“On the surface, increasing life expectancies are the happy by-product of an affluent society,” said EFORT President Prof Enric Cáceres of the University of Barcelona. “Unfortunately, musculoskeletal complaints become more common as people get older. Bones become fragile, muscles degenerate and joints wear out. In the EU, musculoskeletal disorders are the most common cause of severe chronic pain and frequently lead to incapacity and disability,” Prof Cáceres added.
177 percent increase in over 65s
The number of EU citizens aged over 65 is expected to climb by 177percent by the year 2050. This will have a significant impact on health services. The number of osteoporotic hip fractures has already increased by two-thirds over the past twenty years. Musculoskeletal disorders in particular are a cause of spiralling healthcare costs, for example due to more frequent visits to the doctor and hospital stays. However, they are also responsible for indirect costs to society, with sick leave and early retirement resulting in productivity losses. “All studies agree that helping elderly patients stay mobile and active is the sound approach economically, socially, medically and ethically. The application of orthogeriatrics, an integrated therapeutic approach bringing together orthopaedic surgery and geriatrics, has mushroomed in recent years,” EFORT President Cáceres stated.
Early childhood intervention for an active life
The annual EFORT congress is not only focusing on the situation facing older members of society. Children’s circumstances are also an important topic. “The basis for physical mobility into old age is laid in early childhood, and is closely connected with social mobility and a nurturing environment,” the EFORT President explained. Prof Cáceres pointed to the growing divide between rich and poor in Europe and called for high-quality early education programmes for socially disadvantaged children. “The effects of adverse early childhood environments, where children do not gain an enthusiasm for physical exercise and develop little awareness of their body, persist over a lifetime with negative impacts on health,” Prof Cáceres is convinced. People from socially disadvantaged backgrounds are often among the first to suffer from pain due to musculoskeletal disorders, to have to leave their profession due to incapacity, or to need a joint replacement. Evidence from a broad range of studies shows the positive impact of early childhood education programmes not only on children’s intellectual development but also on physical and mental health. “Investment in more educational programmes and in improvements to them results in significant returns for society, the health economy and the economy as a whole,” Prof Cáceres summed up.
Improve safety for the frailest members of society
EFORT Past President Prof Pierre Hoffmeyer of the University of Geneva called for a move away from the need for surgical intervention and towards greater prevention. “Of course orthopaedic techniques have evolved and we can now repair complex fractures. But the main goal for society must be to prevent falls and fractures in the first place,” Prof Hoffmeyer commented. Outdoor activity is one of the best ways to help preserve bone and muscle tissue in osteoporosis patients – but only if it can be made safe. “Authorities need to provide areas where active elderly people are not at risk of falls,” Prof Hoffmeyer said. He pointed out that in many countries, access for people with disability is being prioritised, but safeguards against falls are not necessarily being put in place. Too many landlords are refusing to make access to stairs, lifts and apartments safe in this respect. Public transportation is also poorly equipped for the needs of osteoporosis sufferers, according to Prof Hoffmeyer. “A fragile bone can easily be broken as the result of a bus door closing forcefully and prematurely, or a driver braking too suddenly.” He called on all stakeholders and policymakers in particular “to help make our society a place where even its frailest members can move around safely.”