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Vitamin D is an essential nutrient that plays a crucial role in maintaining muscle and bone health. Its primary functions include regulating the balance of calcium and phosphate through intestinal absorption and renal reabsorption, enhancing muscle function via vitamin D receptors in muscle fibers, and supporting bone strength.

Osteoporosis is a common but often overlooked condition, especially among older adults. Understanding its risks, causes, prevention, and treatment can help reduce complications and improve quality of life.

The selection of medications for osteoporosis should consider the mechanism of action, effectiveness in increasing bone density, fracture risk reduction, contraindications, and potential side effects. Treatment should be individualized.

The importance of osteoporosis to joint replacement surgery. Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most commonly performed orthopedic procedures. Osteoporosis has been identified as a risk factor that affects the success outcomes of total joint arthroplasty (TJA). Complications associated with TJA include intraoperative fracture, aseptic loosening of the prosthesis, and periprosthetic fracture. Studies have shown that osteoporosis increases the incidence of periprosthetic fractures by 0.3–5.5% after primary joint replacement surgery, and up to 30% following revision joint replacement surgery.

Current treatment for osteoporosis has evolved from a traditional response-to-treatment approach to a goal-directed approach. The core concept of targeted treatment is to ensure each patient receives the most appropriate medication to reduce fracture risk as quickly and effectively as possible. The ultimate goal of treatment is to remain fracture-free.

Osteoporosis is a major public health problem, comparable to diabetes, hypertension, and hyperlipidemia. It has long posed a serious threat to the health and quality of life of the Thai population, particularly older adults. Most elderly individuals with osteoporosis experience no warning symptoms or early signs, resulting in delayed diagnosis and lack of early treatment. Consequently, these individuals are at high risk of fragility fractures at various sites, including the wrist, spine, hip, and upper arm.