The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal acute care for the patients aged 50 years and over with a recent fragility fracture and the prevention of subsequent fractures in high-risk patients, which can be facilitated by close collaboration between orthopaedic surgeons and rheumatologists or other metabolic bone experts. Therefore, the aim was to establish for the first time collaborative recommendations for these patients. According to the EULAR standard operating procedures for the elaboration and implementation of evidence-based recommendations, 7 rheumatologists, a geriatrician and 10 orthopaedic surgeons met twice under the leadership of 2 convenors, a senior advisor, a clinical epidemiologist and 3 research fellows. After defining the content and procedures of the task force, 10 research questions were formulated, a comprehensive and systematic literature search was performed and the results were presented to the entire committee. 10 recommendations were formulated based on evidence from the literature and after discussion and consensus building in the group. The recommendations included appropriate medical and surgical perioperative care, which requires, especially in the elderly, a multidisciplinary approach including orthogeriatric care. A coordinator should setup a process for the systematic investigations for future fracture risk in all elderly patients with a recent fracture. High-risk patients should have appropriate non-pharmacological and pharmacological treatment to decrease the risk of subsequent fracture.
- Bone Mineral Density
- Orthopedic Surgery
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Handling editor Hans WJ Bijlsma
WFL and KED are co-first authors. *Jean Puget has since passed away.
↵*Jean Puget has since passed away.
Contributors All authors were contributor to the design of the study including the formulation of research questions, to the analysis of and the discussion around the literature and have read and given comments on the manuscript.
Funding Two one-day meetings were organised, these were financially supported by unrestricted grants from the European League Against Rheumatism and the European Federation of National Associations of Orthopaedics and Traumatology.
Competing interests WFL reports personal fees (speakers fee/advisory boards) from Amgen, Eli Lilly, Novartis and Merck. KED reports personal fees from Agnovos, Amgen, Bayer, Bertelsmann, Heel, Janssen, Eli Lilly, Merck, Sanofi and UCB. HB-F reports to have been an invited speaker/on advisory boards by Roche Diagnostics, Nestlé, Pfizer, WILD, Sanofi and Sandoz. Investigator initiated funding from Nestlé, Pfizer, WILD and DSM Nutritional Products. EC reports remuneration from Amgen and Regeneron during the conduct of the study. TK reports personal fees from AbbVie, Biogen, BMS, Boehringer Ingelheim, Celltrion, Eli Lilly, Epirus, Janssen, Merck-Serono, MSD, Mundipharma, Novartis, Oktal, Orion Pharma, Hospira/Pfizer, Roche, Sandoz and from UCB Pharma. CR reports personal fees from Amgen, MSD, Eli Lilly and grants from Ultragenyx. PG reports grants and other from Amgen and Eli Lilly, and grants from Pfizer, MSD, UCB, Abbott, BMS, Novartis, Roche and Will Pharma.
Provenance and peer review Not commissioned; externally peer reviewed.
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