Transcript Document

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UNDERSTANDING OSTEOPOROSIS
I.M. Doctor, M.D.
My Office
My City, State
Understanding Osteoporosis
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What is Osteoporosis
Osteoporosis myths
Osteoporosis facts
Understanding Osteoporosis
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Osteoporosis symptoms and warning signs
Who is at risk?
Diagnosing Osteoporosis
Understanding Osteoporosis
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Treatment options
 Medication
 Treatments
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Steps you can take to prevent Osteoporosis
What is an orthopaedic surgeon?
MD or DO who specializes in treatment and
health maintenance of musculoskeletal system
(bones, joints, ligaments, muscles, tendons,
cartilage and spine)
What is an orthopaedic surgeon?
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The expert in treating the
musculoskeletal system
The expert in maintaining
musculoskeletal health
Educating an Orthopaedic Surgeon
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College
Medical School
Internship
Orthopaedic Residency
Fellowship (optional)
2 Years Practice
TOTAL
4
4
1
4
(1)
2
16 years!
What do orthopaedic surgeons do?
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Diagnose
Treat
 Medication
 Physical Therapy
 Exercise
 Brace
 Surgery
Prevent Injury and/or Disease Progression
Osteoporosis
Osteoporosis, or porous bone, is a
progressive disease that robs its
victims of bone mass.
Osteoporosis
Normal Bone
Osteoporotic Bone
Myth #1: “Osteoporosis is not serious enough for me
to worry about”
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It is a progressive disease and irreversibly
weakens bones
Minor trauma can cause debilitating fracture
Chronic pain and disability are the potential
outcomes
Hip fractures can cause death
Myth #2: Osteoporosis Myths
“I’m a healthy person. I eat right and
exercise so I am not at risk.”
Myth #3: Osteoporosis Myths
“I’m too young to worry about
osteoporosis.”
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It is never too early to prevent
Osteoporosis
Osteoporosis can strike at any
age
Bone is a living, growing tissue
that constantly rebuilds
Myth #4: Osteoporosis Myths
“It’s too late for me to do anything
about Osteoporosis.”
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Prevalence
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More than 10 million Americans suffer from
Osteoporosis
80% are women
1 in 2 women and 1 in 4 men over 50 years old
will be diagnosed
Source: National Osteoporosis Foundation
2 Million Fractures Annually
Vertebral Fractures:
550,000+
Wrist Fractures:
400,000+
Hip Fractures:
300,000+
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Source: National Osteoporosis Foundation, 2000
Other Fractures:
810,000+
Burden of Disease
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$19 billion in
2005
Approximately
$52 million daily
Burden of Disease
Burden of Disease
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Most patients with hip fractures are hospitalized for
about one week.
One in four adults who lived independently before
their hip fracture has to stay in a nursing home for at
least a year after their injury.
One in five hip fracture patients dies within a year
of injury.
Source: National Center for Injury Prevention and Control,
Centers for Disease Control and Prevention
Osteoporosis
Normal
Spine
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Source: National Osteoporosis Foundation, 2000
Osteoporotic
Spine
Symptoms and Warning Signs
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Persistent, unexplained back pain
Shorter than you used to be
Can no longer stand up straight
Spinal deformities
Symptoms and Warning Signs
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Recurrent fractures
Fracture from minimal trauma
Experiencing chronic medical problems
Risk Factors
Female
 Thin or small frame
 Older age
 Family history
 Smoking
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Risk Factors
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Advanced age
History of fragility fracture
Family history - primary relative with
Osteoporosis or fragility fracture
Risk Factors
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Post Menopausal
 Hormonal
imbalances can result in rapid bone
loss
 Women can lose up to 20% of their bone mass
in 5-7 years
Risk Factors
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Amenorrhea, anorexia, and bulimia
Diet low in calcium
Certain medications
Low testosterone in men
Risk Factors
Inactive lifestyle
Cigarette smoking
Excessive alcohol
consumption
Ethnicity & Osteoporosis
Hispanic women at
highest risk
10% of Hispanic
women over 50 have
osteoporosis now
49% are estimated to
have low bone mass,
putting them at risk
for the disease
Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National
Institutes of Health, Department of Health and Human Services
Ethnicity & Osteoporosis
Hispanic women
get less calcium
than RDA
Twice as likely to
develop diabetes
Rate of hip fractures
on the rise
Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases,
National Institutes of Health, Department of Health and Human Services
Ethnicity & Osteoporosis
Caucasian and Asian-American Women also
at high risk
Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases,
National Institutes of Health, Department of Health and Human Services
Ethnicity & Osteoporosis
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African-American
women get 50% of
RDA of calcium
Lupus and sicklecell anemia can
raise osteoporosis risk
Source: National Institute of Arthritis and Musculoskeletal and Skin
Diseases, National Institutes of Health, Department of Health and
Human Services
Ethnicity & Osteoporosis
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Osteoporosis undertreated
in African-American women
Risk doubles every 7 years
African-American women
more likely to die from hip
fractures
Source: National Institute of Arthritis and Musculoskeletal and Skin
Diseases, National Institutes of Health, Department of Health and
Human Services
Men & Osteoporosis
Underdiagnosed
Unrecognized
Underreported
Inadequately researched
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Men & Osteoporosis
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2 million American men suffer
from osteoporosis
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Millions more are at risk
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80,00 hip fractures each year
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One-third die one year after
fracture
Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National
Institutes of Health, Department of Health and Human Services
Diagnosis
Medical history
Physical exam
X-rays
Bone densitometry
Specialized lab
tests
Bone Densitometry
Bone Densitometry
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Anyone with a fragility fracture
All women age 65 and older
Postmenopausal women younger than 65
with risk factors
Men over 50 with risk factors
Diagnosis
Before Your Appointment
Prepare to describe your symptoms
Gather medical history
Make list of medications
Write down concerns and questions and
bring them
Diagnosis
During Your Appointment
1.
Expect what from treatment?
2.
Treatment effect on daily activities?
3.
How to prevent further disability?
Treatment
Medication
Bisphosphonates
 Estrogen Replacement Therapy
 Medications made from natural hormones
 SERMs (Selective Estrogen Receptor
Modulators)
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Treatment
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Appropriate
treatment of
fragility fractures
Surgery if necessary
Prevention
Calcium and Vitamin D Intake
Adults: 1000-1200 Units per day
 400-800 IU vitamin D per day
 Consult your physician for dosage
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Prevention
Weight-Bearing Exercise
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Consult your physician first
Prevention: 10-20 Year Olds
Prevention: 20-35 Year Olds
Prevention: 35-50 Year Olds
Prevention: Over 50
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
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Osteoporosis
While you cannot change your genetics
or heredity, skeletal frame, gender, race
or age, you can control other risk factors
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
Understanding Osteoporosis
What are your questions and concerns?
Understanding Osteoporosis
Thank you for participating today
 Remember, your orthopaedic surgeon
can help get you back in the game
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