A fracture liaison service (FLS) is a coordinated system of care that streamlines osteoporosis management in the orthopaedic setting and can serve as an effective form of secondary preventative care in these patients.

The present work reviews the available evidence regarding the impact of fracture liaison services on clinical outcomes.

The literature was reviewed for studies reporting changes in the rates of bone mineral density scanning (DXA), antiresorptive therapy, new minimum trauma fractures, and mortality between cohorts with access to an FLS or not. Studies including intention to treat level data were retained.

A Medline search for “fracture liaison” OR “secondary fracture prevention” produced 146 results, 98 were excluded based on the abstract, 38 were excluded based on full-text review.

Ten level III studies encompassing 48,045 patients were included, of which 5 studies encompassing 7,086 were analyzed.

Odds-ratios for DXA and anti-osteoporosis pharmacotherapy rates were calculated from data.

Fixed and random effects analyses were performed using the Mantel-Haenszel method.