ORTHOPEDICS

Dr. Patricia Baumann

OSTEOPOROSIS IS A disease of progressive bone loss which is associated with an increase risk of fractures (broken bones).  It affects 28 million Americans and is a contributing cause of 1.5 million fractures annually.  One in two women and one in five men who are older than 65 will sustain a fracture that can be attributed to osteoporosis.

These types of fractures are most commonly in the spine, hip, wrist, arm and leg.  The numbers are impressive.  Annually, approximately 300,000 hip fractures, 700,000 spine fractures, 250,000 wrist fractures and 300,000 fractures at other sites in the body result from complications of osteoporosis.

A hip fracture that is associated with osteoporosis is a serious health problem.  An independent individual who prior to their fracture lived alone may not be able to return to their pre-fracture lifestyle meaning that they may have to live with family members or in a nursing facility.  Also the health care cost associated with a hip fracture and osteoporosis is estimated at thirty to forty thousand dollars per patient and overall ten billion dollars annually in the United States.

What can’t I change to prevent osteoporosis?

• Gender–females are at a higher risk.
• Age – once you are over thirty years old your risk increases, as this is when you begin to lose bone density.
• Heredity – if your mom, sister or aunt has osteoporosis you are at a higher risk.
• Diabetes – currently there is no cure for diabetes but you can control your blood sugar better.
• Steroid use – asthmatics and people with chronic pulmonary disorders require the steroids to breathe – you can’t just stop these medications.

What can I change to prevent osteoporosis?

• Body habitus – a thin patient is at higher risk therefore your ideal body weight is best.
• Vitamin D and Calcium – these can be supplemented in your diet;
• Exercise – weight bearing exercises help to maintain bone; walking three to four times per week for twenty minutes decreases your risk;
• Smoking and alcohol use – stop.

THE KEY to the treatment of osteoporosis is prevention, and should be started at a young age. As the Baby Boomer generation ages, healthcare strategies to prevent and treat osteoporosis, and prevent falls, will become increasingly more important.

How is osteoporosis diagnosed?
Screen for osteoporosis with a physical examination by your physician annually combined with radiographs (xrays), lab tests and bone densitometry (DEXA). The DEXA scan measures how dense your bones are compared to what is normal in a twenty to twenty five year old person.

Osteoporosis Treatment
Osteoporosis is a disease that requires a team approach by the orthopedist, primary care physician, gynecologist (females) and an endocrinologist.  The goal of treatment is prevention.  Diet and exercise combined with one or more of the following will help prevent osteoporosis.  Some of the available therapies include:

• Selective estrogen receptor modulators which can increase bone mass, decrease the risk of spine fractures and lower the risk for breast cancer;
• Calcitonin which is available as a nasal spray can increase bone mass and decrease spine fractures;
• Biphosphonates (Actonel, Fosamax, Boniva) increase bone mass and prevent spine and hip fractures.

The key to the treatment of osteoporosis is prevention, and should be started at a young age.  People who are between the ages of 10 and 20 need to get 1300mg of calcium daily with vitamin D.  At this age we are banking our bone for the future.

People between the ages of 20 and 35 need at least 1000mg of calcium and vitamin D supplements daily, as well as participating in weight bearing exercises (as this is when you reach your peak bone strength).
People between the ages of 35 and 50 need 1000mg of calcium and Vitamin D supplements, with weight bearing exercises, as this is the age when you begin to lose bone density. People older than 50 need 1000mg of calcium with vitamin D supplements, weight bearing exercises and balance programs to prevent falls.

As the Baby Boomer generation  ages, healthcare strategies to prevent and treat osteoporosis, and prevent falls, will become increasingly more important.  A collective effort involving the community and healthcare providers in educating about osteoporosis is imperative to these prevention goals.

Dr. Baumann is fellowship trained in adult reconstructive total joint replacements, which is a subspecialty of orthopedic surgery.  She is Board Certified.  Her practice, Premier Orthopedics is located in Port St. John and she is on staff at Parrish Medical Center and Cape Canaveral Hospital. Please call 321-433-1439 for information.

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