Clinical guidelines for the prevention and treatment of osteoporosis: summary statements and recommendations from the Italian Society for Orthopaedics and Traumatology

• Published in: Journal of orthopaedics and traumatology Vol. 18; no. Suppl 1; pp. 3 - 36
• Main Authors: Tarantino, Umberto, Iolascon, Giovanni, Cianferotti, Luisella, Masi, Laura, Marcucci, Gemma, Giusti, Francesca, Marini, Francesca, Parri, Simone, Feola, Maurizio, Rao, Cecilia, Piccirilli, Eleonora, Zanetti, Emanuela Basilici, Cittadini, Noemi, Alvaro, Rosaria, Moretti, Antimo, Calafiore, Dario, Toro, Giuseppe, Gimigliano, Francesca, Resmini, Giuseppina, Brandi, Maria Luisa
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-11-2017; Springer Nature B.V; SpringerOpen
• Subjects: Biocompatibility; Bisphosphonates; Clinical practice guidelines; Conservative Orthopedics; Denosumab; Diagnosis; Fracture; Fracture liaison service; Fractures; Guidance; Guidelines; Immunotherapy; Literature reviews; Medical personnel; Medicine; Medicine & Public Health; Monoclonal antibodies; Original; Original Article; Orthopedics; Osteoporosis; Pharmacology; Prevention; Quality; Rheumatology; Sports Medicine; Surgical Orthopedics; Teriparatide; Traumatic Surgery; Guidance; Fracture liaison service; Strontium ranelate; Fracture; Denosumab; Bisphosphonates; Teriparatide
• ISSN: 1590-9921; 1590-9999
• DOI: 10.1007/s10195-017-0474-7

Background
The Italian Society for Orthopaedics and Traumatology conceived this guidance—which is primarily addressed to Italian orthopedic surgeons, but should also prove useful to other bone specialists and to general practitioners—in order to improve the diagnosis, prevention, and treatment of osteoporosis and its consequences.
Materials and methods
Literature reviews by a multidisciplinary team.
Results
The following topics are covered: the role of instrumental, metabolic, and genetic evaluations in the diagnosis of osteoporosis; appraisal of the risk of fracture and thresholds for intervention; general strategies for the prevention and treatment of osteoporosis (primary and secondary prevention); the pharmacologic treatment of osteoporosis; the setting and implementation of fracture liaison services for tertiary prevention. Grade A, B, and C recommendations are provided based on the main levels of evidence (1–3). Toolboxes for everyday clinical practice are provided.
Conclusions
The first up-to-date Italian guidelines for the primary, secondary, and tertiary prevention of osteoporosis and osteoporotic fractures are presented.