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					Understanding Osteoporosis



    I.M. Doctor, M.D.

    My Office
    My City, State


1
Understanding Osteoporosis -
Outline

    z Orthopaedics and The Bone and
      Joint Decade

    z What is Osteoporosis

    z Osteoporosis myths

    z Osteoporosis facts
2
Understanding Osteoporosis -
Outline

    z Osteoporosis symptoms and warning
      signs

    z Who is at risk?

    z Diagnosing Osteoporosis


3
Understanding Osteoporosis -
Outline

    z Treatment options

      y Medication

      y Treatments

    z Steps You Can Take to Prevent
      Osteoporosis
4
Who is an orthopaedic surgeon?


    z A Medical doctor with extensive
      training in helping you keep your
      bones, joints, ligaments, muscles,
      tendons, cartilage and spine in good
      working order.


5
Educating an Orthopaedic Surgeon

 z College                 4

 z Medical School          4

 z Internship              1

 z Orthopaedic Resident    4

 z Fellowship (optional)   (1)

 z 2 Years Practice        2

 6    Total                16 years!
Who is an orthopaedic surgeon?


    z Greatest knowledge of wide range of
      conditions and treatment options
      available

    z Greatest experience in treating
      musculoskeletal health

7
What do orthopaedic surgeons do?



    z Use most effective & efficient
      diagnostic tools

    z Determine best course of treatment



8
9
 Why Musculoskeletal Problems?


     z Musculoskeletal conditions affect
       hundreds of millions of people

     z $230 billion per year spent



10
 Why Musculoskeletal Problems?


 z Most common causes of severe
   long-term pain and physical
   disability

 z Research is at a critical point


11
12
Understanding Osteoporosis


  Your Orthopaedic Surgeon

Getting You Back Into The Game



                             13
 Osteoporosis




     Osteoporosis, or porous bone, is a
      devastating disease that robs its
           victims of bone mass.



14
 Osteoporosis




     Normal Bone   Osteoporotic Bone

15
         “Osteoporosis is not serious
         enough for me to worry about”


     z It is a progressive disease and
       irreversibly weakens bones
     z Any movement or bump can cause
       debilitating fracture
     z Chronic pain and disability are the
       potential outcomes

16
     z Hip fractures can cause death
        Osteoporosis Myths




     “I’m a healthy person. I do the right
            things so I am not at risk.”
17
            Osteoporosis Myths

           “I’m too young to worry about
                  Osteoporosis now.”
     z It is never too early to prevent
       Osteoporosis
     z Osteoporosis can strike at any age
     z Bone is a living, growing tissue that
18
       constantly rebuilds
     Osteoporosis Myths

“It’s too late for me to do anything
        about Osteoporosis.”
 Prevalence


     More than 28 million Americans suffer
              from Osteoporosis

     z 80% are women

     z 1 in 2 women & 1 in 8 men over 50
       years old
20
 1.5 Million Fractures Annually
 Vertebral Fractures:
 700,000+

                                                  Wrist Fractures:
                                                  200,000+




   Hip Fractures:
   300,000+                                      Other Fractures:
                                                 300,000+
Source: National Osteoporosis Foundation, 2000
 Burden of Disease

          $14 Billion Annually
     z Approximately $38 million daily

     z Congestive heart failure costs $8
       billion annually

     z Asthma costs $9.8 billion annually
22
 Burden of Disease




23
 Burden of Disease


     z 1 out of 4 osteoporotic hip fractures
       result in long-term nursing home care

     z One half of these are unable to walk
       without assistance

     z 24% greater risk of dying within one
       year
24
   Osteoporosis
                          Normal
                          Spine                  Osteoporotic
                                                 Spine




Source: National Osteoporosis Foundation, 2000
 Symptoms and Warning Signs


     z Persistent, unexplained back pain

     z Shorter than you used to be

     z Spinal deformities


26
 Symptoms and Warning Signs


     z Recurrent fractures

     z Fracture from minimal trauma

     z Experiencing chronic medical
       problems

27
 Risk Factors

     z Female

     z Thin or small frame

     z Low body weight

     z Smoker

28
 Risk Factors

     z Advanced age

     z History of fragility
       fracture

     z Family history- primary
       relative with
       Osteoporosis or fragility
       fracture
29
 Risk Factors

     z Post Menopausal

       y Hormonal imbalances can result in rapid
         bone loss

       y Women can lose up to 20% of their
         bone mass in 5-7 years


30
 Risk Factors


     z Amenorrhea, Anorexia & Bulimia

     z Diet low in calcium

     z Certain medications

     z Low testosterone in men
31
 Risk Factors

        Inactive lifestyle


          Cigarette smoking


     Excessive alcohol
     consumption
32
 Ethnicity & Osteoporosis

 z Hispanic Women at Highest Risk

 z 13-16% with
   Osteoporosis now

 z 36-49% of Mexican
   American women 50+
   have experienced
   significant bone loss
33
 Ethnicity & Osteoporosis

     Caucasian & Asian-American Women
               Also High Risk




34
 Ethnicity & Osteoporosis




     z 10% of African-American women
       50+ have Osteoporosis

35   z 30% more have low bone density
 Ethnicity & Osteoporosis

     z 300,000 African-American women
       suffering from Osteoporosis today

     z 80-95% of all fractures suffered by African
       -Americans 64+ are osteoporotic

     z African-American women more likely to
       die from hip fractures

36
 Ethnicity & Osteoporosis


         z Risk of hip fractures
           doubles approximately
           every 7 years

         z 50% less calcium than
           RDA


37
 Men & Osteoporosis

      Underdiagnosed


                    Unrecognized
Underreported


38
     Inadequately researched
 Men & Osteoporosis
        z 2 million American men suffer
          from Osteoporosis
        z 3 million more are at risk
        z 1/3 of male hip fractures
          related to Osteoporosis
        z 1/3 of these men will not
          survive 1 year after fracture
39
 Diagnosis




40
 Diagnosis

Before Your Appointment

     y Prepare to describe your symptoms

     y Gather medical history

     y Make list of medications

     y Write down concerns and questions
       and bring them
41
 Diagnosis


During Your Appointment
• Expect what from treatment?

• Treatment effect on daily activities?

• How to prevent further disability?
42
 Bone Densitometry




43
 Bone Densitometry


     z Anyone with a fragility fracture

     z All women age 65 and older

     z Postmenopausal younger than 65
       with risk factors

     z Men over 50 with risk factors
44
 Treatment




45
 Medication


     z Bisphosphonates

     z Estrogen Replacement Therapy

     z Medications made from natural
       hormones

     z SERMs
46
 Medication-Under Investigation


             Vitamin D metabolites

        Parathyroid hormone

     New bisphosphonates

47
             New SERMs
 Treatment


     z Appropriate treatment of fragility
       fractures

     z Hip nailing




48
 Prevention

      Calcium and Vitamin D Intake

z 400-800 Units per day

z Consult your doctor for dosage



49
 Prevention




50
Weight-Bearing Exercise




 Consult your doctor first
Tai-chi helps reduce falls




         Consult your doctor first
Prevention

 10-20 Year Olds




53
Prevention

 20-35 Year Olds




54
Prevention

 35-50 Year Olds




55
Prevention

 Over 50




56
 Getting You Back In the Game



     Name: Ruth C. Snyder
        Age:Over 50
     Injuries/conditions: Fracture of dorsal
          lumbar spine, Osteoporosis,
         hip fracture, and trigger finger
57
 Osteoporosis



     While you cannot change your
     genetics or heredity, skeletal frame,
     gender, race or age, you can control
     other risk factors


59
 Resources


 American Academy of Orthopaedic Surgeons
           6300 North River Road
            Rosemont, IL 60018
           www.orthoinfo.org


      National Osteoporosis Foundation
               (202) 736-1656
               www.nof.org
60
 Understanding Osteoporosis




     What are your questions and concerns?




61
 Understanding Osteoporosisc



     z Thank you for participating today

     z Remember, your orthopaedic
       surgeon can help get you back into
       the game


62

				
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