An older patient coming in for a hip or knee replacement is often at high fracture risk and rarely on bone protection. Use the pre-operative visit to calculate a FRAX score, check vitamin D and calcium, and ask about falls. It costs minutes, and it addresses the two things — bone quality and falls — that drive the periprosthetic fractures that come back years later.
- Calculate FRAX at the pre-operative arthroplasty visit.
- Check vitamin D and start bone protection where indicated.
- Ask about falls in the past year and refer for assessment if positive.
Why it matters
The patient in front of you for a new hip is the patient most at risk of breaking bone around it later.
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