This consensus was prepared by a group of experts from various specialties in the interests of improving the quality of specialized medical care for elderly and old age patients with hip fractures, which are almost always the result of osteoporosis and an increased risk of falls. Difficulties in the treatment of this category of patients are due to both the severity of the injury itself and comorbidity, which is accompanied by high mortality and extremely low quality of life for survivors. Effective management of such patients is possible only with the joint involvement of doctors and nurses of surgical and internal medicine and geriatric profiles within the framework of the so-called orthogeriatric approach. Experts in the field of traumatology and orthopedics, anesthesiology and intensive care, geriatrics, rehabilitation, clinical pharmacology, therapy, rheumatology and endocrinology based on the available clinical recommendations and orders of the Ministry of Health Care of the Russian Federation, literature data and general discussion formulated the basic principles of interdisciplinary management of elderly and senile people with hip fracture. The aim of the consensus is to help establishing effective interaction between professionals of different specialties based on their better mutual understanding, which will contribute to improving specialized medical care, saving lives and reducing disability of elderly patients with hip fracture.

Osteoporosis is a systemic metabolic bone disease characterized by progressive loss of bone mineral density (BMD) and deterioration of bone microarchitecture, leading to increased bone fragility and susceptibility to low-energy fractures. This condition is of particular concern in geriatric populations, where its prevalence reaches critical levels. Epidemiological studies indicate that osteoporosis affects one in three women and one in five men over 65 years of age, representing a significant medical and socioeconomic burden. The clinical significance of osteoporosis stems from its severe complications, including chronic pain syndrome, profound mobility limitations, reduced quality of life, and increased risks of disability and mortality (particularly following hip fractures). Consequently, developing effective treatment and prevention strategies for osteoporosis in elderly and senile patients remains a priority in modern gerontology and osteology. Contemporary pharmacological approaches to osteoporosis management include antiresorptive (bisphosphonates, denosumab) and anabolic (teriparatide, romosozumab) agents, with treatment selection requiring careful consideration of age-related factors, comorbidities, and individual fracture risk profiles. This review synthesizes current evidence on pharmacological interventions for osteoporosis in geriatric practice, including emerging therapeutic strategies and future treatment directions.

The clinical guidelines reflect the features of osteoarthritis management in elderly patients. The high prevalence of comorbidity in this category of patients, the relationship between osteoarthritis and geriatric syndromes, such as frailty and sarcopenia, are discussed. The high prevalence of neuropathic pain in elderly patients with osteoarthritis is emphasized. All these features suggest optimization of non- and drug therapy.