Summary
Postmenopausal osteoporosis is a real problem for a huge number of the older aged patients, and the population is aging. In daily orthopaedic praxis, I see a lot of osteoporosis related fractures of the wrist, the hip, and the vertebral column. Just yesterday, I operated a pseudarthrosis in the femoral neck of an 89year old lady with an extremely thin osteoporotic cortical shell. Not only that osteoporosis makes fractures at the mentioned anatomic sites more probable, but also the risk for early or later failure of surgery is higher in osteoporosis patients.
Analysis
The above mentioned facts make early and efficient osteoporosis therapy necessary, and highly desirable. Denosumab, the new drug developed by Amgen, is an important new development. Still, from studies, and this authors own experience, it is known that patients are unlikely to favor 2 injections of the drug per day. This will decrease the patients compliance. In conclusion, this author doubts that the real effect of denosumab on BMD will be better than that of Fosamax as Fosamax is applied as a tablet. Additionally, the patient can choose to take Fosamax tablets of 10mg daily or Fosamax tablets of 70mg once a week. This makes Fosamax more likely to be taken regularly by the patients.
