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Dr.

Suneet Tandon

Assistant Prof. Orthopaedics


Gandhi Medical College, Bhopal
OSTEOPOROSIS
What is it?
Osteoporosis, or porous bone, is a disease
characterized by low bone mass and structural
deterioration of bone tissue, leading to bone
fragility and an increased susceptibility to
fractures, especially of the spine, hip and wrist,
although any bone can be affected .
Bones…

 Real bone is not what


one sees in dissection
hall or graveyard
 Real bone is the
living tissue of the
body, it is very
dynamic structure
with high metabolic
activity.
Bones…
 Human skeleton consists of two
types of bone

– Cortical or Compact bone :


makes up 80% of bone mass. It is
found primarily in skull and shaft of
long bones.

– Cancellous bone: makes up


20% of total bone mass. It is found
primarily in vertebrae, distal ends of
long bones.
Bones…
 No available material in the
world can withstand all the
mechanical stresses put on it for
a long time without breaking.
 Our bones may last for as long
as 100 years without breaking.
 That’s why the term :
“AS HARD AS BONE ,
AS STRONG AS BONE.”
Bone Turnover…
 Throughout your lifetime, old bone is removed
(resorption) and new bone is added to the
skeleton (formation).

• During childhood and teenage years, new bone is


added faster than old bone is removed. As a result,
bones become larger, heavier, and denser.
• Bone formation continues at a pace faster than
resorption until peak bone mass (maximum bone
density and strength) is reached around age 30.
Bone Turnover…
 After age 30, bone resorption slowly
begins to exceed bone formation. Calcium
starts going out of the bone at the rate of
2-3% during the first few years and
thereafter at the rate of 0.5-1%. Bone loss
is most rapid in the first few years after
menopause but persists into the
postmenopausal years.
 Osteoporosis develops when bone
resorption occurs too quickly or if
replacement occurs too slowly.
Osteoporosis is more likely to develop if
you did not reach optimal bone mass
during your bone building years.
RISK FACTORS
Risk factors you cannot change:
 Gender - Your chances of developing osteoporosis
are greater if you are a woman. Women have less
bone tissue and lose bone more rapidly than men
because of the changes involved in menopause.
 Age - the older you are, the greater your risk of
osteoporosis. Your bones become less dense and
weaker as you age.
 Body size - Small, thin-boned women are at greater
risk.
 Ethnicity - Caucasian and Asian women are at
highest risk. African-American and Latino women
have a lower but significant risk.
 Family history - Susceptibility to fracture may be, in
part, hereditary. People whose parents have a history
of fractures also seem to have reduced bone mass
and may be at risk for fractures.
RISK FACTORS
Risk factors you can change:
 Sex hormones: abnormal absence of
menstrual periods (amenorrhea), low
estrogen level (menopause), and low
testosterone level in men.
 Anorexia. A lifetime diet low in calcium
and vitamin D. Use of certain
medications, such as glucocorticoids or
some anticonvulsants. An inactive
lifestyle or extended bed rest.
 Cigarette smoking.
 Excessive use of alcohol
CLINICAL FEATURES…
 Osteoporosis : Silent
epidemic because as such
it does not cause any
symptom.
 Only signs and symptoms
are of Fracture.
Like -
 Pain
 Deformity
 Disability
FACTS AND FIGURES…
 As per WHO report over 65Yrs world population will
almost double from 380 million in year 1996 to 690
million in year 2020. A growth of about 84% and
along with it grows the no. of patients having
osteoporosis.
 With the advances in the field of medicine a woman
is expected to spend more than one third of her
lifetime in the post menopausal days
 Osteoporosis affects 200 million people around the
world
 In India 61 million people suffer from osteoporosis.
 80% of them are females.
FACTS AND FIGURES…
 Every 20 seconds osteoporosis causes a fracture.
Osteoporosis is supposed to cause 1.5 million fractures
annually.
 20% of women who experience a vertebral fracture will
have another fracture within a year.
 24% of hip fracture patients die within a year of getting
the fracture.
 50% of hip fracture patients require support for
walking.
FACTS AND FIGURES…
 Out of 50million Americans with
hypertension two out of three are
diagnosed and about one half are under
treatment. In contrast 9 out of 10
individuals with significant bone loss
receive no treatment.
 In India it is estimated that 99 percent of
osteoporosis goes undiagnosed.
 One in Two women and One in Four men
over age 50 will have an osteoporosis-
related fracture in her/his remaining
lifetime
Don’t worry it is not that gloomy…

 Osteoporosis is a disease
which can be treated.
 Osteoporosis is a disease
which can be prevented
from occurring.
 What is required is
awareness.
Don’t worry it is not that gloomy…
Reaching optimal peak bone mass during
adulthood is most effective weapon to
combat osteoporosis. For this purpose
factors worth taking into consideration
are
 Calcium
 Vitamin D
 Regular exercises
 Avoiding smoking and excessive
alcoholism.
 Avoiding long term medications of
drugs which causes decreased bone
mass.
 Bone density testing and taking
medications when appropriate.
Detection …
 Bone mineral density (BMD) tests measure
bone density in the spine, wrist, and/or hip (the
most common sites of fractures due to
osteoporosis), while others measure bone in the
heel or hand. These tests are painless,
noninvasive, and safe.

 Bone density tests can:


# Detect low bone density before a fracture
occurs.
#Confirm a diagnosis of osteoporosis if you
have already fractured.
#Predict your chances of fracturing in the
future.
#Determine your rate of bone loss and/or
monitor the effects of treatment if the test is
conducted at intervals of a year or more.
Prevention of falls
 Protect
other problems of old age by
proper medical management.
 Vision testing.
 Hearing testing.
 Home visits.
 Proper lighting.
 Hip protectors.
Prevention of falls
 AVOID:

– Use of sedatives and alcohol.


– Wearing inappropriate foot wear &
spectacles.
– Hazardous home arrangement.
– Traveling in poor weather
condition.
Remember…
Osteoporosis is by no means a

price that must be paid for growing


old.
THANKS

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