The 2018 Global Call to Action on Fragility Fractures highlighted the urgent need to improve acute care, rehabilitation, and secondary fracture prevention worldwide—a priority now widely endorsed across medical specialties.
In response, Dato’ Dr Lee Joon Kiong, Consultant Orthopaedic Surgeon, contributed to a position paper to establish and standardise Bone Health Optimisation (BHO) for older patients undergoing elective orthopaedic surgery in Malaysia, particularly joint replacements and spinal procedures.
Osteoporosis and osteopenia are common in older surgical patients and significantly increase risks such as periprosthetic fractures, implant loosening, and spinal complications. BHO shifts orthopaedic care from reactive management to proactive bone strengthening, improving surgical outcomes and recovery.
Developed from a comprehensive literature review (2019–2024), the BHO framework addresses 12 core themes spanning risk assessment, management strategies, and outcome measurement. Key recommendations include routine bone health assessment across pre-, intra-, and post-operative phases, adoption of a “5IQ” clinical standards approach supported by 18 key performance indicators, and the creation of a Malaysian BHO Registry for real-time benchmarking and national quality improvement.
This framework marks a paradigm shift—from fixing bones to fortifying them first. With multidisciplinary collaboration, clear standards, and national oversight, BHO provides a practical roadmap to safer surgery, fewer complications, and better long-term patient outcomes.
Read more here : PubMed
