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UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State
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UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Dec 14, 2015

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Page 1: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

UNDERSTANDING OSTEOPOROSIS

1

I.M. Doctor, M.D.

My Office

My City, State

Page 2: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Understanding Osteoporosis

What is Osteoporosis Osteoporosis myths Osteoporosis facts

Page 3: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Understanding Osteoporosis

Osteoporosis symptoms and warning signs

Who is at risk? Diagnosing Osteoporosis

Page 4: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Understanding Osteoporosis

Treatment options Medication Treatments

Steps you can take to prevent Osteoporosis

Page 5: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

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)

Page 6: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

What is an orthopaedic surgeon?

The expert in treating the musculoskeletal system

The expert in maintaining musculoskeletal health

Page 7: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Educating an Orthopaedic Surgeon

College Medical School Internship Orthopaedic

Residency Fellowship (optional) 2 Years Practice

TOTAL

4414(1)2

16 years!16 years!

Page 8: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

What do orthopaedic surgeons do?

Diagnose Treat

Medication Physical Therapy Exercise Brace Surgery

Prevent Injury and/or Disease Progression

Page 9: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Osteoporosis

Osteoporosis, or porous bone, is a progressive disease that

robs its victims of bone mass.

Page 10: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Osteoporosis

Normal Bone Osteoporotic Bone

Page 11: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Myth #1: “Osteoporosis is not serious enough for me to worry about”

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

Page 12: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Myth #2: Osteoporosis Myths

“I’m a healthy person. I eat right and exercise so I am

not at risk.”

Page 13: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Myth #3: Osteoporosis Myths

It is never too early to prevent Osteoporosis

Osteoporosis can strike at any age

Bone is a living, growing tissue that constantly rebuilds

“I’m too young to worry about osteoporosis.”

Page 14: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Myth #4: Osteoporosis Myths

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

14

Page 15: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Prevalence

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

Page 16: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Wrist Fractures:400,000+

Hip Fractures:300,000+

Vertebral Fractures:550,000+

Other Fractures:810,000+

Source: National Osteoporosis Foundation, 2000

2 Million Fractures Annually2 Million Fractures Annually

16

Page 17: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Burden of Disease

$19 billion in 2005

Approximately $52 million daily

Page 18: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Burden of Disease

Page 19: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Burden of Disease

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

Page 20: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

OsteoporosisNormal Spine Osteoporotic

Spine

Source: National Osteoporosis Foundation, 200020

Page 21: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Symptoms and Warning Signs

Persistent, unexplained back pain Shorter than you used to be Can no longer stand up straight Spinal deformities

Page 22: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Symptoms and Warning Signs

Recurrent fractures Fracture from minimal trauma Experiencing chronic medical

problems

Page 23: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Risk Factors

Female Thin or small frame Older age Family history Smoking

Page 24: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Risk Factors

Advanced age History of fragility fracture Family history - primary relative

with Osteoporosis or fragility fracture

Page 25: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Risk Factors

Post Menopausal Hormonal imbalances can result in

rapid bone loss Women can lose up to 20% of their

bone mass in 5-7 years

Page 26: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Risk Factors

Amenorrhea, anorexia, and bulimia

Diet low in calcium Certain medications Low testosterone in men

Page 27: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Risk Factors

Inactive lifestyle

Cigarette smoking

Excessive alcohol consumption

Page 28: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

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 riskfor the diseaseSource: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Department of Health and Human Services

Page 29: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Ethnicity & Osteoporosis

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Department of Health and Human Services

Hispanic womenget less calciumthan RDA

Twice as likely todevelop diabetes

Rate of hip fractureson the rise

Page 30: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

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

Page 31: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Ethnicity & Osteoporosis

African-Americanwomen get 50% ofRDA of calcium

Lupus and sickle-cell anemia canraise osteoporosis risk

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Department of Health and Human Services

Page 32: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Ethnicity & Osteoporosis

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

Page 33: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Men & Osteoporosis

Underdiagnosed

Unrecognized Underreported

Inadequately researched 33

Page 34: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Men & Osteoporosis

2 million American men suffer from osteoporosis

Millions more are at risk

80,00 hip fractures each year

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

Page 35: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Diagnosis

Medical history

Physical exam

X-rays

Bone densitometry

Specialized lab tests

Page 36: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Bone Densitometry

Page 37: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Bone Densitometry

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

Page 38: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Diagnosis

Before Your Appointment

Prepare to describe your symptoms

Gather medical history

Make list of medications

Write down concerns and questions and bring them

Page 39: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Diagnosis

1. Expect what from treatment?

2. Treatment effect on daily activities?

3. How to prevent further disability?

During Your Appointment

Page 40: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Treatment

Page 41: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Medication

Bisphosphonates Estrogen Replacement Therapy Medications made from natural

hormones SERMs (Selective Estrogen

Receptor Modulators)

Page 42: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Treatment

Appropriate treatment of fragility fractures

Surgery if necessary

Page 43: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Prevention

Calcium and Vitamin D Intake Adults: 1000-1200 Units per day 400-800 IU vitamin D per day Consult your physician for dosage

Page 44: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Prevention

Page 45: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Weight-Bearing Exercise

Consult your physician first45

Page 46: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Prevention: 10-20 Year Olds

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Prevention: 20-35 Year Olds

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Prevention: 35-50 Year Olds

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Prevention: Over 50

Page 50: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Getting You Back In the Game

Name: Ruth C. SnyderAge: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

Page 53: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

Resources

National Osteoporosis Foundation(202) 736-1656

www.nof.org

American Academy of Orthopaedic Surgeons

6300 North River RoadRosemont, IL 60018 www.orthoinfo.org

Page 54: UNDERSTANDING OSTEOPOROSIS 1 I.M. Doctor, M.D. My Office My City, State.

What are your questions and concerns?

Understanding Osteoporosis

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Understanding Osteoporosis

Thank you for participating today Remember, your orthopaedic surgeon

can help get you back in the game