1 in 3 women and 1 in 12 men over 50 have osteoporosis. In Spain, every year 80,000 people have fractures, 720,000 vertebral some break while 200,000 wrist break generating enormous economic costs and enormous suffering in patients. In Europe, every 30 seconds a fracture caused by osteoporosis and the numbers are increasing with the aging of the population and lack of awareness of the problem by health authorities, doctors and patients. Only 10% of patients with osteoporosis are treated.
Osteoporosis is characterized by low bone mass and deterioration in the microscopic structure of bone tissue. The bone becomes fragile and fractures increase. This is one of the most prevalent bone disease, along with osteoarthritis, and the second most important problem in the field of health after cardiovascular diseases.
Risk factors for osteoporosis
Some of the factors that indicate that a person may suffer from osteoporosis are:
- Sex, women suffer more than men
- family history
- Menopause before 45
- Fragility fractures before age 45
- Hip fracture
- Low intake of calcium and vitamin
- Diseases like Parkinson's, rheumatoid arthritis, IDDM or hyperthyroidism
Normal bone and osteoporotic bone
At first the disease progresses without obvious symptoms, so it is known as "the silent epidemic". If it progresses, pain appear, the main symptom of the disease, which usually focus on is Palda, hips, wrists or shoulders and finally pathologic fractures. These occur with minor trauma, under normal conditions, should not cause fracture; or atraumatic. The main osteoporotic fractures, which are to serve as a warning to specialists, are:
- The vertebral fracture. It is the cause of kyphosis or "hump" of many older people.
- Hip fracture. "We come into the world through the pelvis and go for the for the femoral neck," says one of our treaties classic text.
- The fracture of the distal radius, the wrist.
- The fracture of the proximal humerus, shoulder.
- Periprosthetic fractures. They are those that occur on a prosthetic hip, knee, shoulder or elbow. Represent an emerging problem for the large number of prostheses implanted and difficulties in obtaining a reliable reconstruction that does not limit the activity and patient autonomy. They are difficult to solve, are to be treated by specialists in reconstructive knee surgery and hip and are an enormous resource consumption, much higher than in other types of fractures.
It is important to see a specialist primary care Rheumatology and Traumatology in cases of widespread pain in bones and joints.
Preventing osteoporosis includes measures such as quitting smoking, eating a proper diet (especially calcium and vitamin D), take the sun moderately, to exercise and prevent falls.
Osteoporotic vertebrae and proximal femur
Treatment of osteoporosis aims to control pain, stop bone loss and prevent fractures. It can be classified into three types:
- Antiresorptive drugs: the most powerful are bisphosphonates. Inhibit bone cells are eaten.
- Osteoforming drugs: reduce the incidence of vertebral and non-vertebral fractures by 50 to 65%.
- Drug dual action: it reduces bone resorption and stimulates formation. It is important to include these treatments calcium and vitamin D.
The orthopedic surgeon occupies an excellent observation site. It is the professional who can better assess the need to establish prophylaxis and, often the first to detect when an osteoporotic fracture is a known risk factor for having other fractures.
One of our responsibilities is to inform, educate, make longer silent epidemic and treat complications from the disease, encouraging multidisciplinary treatment.