Two years ago, a visionary team at Duke University Hospital launched the Fragility Fracture & Bone Health Clinic with a bold mission: to transform the way osteoporosis and fracture care is delivered. At the forefront of this initiative is Christian Pean, MD, MS, Executive Director for Artificial Intelligence and Information Technology Innovation, and Assistant Professor of Orthopaedic Surgery at Duke Orthopaedics, whose leadership has helped shape a model of care that is both data-driven and deeply human-centered.
Since its inception, the clinic has made remarkable strides. In just the first year, the team treated hundreds of patients, doubled the rate of guideline-concordant osteoporosis therapy, and reduced the risk of second fractures by an estimated 50–60%. These outcomes were presented at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting, signaling a new standard in post-fracture care.
But the clinic didn’t stop there. Over the past year, it has expanded to new sites and begun integrating AI-powered care navigation—a move that’s already showing promise in keeping patients engaged between visits. Early data indicate that one in five patients encounter at least one social determinant of health, such as transportation or housing insecurity. By addressing these barriers through dedicated navigation, the clinic is reducing no-show rates and improving outcomes, particularly for underserved populations.
Dr. Pean emphasizes that the challenge of osteoporosis extends far beyond any single clinic. “As our population ages, fragility fractures are becoming more common, complicating everything from spine surgery to joint replacement,” he explains. “Orthopaedic surgeons must adopt an ‘Own the Bone 2.0’ mindset—one that sees bone health as central to musculoskeletal care.”
With upcoming CMS models, such as TEAM, holding hospitals accountable for 30-day episodes of care, Duke’s approach—blending fracture management, bone-strengthening therapy, social risk navigation, and seamless transitions—is not just innovative, but essential. It’s a model designed to preserve mobility, independence, and quality of life for millions.
Dr. Pean credits the clinic’s success to its multidisciplinary team, the support of Duke’s Population Health Management Office, and, most importantly, the patients who entrust them with their care. “If you or a loved one over 50 has experienced a fracture, send them to us,” he says. “We’re committed to delivering the highest level of care through surgical excellence and initiatives like this one.”