Osteoporosis-Network Hamburg, Germany
Recently implemented in April 2015, the Osteoporosis-Network Hamburg is among the first and largest fully structured sector-spanning Fracture Liaison Services (FLS) in Germany, serving a population of about 2 million people. A dedicated FLS team from the Department of Trauma, Hand and Reconstructive Surgery at the University Medical Center Hamburg-Eppendorf refers inpatients with fragility fractures for diagnosis and treatment to one of 20 participating certified osteoporosis experts (mainly orthopedic surgeons and endocrinologists) working in private practice. Subsequent patient care is provided according to the national guidelines (DVO) for the diagnosis and treatment of osteoporosis, which were developed with the participation of members of the Department. All cases are well documented based on a comprehensive questionnaire, including follow-up visits and all data will be transferred to the national DVO registry. Currently, the network is about to be expanded by including more hospitals located in the City of Hamburg. In addition to this cooperative multi-center care system, an osteoporosis unit is being established within the Department of Trauma, Hand and Reconstructive Surgery of the University Hospital. This will provide in-house diagnosis and treatment of osteoporosis as well as long-term follow-up of osteoporosis patients according to the national guidelines. Importantly, the osteoporosis unit will be an integral part of a planned interdisciplinary ortho-geriatric concept aimed at providing special care for the elderly with the participation of experts from Trauma Surgery, Anesthesiology, Geriatrics, Pharmacology, Nutritional Health and Physiotherapy. In addition to clinical care, the osteoporosis unit will provide ample opportunities for research, in particular for translational science conducted within the Department but also for clinical investigations on musculoskeletal health, for example in the context of the Hamburg City Health Study (HCHS), the largest longitudinal study worldwide in which 45.000 individuals will be investigated for a period of 30 years. The Hamburg FLS and the FLS of the University Hospital Munich (described below) are the first FLS in Germany listed on the IOF Map of Best Practice for evaluation by the IOF Capture the Fracture® programme.