Naples Orthopedic Surgeon - Dr. Robert J. Zehr » osteoporosis

Most hip fractures occur in women over 65. Why?

admin — Thu, 15 Jul 2010 14:00:32 +0000

I heard that most hip fractures are in women over 65. Can you explain why this happens?

Two major factors account for the number of hip fractures in older adults, especially women over age 65. The first is osteoarthritis of the joints — wear and tear on the joints that seems to be part of the aging process for many adults. The second is osteoporosis (brittle bones), which often occurs as a result of menopause for women. Osteoporosis can also affect men in this age group.

Loss of balance and falls are a major cause of hip fractures. There are many risk factors for falls for both men and women. Muscle weakness and decreased reaction time when the balance is challenged are part of the problem. Medications that cause dizziness or dehydration can also contribute to falls.

Sometimes simple household situations can cause problems. For example slippery floors, throw rugs, animals under foot, or stairs without handrails can lead to falls. Problems with vision and hearing so common in older age can add to the risk. Use of alcohol or other substances is another risk factor.

Doctors, nurses, and physical therapists are working together to teach older adults about the dangers and risks that can lead to falls and hip fractures. Osteoporosis prevention for men and women begins with nutrition and exercise early in life. Staying active and doing specific balance exercises can also make a difference.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

What causes total shoulder replacement to fail?

admin — Thu, 10 Jun 2010 01:36:22 +0000

Two years ago, I had a total shoulder replacement. Now, I have painful clicking and popping in that shoulder. The doctor thinks I have a failed replacement. What could have caused this to happen?

In about one-third of all cases, implant failure occurs after some kind of trauma. In other patients, bone loss contributes to joint failure. This may occur as a combination of decreased bone density from osteoporosis and bone removal during the operation.

A recent study at the Mayo Clinic reports results after shoulder replacement. Failures were often caused by more than one factor. Muscle tears, improper position of the implant, and tension in the joint capsule were all listed as possible causes. Soft-tissue imbalance was present in all cases.

Is a total hip replacement safe for patients with osteoporosis?

admin — Fri, 28 May 2010 10:31:40 +0000

I’ve had osteoporosis for the past 10 years. I’m doing my exercises and taking my medications. I also need a hip replacement. Is it safe to try for it? I’ve heard brittle bones can break during that operation.

Many people with osteoporosis have had total hip replacements. Often the hip breaks and it can’t be repaired because of the osteoporosis. Doctors have special ways of handling such cases.

They use cement to hold the implant in place. They can choose implants that don’t need the inside of the femur (thigh bone) to be drilled out. They are more likely to use an open method of surgery instead of the newer mini-incisions.

Ask your doctor for his or her opinion. A decision can be made based on your X-rays and bone mineral density studies. Your overall health is a factor and whether you smoke. Tobacco-use delays wound healing and increases your risk of a fracture. If everything checks out, you could be a good candidate for a hip replacement.

Power walking can aid osteoporosis

admin — Tue, 04 May 2010 12:08:28 +0000

I’ve seen a few women at the park carrying small weights and walking faster than usual. What’s the advantage of doing this? Maybe I should give it a try.

Some people refer to this style of walking as “power walking.” With a small one or two pound weight in each hand and swinging the arms, you can get a boost to your workout. You’ll keep your pace up and raise your heart rate. You may even burn a few more calories and shed an extra pound or two.

There’s the added advantage of stress on the bones of the upper extremities, which can help with osteoporosis. Bone growth is stimulated whenever tension is applied by the tendon to the bone.

Some men and women who try this method of walking say it helps them remember to swing their arms and keep a more moderately brisk pace.

Osteoporosis may cause rotator cuff repair to fail

admin — Thu, 24 Dec 2009 19:45:09 +0000

I’m 78-years old and have been diagnosed with a rotator cuff tear and osteoporosis. I’ve been told the osteoporosis puts me at risk for a failed rotator cuff repair. If the muscle is the problem, what difference does it make if the bones are brittle?

The tendons attach to the bone and must be reattached after injury in order to give you back shoulder motion and strength. Some of the newer ways of repairing rotator cuff tears involve drilling holes through the bone. Then the doctor threads the sutures through the tunnel to the other side. This gives the repair strength and the shoulder stability.

The sutures may not hold if the bone is soft or brittle from osteoporosis. In cases of bone problems, they can use special anchors that look like buttons to help hold the stitches in place.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

Is osteoporosis hereditary?

admin — Fri, 23 Oct 2009 14:44:48 +0000

There seems to be quite a few older adults in my family with hip fractures from osteoporosis. Is this a hereditary disease?

There is new evidence that genetics plays a role in osteoporosis. Many different genes affect bone growth. Genes to code the structure of proteins that help build bone are important. Genes involved in making sex hormones are involved. Estrogen and testosterone are key factors in bone growth.

Vitamin D is needed for calcium to be used in forming bone. A special gene is linked with this activity, too. In general these kinds of genes are called osteoporosis candidate genes. Any changes in these genes can cause a problem with bone growth.

Men seem to be more affected by genetic factors than women. A study of families show bone mass is lower in relatives of men with osteoporosis. Increasing age seems to be related to increased bone loss in men with certain types of gene structure.

More research is needed in this area to know what and how genetics plays a role in osteoporosis. There may be some major differences between genetic factors in men versus women.

How could I have dislocated my hip after a total hip replacement?

admin — Fri, 11 Sep 2009 11:14:25 +0000

A year ago I had a total hip replacement done. Last week I was out gardening on my hands and knees and it dislocated. I thought I was all healed. What happened?

Many factors can play a part in hip dislocation after replacement. For example, which side of your hip is the scar located? Any position you get in that can push the hip in that direction has the potential to cause a dislocation.

When you are on your hands and knees, you have your body weight against that hip. If you twist or angle your body against the hip, injury can occur. Your weight and bone density are also important factors. Being overweight means that much more pressure through the hip. Having osteoporosis (brittle bones) or decreased bone density makes it harder for the bone to grow around the new implant and hold it in place. Bone or muscle weakness can also lead to injury.

Most patients are given positioning precautions for the first 12 weeks post-op. In theory at 12 months you should be free to assume any position possible. In practice, sometimes our theories (and hips) don’t hold up.