Osteoporosis is a healthcare crisis. The burden of cost to society is more than congestive heart failure, breast cancer, and asthma combined. With more than one in two women and one in four men affected, the prevalence is common. Furthermore, baby boomers are now getting older and will be afflicted with this not-so-silent disease. A better term for osteoporosis treatment is bone health. Bone health encompasses prevention of bad bone health, enhancement fracture healing, and prevention of potentially preventable fractures. As orthopaedic surgeons, we should be in charge of bone health for three main reasons. First, we should lead the way in preventing osteoporotic fractures. Second, we should enhance fracture healing in our patients. Third, we should relieve some of the burden of this chronic disease from our hard-working medical colleagues. Preventing osteoporotic fractures is paramount. The aging population is growing. The number of osteoporotic hip fractures is growing even more rapidly. With one-fourth to one-third of all hip fractures resulting in death within 3 to 6 months of the event, the mental burden to the family is terrible, and the financial burden to society is enormous. We need to do whatever is needed to prevent this tsunami of future fractures. When treating a fracture resulting from a low energy fall, the orthopaedist should initiate the bone health evaluation, diagnosis, and treatment process. Unless the orthopaedist sounds the alarm, the patient will be missed and forgotten until he or she has another low energy fall fracture. Enhancing fracture healing starts with initiating bone health treatment. Metabolic problems have been reported in fracture patients, particularly those who have fracture-healing problems and nonunions. Removing or reducing bad bone health factors—such as poor diet, little or no exercise, and smoking—is more difficult than it sounds. Is the patient taking any harmful bone-health medicines (anti-seizure medicines, antacids, long-term bisphosphonates, or steroids)? Should the patient be taking vitamin D, vitamin C, and calcium-containing compounds to supplement his or her diet? These are aspects of the intake history and physical components of importance to the orthopaedic surgeon.
Posted on: Mon, 19 Jan 2015 11:07:44 +0000
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