What’s New in Osteoporosis: Emphasis on the Aging Athlete

Ting Cong; Dan Caraí Maia Viola; Witchaporn Witayakom; Jeri W. Nieves; Joseph M. Lane

doi:10.2106/jbjs.24.00644

July 25, 2024Journal of Bone and Joint Surgery

What’s New in Osteoporosis: Emphasis on the Aging Athlete

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Key Points

To review contemporary advances in osteoporosis treatment and fracture risk stratification, highlighting the distinction between chronological and biological age in active older adults.
Synthesized recent clinical trials, meta-analyses, and observational studies evaluating dual x-ray absorptiometry, fracture prediction algorithms, and bone microarchitecture.
Evaluated sequential regimens of osteoanabolic biologics, such as romosozumab, followed by antiresorptive agents including denosumab and zoledronic acid.
Assessed functional biomarkers and physical assessment batteries, such as the Short Physical Performance Battery, across divergent patient phenotypes.
Standard screening combining FRAX with bone mineral density yields an area under the curve predictive value of approximately 0.7 for 5-to-10-year fracture risk, leaving substantial residual risk unexplained.
Community prevalence of osteosarcopenia was identified at 21%, with significant risk conferred by female sex (OR, 5.10; p < 0.0001), older age (OR, 1.12; p = 0.008), and prior fracture (OR, 2.92; p = 0.0003).
Sequential treatment initiating with an osteoanabolic agent followed by an antiresorptive provides superior bone density and microarchitecture improvements compared with antiresorptive monotherapy or reverse sequencing.

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Implication

Clinical review outlines evolving pharmacotherapies and risk stratification in aging athletes, indicating that physical reserve dictates fracture outcomes beyond standard bone density.

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Cong et al. (2024) studied this question.

synapsesocial.com/papers/6a71febc5d37378ac1def390 https://doi.org/10.2106/jbjs.24.00644

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What’s New in Osteoporosis: Emphasis on the Aging Athlete

Key Points

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Cite This Study

What’s New in Osteoporosis: Emphasis on the Aging Athlete

Key Points

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Implication

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