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October 2019


A next generation Own the Bone patient registry will be launched in late October on the REDCap Cloud® platform. The existing Clinipace registry is scheduled to close at 5:00pm ET on Tuesday, October 15. There will be a transition period while the data from all Own the Bone centers is transitioned to the new platform. All existing Clinipace users should expect to receive an email notification that their new REDCap Cloud registry credentials are ready by Wednesday, October 30.

In preparation for the transition, on-demand video training is available on the Own the Bone website, and a schedule of “office hours” has been established for users to seek additional information and support from Own the Bone staff during the week of October 21.

For more information on the training or the registry transition please read the FAQs here. If you have any questions please contact Own the Bone staff at ownthebone@aoassn.org or 847-318-7336.

Program News




The Own the Bone program recognized 2020 Star Performer and newly-enrolled institutions through an advertisement in the US News & World Report Best Hospitals Guide 2020 print edition. Enrolled institutions should be receiving both a copy of the guide and their semi-annual data set shortly. For more information on how your institution can meet the criteria and be recognized next year contact Own the Bone staff at ownthebone@aoassn.org or 847-318-7336.






Own the Bone Organizational Alliance member, the International Osteoporosis Foundation (IOF), created and organizes World Osteoporosis Day (WOD) every October 20th. This day launches a year-long campaign to raise global awareness of the prevention, diagnosis, and treatment of osteoporosis and metabolic bone disease. It aims to put bone health and fracture prevention on the global health agenda and reaches out to health-care professionals, the media, policy makers, patients, and the public at large.

In 2019 the campaign will feature “THAT’S OSTEOPOROSIS” as a headline, and, for the first time, will highlight emotionally impactful visuals and stories of real people living with osteoporosis in all regions of the world. The official campaign toolkit is linked here.

Own the Bone subscribers can also access a special Own the Bone media kit to help publicize their commitment to bone health in relation to World Osteoporosis Day. The media kit includes press releases, an activity guide, and a social media guide and is linked here. Star Performer sites will recieve additional materials in a mailing this month.

Upcoming Own the Bone Education




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. Each month, a panel of experts will host participants on a videoconferencing platform to discuss current topics related to bone health and to initiate a dialogue around patient cases presented by participants. These "teleECHO® clinics" are multidisciplinary and interactive, so participants are encouraged to learn but also to share their knowledge and experiences.

Upcoming Clinic Date: Thursday, October 17
Time: 12:00pm - 1:15pm CT
Presenter: Sarah L. Morgan, MD, MS, RD
Topic: Nutrition for Osteoporosis

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.

Participants are encouraged to submit patient cases and present them during future calls. Please contact Associate Program Manager, Ben Grace, at grace@aoassn.org for more information.
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.

Other Learning Opportunities




  • Association of Hip and Knee Surgeons Annual Meeting
    • November 7-10; Dallas, TX
  • Pennsylvania Orthopaedic Society Annual Scientific Meeting
    • November 8-9; Philadelphia, PA
  • 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.
      • October 17; 11:00am - 12:00pm; Mercy Housing - Marian Park Apartments in Wheaton, IL
      • October 19; 10:30am - 11:30am; Shreve Memorial Library Broadmoor Branch in Shreveport, LA
      • October 22; 2:30pm - 3:30pm; Meadow Cliff Apartments in Oklahoma City, OK
      • October 24; 12:30pm - 1:30pm; Sherwood Regional Family YMCA in Sherwood, OR
      • November 4; 2:00pm - 3:00pm; Colorado Springs Senior Center in Colorado Springs, CO
      • November 5; 12:00pm - 1:00pm; Bryant University in Smithfield, RI
      • November 8; 3:00pm - 4:00pm; The Evangelical Lutheran Good Samaritan Society in Greeley, CO
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



JAMA Internal Medicine (08/19/19) Cummings, Steven; Lui, Li-Yung; Eastell, Richard; et al.
Researchers conducted a study to assess whether randomized clinical trials demonstrate that treatment with bisphosphonates, particularly zoledronate, is associated with reduced mortality rates. Science Direct, MEDLINE, Embase, and the Cochrane Library were searched for randomized placebo-controlled clinical trials of drug treatments for osteoporosis published after 2009 and published or in press before April 19, 2019. Of 38 clinical trials that included 101?642 unique participants, 38 were included in the meta-analyses of all drug treatments; 21 clinical trials, of bisphosphonate treatments; and 6 clinical trials, of zoledronate treatments. No significant association was found between all drug treatments for osteoporosis and overall mortality rate. Clinical trials of bisphosphonate treatment showed no significant association with overall mortality. Also, clinical trials of zoledronate treatment showed no association with overall mortality rate; however, evidence existed for heterogeneity of the results. The study concluded bisphosphonate treatment may not be associated with reduced overall mortality rates in addition to decreased fracture risk and should only be recommended to reduce fracture risk. Additional trials are needed to clarify whether treatment with zoledronate reduces mortality rates. Read More

Menopause (08/19) Lijuan, Yang; Xiang, Hu; Wei, Pan; et al.
Researchers investigated the association of family history of diabetes (FHD) with bone mineral density (BMD) in postmenopausal women. In all, 892 normoglycemic postmenopausal women were divided into subgroups of participants with or without a first-degree FHD. BMD was measured using dual-energy x-ray absorptiometry. Fasting plasma insulin and glucose levels were measured, and insulin resistance was evaluated using the Homeostasis Model Assessment—Insulin Resistance (HOMA-IR) index. The BMD of the lumbar spine and femoral neck were much higher in the participants with a first-degree FHD than in those without an FHD. Lumbar spine BMD and femoral neck BMD were both positively associated with HOMA-IR. Multiple stepwise regression analysis showed that a first-degree FHD was an independent factor that was positively associated with lumbar spine BMD and femoral neck BMD. A first-degree FHD was associated with increased BMD, insulin resistance, and hyperinsulinemia. The study indicated that normoglycemic postmenopausal women with a first-degree FHD exhibit increased BMD with insulin resistance and hyperinsulinemia. A first-degree FHD was an independent factor associated with elevated BMD in Chinese women after menopause. Read More

The Lancet Diabetes & Endocrinology (08/22/19) Tsai, Joy; Lee, Hang; David, Natalie; et al.
In a Denosumab and Teriparatide Administration (DATA) study, researchers showed that denosumab fully inhibits teriparatide-induced bone resorption while allowing for continued teriparatide-induced bone formation, resulting in larger increases in hip and spine bone mineral density (BMD) than with either drug alone. New research aimed 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, randomized, 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 9 months. At 3 months, both groups were started on denosumab 60 mg every 6 months via subcutaneous injection for 12 months. The research found that at 15 months, mean spine aBMD had increased to a significantly greater extent in the 40 µg group than the 20 µg group. The researchers concluded that combined treatment with teriparatide 40 µg and denosumab increases spine and hip BMD more than standard combination therapy. Read More

JAMA (08/27/19) Burt, Lauren; Billington, Emma; Rose, Marianne; et al.
Researchers conducted a study to determine if higher-doses of vitamin D supplementation can improve bone mineral density (BMD) and bone strength. The study included 311 healthy adults treated with vitamin D for three years at a dose of 4,000 IU per day or 10, 000 IU per day, compared with 400 IU per day. This resulted in statistically significant lower radial BMD. Tibial BMD was also found to be significantly lower only with the daily dose of 10,000 IU. However, there were no significant differences in bone strength at the radius or tibia. Researchers concluded that supplementation with higher doses of vitamin D did not result in improved bone health, but more research would be needed to determine if it is harmful. Read More

Health Leaders Media (09/11/19) O'Brien, Jack
A Milliman study commissioned by the National Osteoporosis Foundation (NOF) estimates that osteoporosis and subsequent bone fractures exceeded $6.3 billion in additional costs to Medicare in 2015. Two million Medicare beneficiaries suffered 2.3 million fractures in 2015, yet only 9 percent of enrollees were screened for osteoporosis within half a year of the initial fracture. In the year-long period following osteoporotic fracture, the direct medical cost topped $21,800 per beneficiary, more than double the costs incurred in the 12-month period prior to the injury. Although more than 40 percent of beneficiaries who suffered an osteoporotic fracture were hospitalized within a week, nearly 20 percent died within 12 months of undergoing an additional fracture. Last year, the total yearly cost of providing care associated with osteoporotic fractures was $57 billion, which is expected to reach $95 billion in 2040. NOF CEO Elizabeth Thompson criticized the healthcare system for failing millions of osteoporosis sufferers, noting proven methods can curb its impact, including "state-of-the-art bone density testing to identify those who are at risk of bone fractures." She also cited drug treatments approved by the U.S. Food and Drug Administration that can help reduce spine and hip fractures and cut repeat fractures. Read More

Osteoporosis International (08/19) P. 1 Tebe, C.; Martinez-Laguna, D.; Carbonell-Abella, C.; et al.
A study was held to compare hip fracture and post-hip fracture mortality in type 2 diabetes mellitus (T2DM) and non-diabetic patients, with the key observation that subjects in T2DM cohorts have a greater risk of dying after a hip fracture. The researchers studied a population-based cohort from Catalonia, Spain, including all subjects 65 to 80 years old with a recorded diagnosis of T2DM on Jan. 1, 2006, along with non-T2DM subjects matched according to year of birth, gender, and primary care practice. A total of 44,802 T2DM and 81,233 matched controls were monitored for a median of eight years, with 23,818 dying without fracturing and 3,317 suffering a hip fracture—with 838 in the latter group subsequently dying. Adjusted HRs for hip fracture-free mortality were 1.32 for men and 1.72 for women. HRs for hip fracture were 1.24 and 1.48, while HRs for post-hip fracture mortality were 1.28 and 1.57 in men and women, respectively. Read More


Recognizing Our Corporate Supporters



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


Educational Alliance
($125,000+)


Gold
($50,000-$74,999)

Silver
($25,000-$49,999)


Friend
(Under $24,999)

In Case You Missed It




Use Own the Bone's Video Library to watch last month's didactic presentation from Natalie Eddy, DNP, FNP-BC on Denialism vs. Osteoparanoia: Patient Mindset and Overcoming Barriers to Care.

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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