Orthopedic Concerns


What is osteoporosis?

Osteoporosis is a painless condition defined by loss of bone density. The bone becomes thinner, with more space and less mineral content. The architecture of the bone changes, and becomes more porotic. Osteoporosis occurs when natural bone turnover becomes imbalanced, and bone removal outpaces bone formation. This is usually preceded by osteopenia, in which the bone thinning occurs to a lesser degree than osteoporosis.


How is osteoporosis diagnosed?

Osteoporosis is diagnosed with bone density testing, or DXA scanning. Regular x-rays may show the bone is thin or fragile, but osteoporosis can’t be diagnosed with a regular x-ray. Many people don’t realize they have osteoporosis until they break a bone (fracture). Fragility fractures occur in people with osteoporosis and the three most common areas are the wrist, hip, spine and shoulder.


What are the risk factors for osteoporosis?

Increasing age is the most important risk factor. Other risk factors include being female, hereditary factors including being of Northern European descent, low body mass, lack of exercise (specifically weigh bearing and strengthening exercises), smoking, poor nutrition, and vitamin D deficiency. Osteoporosis can also be associated with multiple different medical conditions and some medications.


How is osteoporosis treated?

Osteoporosis can be treated with dietary calcium and vitamin D, lifestyle changes including exercise and smoking cessation, and with prescription medications. Bisphosphonates are a class of medication that slows bone turnover. Other medications such as Forteo are similar to parathyroid hormone and forms new bone, increasing skeletal mass.


What happens if I need surgery?

Orthopedic surgeons can treat the fractures sustained as a result of thinner, weaker bone. This may involve fixing broken bones with plates or screws, hip replacement for certain hip fractures, shoulder replacement for shoulder fractures, or casting.