal outcome; in the subset of patients aged >80 years with ischaemic heart disease (IHD, the highest risk group: 90.2% of all deaths), the corresponding figures were 26 and 20. In the latter group, the five strongest preoperative predictors for PMI were anaemia (AUC 0.7879), monocyte/eosinophil ratio > 13.0 (AUC 0.7814), neutrophil/lymphocyte ratio > 7.5 (AUC 0.7784), eosinophil count < 1.1 × 109/L (AUC 0.7780), and neutrophil/albumin × 10 > 2.4 (AUC 0.7732); additionally, sensitivity was 83.1–75.4% and specificity was 82.1–75.0%. The highest predictors of in-hospital death were platelet/lymphocyte ratio > 280.0 (AUC 0.8390), lymphocyte/monocyte ratio < 1.1 (AUC 0.8375), albumin < 33 g/L (AUC 0.7889), red cell distribution width > 14.5% (AUC 0.7739), and anaemia (AUC 0.7604), sensitivity 88.2% and above, and specificity 85.1–79.3%. Internal validation confirmed the predictive value of the models. Conclusions: Comparison of 27 IIM indices in HF patients identified several simple, widely available, and inexpensive parameters highly predictive for PMI and/or in-hospital death. The applicability of IIM biomarkers to diagnose and predict risks for chronic diseases, including OP/OF, in the preclinical stages is discussed. Full article
(This article belongs to the Special Issue Clinical Management and Future Perspectives in Osteoporosis and Fractures)
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13 pages, 465 KiB  
Article
Exploring Quality of Life and Mortality in Pertrochanteric Fragility Hip Fractures in Northern Greece: A Single Tertiary Center Study
by Panagiotis Konstantinou, Lazaros Kostretzis, Georgios Fragkiadakis, Panagiota Touchtidou, Argyrios Mavrovouniotis, Vasileios Davitis, Athina Zacharoula Ditsiou, Ioannis Gigis, Anastasios P. Nikolaides, Dimitris Niakas, Pericles Papadopoulos and Konstantinos Ditsios
J. Clin. Med. 2024, 13(9), 2478; https://doi.org/10.3390/jcm13092478 - 24 Apr 2024
Cited by 1 | Viewed by 1468
Abstract
Background: Fragility-related pertrochanteric fractures have become a significant public health concern, with a rising incidence attributed to the expanding elderly demographic. Assessing patient-reported health-related quality of life (HRQoL), mortality, and factors correlated with them serves as a crucial metric in evaluating the effectiveness [...] Read more.
Background: Fragility-related pertrochanteric fractures have become a significant public health concern, with a rising incidence attributed to the expanding elderly demographic. Assessing patient-reported health-related quality of life (HRQoL), mortality, and factors correlated with them serves as a crucial metric in evaluating the effectiveness of hip fracture surgery. Methods: In a single-center retrospective study, 259 patients underwent surgical treatment with a cephalomedullary nail, with a mean follow-up of 21.7 months. Health-related quality of life (HRQoL) was assessed using SF-12 (12-item Short Form) and EQ-5D (EuroQoL-5 Dimensions) questionnaires. Mobility status was measured by the Crude Mobility Index (CMI). Surveys were administered during hospitalization and six months postoperatively. Statistical analysis involved descriptive statistics, non-parametric controls (Kendall, Mann-Whitney, and Wilcoxon), and Spearman correlation and logistic regression analysis, which were conducted using IBM SPSS version 28. Results: A statistically significant decrease was observed in the mean EQ-5D and SF-12 scores at 6 months post-op compared to the pre-fracture status. The ASA (American Society of Anaesthesiologists) score showed a significant correlation with the decrease in HRQoL measured by the SF-12 questionnaire. The 30-day post-operative mortality rate was 9.3%, increasing to 32.4% at 1 year. Notably, the 30-day mortality significantly rose during the pandemic era (5.0% vs. 12.0%; p = 0.003). Conclusions: Pertrochanteric hip fractures cause a lasting decline in quality of life. Annual mortality is high, and further investigations are needed to formulate policies that prevent hip fractures and reduce mortality rates. Full article
(This article belongs to the Special Issue Clinical Management and Future Perspectives in Osteoporosis and Fractures)
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Review

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8 pages, 204 KiB  
Review
The Orthopedic Upper Extremity Surgeon’s Role in the Diagnosis and Treatment of Osteoporosis: Making Use of Opportunistic Imaging
by Caitlin M. Ward, Eric J. Gullborg and Xavier C. Simcock
J. Clin. Med. 2024, 13(17), 5095; https://doi.org/10.3390/jcm13175095 - 28 Aug 2024
Viewed by 393
Abstract
Osteoporosis is an underdiagnosed and undertreated public health issue that contributes to a high financial burden on the healthcare system and imposes significant morbidity and mortality on the patient population. Upper extremity orthopedic surgeons are in a unique position to diagnose osteoporosis prior [...] Read more.
Osteoporosis is an underdiagnosed and undertreated public health issue that contributes to a high financial burden on the healthcare system and imposes significant morbidity and mortality on the patient population. Upper extremity orthopedic surgeons are in a unique position to diagnose osteoporosis prior to patients suffering a fragility fracture by using imaging that they already obtain in their current workflow. The use of X-rays and CT scans can effectively diagnose osteoporosis with high sensitivity and specificity. By incorporating these diagnostic methods into standard practice, upper extremity orthopedic surgeons can play a critical role in the early diagnosis and treatment of osteoporosis. This can prevent severe fractures, improve patient outcomes, and reduce the overall healthcare burden by initiating timely treatment and patient education. This review emphasizes the importance of opportunistic imaging in enhancing osteoporosis management and suggests that upper extremity surgeons can significantly and effectively contribute to primary and secondary fracture prevention. Full article
(This article belongs to the Special Issue Clinical Management and Future Perspectives in Osteoporosis and Fractures)
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