Channel: nabil ebraheim
Category: Education
Tags: treatmentorthopaedicsdr. nabil ebraheimutmcdiagnosisspineosteoporosiswristhipbone lossfracturesymptomsnathan elkinssignsmanagmentut
Description: Dr. Ebraheim’s educational animated video describes osteoporosis and bone loss - special considerations. Follow me on twitter: twitter.com/#!/DrEbraheim_UTMC Find me on Instagram @OrthoInitiative Understanding Osteoporosis youtube.com/watch?v=Ps5hEXp-ees Osteoporosis and bone loss special considerations Osteoporosis is a decrease in bone mass and bone strength. The strength of the bone depends on the mineral density and bone quality. Osteoporotic bone is weak and is at risk of fracture at the hip, wrist, and spine. These are the common osteoporotic fractures: • Younger patients sustain wrist fracture first • The older patients sustained hip fractures How about the spine fractures? If a fracture of the vertebral spine occurs, the patient will have a 5 fold increased risk for having a second vertebral fracture or a hip fracture. A second vertebral fracture means that the patient will get more compression fractures in the future. With 1 hip fracture, there will be a 10 fold increase of another hip fracture occurring. Men with hip fractures have a higher mortality rate in women. The lifetime risk of fractures of the hip, spine, and wrist is 40%. The decrease of bone strength in bone mass clearly predicts fracture risk. There is another entity called osteomalacia. What is the difference between osteoporosis and osteomalacia? • Osteoporosis is the loss of bone mass. • Osteomalacia is the reduced mineralization of the bone. Osteoporosis affects 45% of women aged 50 or older. There is also some correlation between osteoporotic fracture and the risk of death. 20 to 25% of elderly patients could die within 1 year of suffering a hip fracture. Men and women both begin to start "spending "or losing bone at a certain point in their lives. Banking or building up bone during youth has benefits during the later years. Let me give you a brief summary of bone physiology. The bone has 2 important cells, the osteoclast and the osteoblast. The osteoclast eats the bone. The osteoblast makes bone. It takes about 100-150 osteoblast to replace the bone that is removed by 1 osteoclast. And osteoporosis, there is mineralization in the bone, but there is an abnormal osteoclast function. You lose the bone and the bone becomes osteoporotic due to abnormal osteoclast function that eats the bone. There is a quantitative but not a qualitative problem of the bone with osteoporosis. The quantity is small because the osteoclast are like machines eating the bone and making the bone softer. The osteoblasts try to make the bone but they are not able to because the wild osteoclast or destroying the bone. Most individuals obtain their peak bone mass between the ages of 16 and 25 years of age. Then begin to lose bone mass after the age of 25 years at a rate of 0.3 % per year. Women begin to lose bone at the rate of 0.5 % per year. After menopause, there is an accelerated rate of bone loss at the rate of 2-3 to put percent per year of the total bone mass for about 10 years. Osteoporosis affects about 45% of women 50 years or older. There are 2 types of osteoporosis: • Type 1 o Postmenopausal o Occurs in women within 15 to 20 years after menopause o It affects the trabecular bone o Increased risk of vertebral and wrist fractures o There is an estrogen deficiency • Type 2 o Senile o Occurs in women and in men over the age of 70 years old o It affects cortical and trabecular bone equally o You can see vertebral and hip fractures o Most common in females than males with a ratio of 2:1 o Aging and long-term calcium deficiency With aging, the inner bone diameter increases will the cortical thickness of the bone decreases. 20 to 25% of elderly patients could die within 1 year of suffering a hip fracture. Risk factors for osteoporosis • Thin patient • People of North European descent • People who live sedentary lifestyles • Smokers/drinkers • Antiseizure and phenobarbital medication