SIOT临床指南：骨质疏松症的预防和治疗

ORIGINAL ARTICLEClinical guidelines for the prevention and treatmentof osteoporosis:summary statements and recommendationsfrom the Italian Society for Orthopaedics and TraumatologyUmberto Tarantino Giovanni Iolascon2.Luisella Cianferotti3.Laura Masi3.Gemma Marcucci3.Francesca Giusti3 Francesca Marini3.Simone Parri3.Maurizio Feola Cecilia Rao Eleonora Piccirilli!Emanuela Basilici Zanetti4.Noemi Cittadini4 Rosaria Alvaro4.Antimo Moretti2.Dario Calafiore2.Giuseppe Toro2 Francesca Gimigliano2Giuseppina Resminis Maria Luisa Brandi3The Author(s)2017.This article is an open access publicationAbstractare provided based on the main levels of evidence (1-3).Background The Italian Society for Orthopaedics andToolboxes for everyday clinical practice are provided.Traumatology conceived this guidance-which is primar-Conclusions The first up-to-date Italian guidelines for theily addressed to Italian orthopedic surgeons,but should alsoprimary,secondary,and tertiary prevention of osteoporosisprove useful to other bone specialists and to general practi-and osteoporotic fractures are presented.tioners-in order to improve the diagnosis,prevention,andtreatment of osteoporosis and its consequences.Keywords Fracture·Fracture liaison service·Guidance·Materials and methods Literature reviews by a multidis-Bisphosphonates·Denosumab·Teriparatide·Strontiumciplinary team.ranelateResults The following topics are covered:the role ofinstrumental,metabolic,and genetic evaluations in the diag-nosis of osteoporosis;appraisal of the risk of fracture andScope of the guidelinesthresholds for intervention;general strategies for the preven-tion and treatment of osteoporosis (primary and secondaryThese recommendations were conceived by the Italian Soci-prevention);the pharmacologic treatment of osteoporosis;ety for Orthopaedics and Traumatology (Societa Italiana dithe setting and implementation of fracture liaison servicesOrtopedia e Traumatologia,SIOT),which was founded infor tertiary prevention.Grade A,B,and C recommendationsRome (Italy)in 1892 to promote continuous education in thefield of modern orthopedics [1].These guidelines-whichare primarily intended for orthopedic surgeons,bone spe-☒Maria Luisa Brandimarialuisa.brandi@unifi.itcialists,and general practitioners,but should prove usefulto health-care professionals in general-were written toPoliclinico Tor Vergata Foundation,Orthopaedicspromote improved diagnosis,prevention,and treatment ofand Traumatology,University of Rome Tor Vergata,Rome,osteoporosis and its consequences.ItalyGuidelines for primary,secondary,or tertiary prevention2 Department of Medical and Surgical Specialtieswill be described,mainly focusing on postmenopausal osteo-and Dentistry,Second University of Naples,Naples,Italyporosis and osteoporosis in men.Although these guidelines3Metabolic Bone Diseases Unit,Department of Surgeryare not intended to cover all situations,especially in the fieldand Translational Medicine,University Hospital of Florence,of secondary