Metabolic Bone Disease
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MEMBERS OF the Metabolic Bone Disease Service support and partner with other services across the institution to improve surgical outcomes by optimizing metabolic bone health pre- and postoperatively for patients with metabolic bone disorders including osteoporosis, osteomalacia, rickets, hypophosphatemia and Paget’s disease. The HSS Osteoporosis and Metabolic Bone Health Center cares for patients with these types of disorders and consists of physicians and nurse practitioners in the fields of orthopaedics, endocrinology, rheumatology and women’s health.
Our service has seen great success through our HSS @ NYP program with NewYork-Presbyterian, in which a fracture liaison nurse practitioner is embedded with the orthopaedic surgical team. We have seen a high rate of capture for patients presenting with fracture to receive a metabolic bone evaluation, with appropriate care prescribed thereafter.
Effect of Abaloparatide vs Alendronate on Fracture Risk Reduction in Postmenopausal Women with Osteoporosis. Leder B, Mitlak B, Hu M-Y, Hattersley G and Bockman R. J Clin Endocrinol Metab. 2020 Mar 105(3): 938-943. PMID: 31674644
Several studies are under way evaluating bone anabolics. The first, called the FAST Healing Trial (Fusion with Anabolics after Spinal Surgery), is being conducted with co-investigators from endocrinology, orthopaedics, radiology and rheumatology. It looks to use anabolics to improve surgical outcomes in patients undergoing spine stabilization. The second is a multicenter trial, for which HSS is the coordinating center, seeking to accelerate pelvic fracture repair and supported by the National Institutes of Health. We are also examining the consequences of steroid treatment on volumetric bone density of the spine.
Future goals for the service include focused integration with the HSS Spine service, with the aim of having spine surgical patients evaluated by a metabolic bone nurse practitioner prior to surgery to optimize bone health.