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November 2019

Own the Bone registry users were sent an email notification on October 31st, prompting them to establish a password for their new account on REDCap Cloud. If you did not receive an account notification email, or if the link has expired, please contact ownthebone@aoassn.org.

On-demand videos are available to introduce users to the new platform. Site users who would like additional assistance can contact ownthebone@aoassn.org to arrange for training. Staff will also hold additional open office hours for users who have specific questions in preparation for the launch of the new registry. See our FAQs “Will there be training?” for more details.

Need more information? Contact ownthebone@aoassn.org, or call 847-318-7336.

Upcoming Own the Bone Education

Date: Thursday, November 14
Time: 6:00pm ET/5:00pm CT
Speaker: Thomas J. Fischer, MD, FAOA
Moderator: Frederick C. Redfern, MD, FAOA

Thomas J. Fischer, MD, FAOA, from The Indiana Hand to Shoulder Center, joins Own the Bone to discuss distal radius fractures. Dr. Fischer will discuss the incidence of upper extremity fractures and the likelihood of subsequent fractures. Attendees of this webinar will come away with an understanding of the challenges in identifying, evaluating, and initiating bone health treatment of upper extremity fracture patients.

For more information on the 2019 Own the Bone webinar series click here.

The AOA and Own the Bone thank DePuy Synthes/Johnson & Johnson, Amgen, Radius, and Zimmer Biomet for their support of the 2019 Own the Bone webinar series.
Do you have an interesting patient case related to bone health to share? Or do you have a current patient case that you'd like expert feedback on in real time? You can share it with no identifiable information to our ECHO group. If you're interested, fill out the this presentation form and email it to Ben Grace at grace@aoassn.org.

Upcoming Clinic Date: Thursday, November 21
Time: 12:00pm - 1:15pm CT
Presenter: William Leslie, MD, MSc
Topic: DXA Calculators and FRAX

To register for this session or future sessions, please sign-up below for the ECHO email list. Registrants will receive emails the week before each session detailing how to log in for the video conference. There is no cost associated with participating in Project ECHO.

Register here.

If you have already registered, you have been placed on our ECHO mailing list. You will receive log in instructions via email prior to each call.

Other Learning Opportunities

  • International Osteoporosis Foundation Annual Congress
    • April 2-5, 2020; Barcelona, Spain
  • Upcoming Fit to a T Sessions
    • Fit to a T educates men and women about fracture prevention, covering risk factors for fracture and osteoporosis, how to prevent bone loss, and how to avoid a fragility fracture, particularly secondary fractures. If you're interested in attending or hosting a session near you register at www.Fit2T.org.
      • November 14; 1:00pm - 2:00pm; Heritage Center in Overland Park, KS
      • December 4; 11:00am - 1:00pm; Cantebria Senior Homes in Encinitas, CA
Look for details on more upcoming meetings of the affiliated societies of the Own the Bone Organizational Alliance on the calendar linked below.

Latest Bone Health News & Research

European Radiology (05/19) Vol. 29, No. 11, P. 6355 Roski, Ferdinand; Hammel, Johannes; Mei, Kai; et al.
A study investigated the in vivo applicability of non-contrast-enhanced hydroxyapatite (HA)-specific bone mineral density (BMD) measurements based on dual-layer CT (DLCT). A spine phantom containing three artificial vertebral bodies with known HA densities was measured to obtain spectral data using DLCT and quantitative CT (QCT), simulating different patient positions and grades of obesity. BMD was calculated from virtual monoenergetic images at 50 and 200 keV. HA-specific BMD values of 174 vertebrae in 33 patients were determined in non-contrast routine DLCT and compared with corresponding QCT-based BMD values. The results showed HA-specific BMD measurements were on a par with QCT measurements. In vivo measurements revealed strong correlations between DLCT and QCT and substantial agreement in a Bland–Altman plot. Researchers concluded that DLCT-based HA-specific BMD measurements were comparable with QCT measurements in in vivo analyses. This suggests that opportunistic DLCT-based BMD measurements are an alternative to QCT, without requiring phantoms and specific protocols. Read More

The Lancet (10/14/19) Tsai, Joy; Lee, Hang; David, Natalie; et al.
Researchers conducted a study to assess whether administration of denosumab with high dose teriparatide would stimulate larger increases in bone mass than those observed in the DATA study. DATA-HD was an open-label, randomised, controlled phase 4 trial done at Massachusetts General Hospital. Eligible women were postmenopausal women with osteoporosis. Participants were randomly assigned to receive teriparatide 20 µg or 40 µg daily via subcutaneous injection for nine months. Women were assessed for eligibility. Seventy-six participants were randomly assigned to 20 µg teriparatide or 40 µg teriparatide, of whom 69 completed at least one post-baseline visit. At 15 months, mean spine aerial bone mineral density (BMD) had increased to a significantly greater extent in the 40 µg group than the 20 µg group. Combined treatment with teriparatide 40 µg and denosumab increases spine and hip BMD more than standard combination therapy. This large and rapid increase in bone mass suggest that this high dose regimen might provide a method of restoring skeletal integrity in patients with osteoporosis. Read More

Annals of the Rheumatic Diseases (09/26/2019) Leutner, Michael; Matzhold, Caspar; Bellach, Luise; et al.
The primary mechanism of statins is HMG-CoA-reductase inhibition, but what role this mechanism plays in the pathogenesis of osteoporosis is not fully understood. The goal of this study was to examine links between different dosages and kinds of statins with osteoporosis. The researchers used medical claims data of all Austrians from 2006 to 2007 to identify all patients treated with statins to compute their daily defined dose averages of six different types of statins. The researchers then applied multiple logistic regression to analyse the dose-dependent risks of being diagnosed with osteoporosis for each statin individually. In the general study population, statin treatment was associated with an overrepresentation of diagnosed osteoporosis compared with controls. There was a highly non-trivial dependence of statin dosage with the odds ratios of osteoporosis. Osteoporosis was underrepresented in low-dose statin treatment (0–10 mg per day), including lovastatin, pravastatin, simvastatin, and rosuvastatin. However, the exceeding of the 40 mg threshold for simvastatin and the exceeding of a 20 mg threshold for atorvastatin and for rosuvastatin was related to an overrepresentation of osteoporosis. The results indicate that osteoporosis is underrepresented in low-dose and overrepresented in high-dose statin treatment, demonstrating the importance of future studies' taking dose-dependency into account when investigating the relationship between statins and osteoporosis. Read More

Archives of Osteoporosis (10/19) Cobden, Adem; Cobden, Serap; Camurcu, Yalkin; et al.
Researchers studied the status of osteoporosis treatment in patients who underwent hemiarthroplasty for an osteoporotic hip fracture and to compare subsequent fractures and the five-year survival rates of these patients with those who did not receive the osteoporosis treatment. Patients who underwent hemiarthroplasty for an osteoporotic hip fracture were included in this retrospective multi-center study. Patients who died within 12 months postoperative, who were lost to follow-up, and those with malignancy and secondary osteoporosis were excluded. Group I comprised patients who had no postoperative osteoporosis screening and treatment, and Group II comprised those who received the screening and treatment. 460 out of 562 patients did not receive osteoporosis treatment after hip fracture. No significant difference was observed between the groups in terms of subsequent fracture numbers and fracture sites. Mean five-year survival rate was significantly higher in Group II. The results showed elderly patients who underwent hemiarthroplasty for an osteoporotic hip fracture were not commonly screened or treated for osteoporosis. The results demonstrated no significant difference between the groups in terms of subsequent fracture. However, researchers observed a five-year survival rate among patients who received the osteoporosis treatment. Read More

Scientific Reports (09/20/19) Castillo, Maria; Ramirez, Maria; Arroyo, Ruben; et al.
A study was conducted to determine whether postprandial plasma levels of glucagon-like peptide 1, glucagon-like peptide 2 and dipeptidyl-peptidase 4 activity, are associated with osteoporosis in non-diabetic postmenopausal women. Researchers studied non-diabetic postmenopausal women with osteoporosis diagnosed by dual-energy X-ray absorptiometry and age-matched (±1 year) controls without osteoporosis or a history of osteoporotic fracture. The study also measured postprandial plasma levels of glucagon-like peptide 1, glucagon-like peptide 2, and dipeptidyl-peptidase 4 activity, bone mineral density, and baseline levels of bone remodeling markers and analyzed the food intake using a food-frequency questionnaire. The main finding of this study was the association between plasma GLP1 levels and osteoporosis in non-diabetic postmenopausal women. Postprandial GLP1 values were significantly lower in non-diabetic postmenopausal women with than without osteoporosis, and higher values were significantly associated with a reduction in osteoporosis risk in the crude and adjusted logistic regression analyses. The researchers observed a clear association with osteoporosis in the comparison of means and in the conditional logistic regression. Read More

American Journal of Kidney Diseases (10/19) Vangala, Chandan; Niu, Jingbo; Montez-Rath, Maria; et al.
Use of selective serotonin reuptake inhibitors (SSRIs) has been associated with hip fracture risk in the general population. A study examined this relationship among patients with kidney failure treated by hemodialysis within which the impact of SSRIs on hip fracture risk remains unexplored. Eligible cases of hip fracture among maintenance hemodialysis patients were identified using the US Renal Data System. To be eligible, study participants needed to have more than 1 year of Medicare Parts A and B coverage and more than 3 years of Part D coverage. For a separate examination of new short-term SSRI exposure, researchers selected cases and controls with more than 18 months of Part D coverage and no prior antidepressant use for 1 year. During the 3-year Part D coverage period, use of SSRIs characterized as any, low, moderate, and high use. SSRI use was associated with increased hip fracture risk. Risk for fracture was estimated for any, low, moderate, and high SSRI use: adjusted conditional ORs were 1.25, 1.31, and 1.26, respectively. The association between hip fracture events and SSRI use was also seen in the examination of new short-term use. The study found an association between increased hip fracture risk and both long- and new short-term SSRI use. The stronger association with new short-term use may suggest an acute mechanism potentially related to falls. Read More

Recognizing Our Corporate Supporters

The American Orthopaedic Association acknowledges the following companies for their generous support of Own the Bone. (as of 11/10/19)

Educational Alliance



(Under $24,999)

In Case You Missed It

Use Own the Bone's Video Library to watch last month's didactic presentation from Sarah L. Morgan, MD, MS, RD on Nutrition for Osteoporosis.

The Own the Bone® Orthopaedic Bone Health ECHO® aims to grow and share bone health knowledge and skills among orthopaedic providers in order to reduce the incidence of fragility fractures and positively impact bone health treatment.

To register for future sessions, please sign-up below for the ECHO email list. Registrants will receive emails the week before each session detailing how to log in for the video conference. There is no cost associated with participating in Project ECHO.

Register here.

Organizational Alliance

The American Orthopaedic Association thanks the 26 members of the Organizational Alliance who collaborate in the shared mission of increasing awareness and improving the bone health care of patients with management of fragility fracture patients.

Learn more

News summaries © copyright 2019 SmithBucklin

Own the Bone® is a national quality improvement program aimed at secondary fracture prevention. Its web-based registry and 10 prevention measures support a multidisciplinary approach to the care of fragility fracture patients.

Own the Bone strives to change physician and patient behavior by promoting post-fracture bone health evaluation and treatment. Ultimately, Own the Bone’s primary goal is to reduce the incidence of future fractures and improve the health and wellbeing of older adults.

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