My mother has knee pain that’s being called an insufficiency fracture. What is it?

March 30th — admin

What is an insufficiency fracture? My mother was told that’s what’s causing her new knee pain.

Insufficiency fracture is a small subset of a larger group of fractures called stress fractures. Insufficiency fractures are caused by the effect of normal stress on weakened bone. Osteoporosis is the most common cause of bone loss leading to insufficiency fractures.

Loss of bone density from osteoporosis decreases the bone’s ability to “give” slightlyand resist everyday loads. The loss of this “elasticity” seems to affect the spine, tibiaand fibular (lower leg bones) and calcaneus (heel) most often.

These fractures seem to be on the rise in older adults, especially postmenopausal women.

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 a 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.

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Having gotten off a bus for 10 years, my mother’s hurt knee was diagnosed as an insufficiency fracture. Why was this time different?

March 25th — admin

My mother was getting off the bus when she had severe, sharp knee pain. The MRI showed a stress fracture. The doctors are calling it an insufficiency fracture. She’s gotten off that bus everyday for the last 10 years. Why was yesterday any different?

You didn’t say your mother’s age but age may be a factor. Older women are at increased risk for this problem. There’s an increased number of these fractures in women who are postmenopausal. Osteoporosis (decreased bone density) in this age group is another important factor.

Without its normal resiliency, the simplest, everyday stress can cause damage to the bone. Anyone who has arthritis is also at increased risk. Often, the osteoporosis added to any slight knee deformity can be enough to cause this problem.

Other factors include alcohol use, Crohn’s (intestinal) disease, and the use of steroids for arthritis. Low calcium absorption, vitamin D deficiency, and hormonal changes are also factors.

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 a 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.

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Most hip fractures occur in women over 65. Why?

July 15th — admin

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.

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What causes total shoulder replacement to fail?

June 9th — admin

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.

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.

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Is a total hip replacement safe for patients with osteoporosis?

May 28th — admin

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.

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.

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Power walking can aid osteoporosis

May 4th — admin

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.

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.

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Osteoporosis may cause rotator cuff repair to fail

December 24th — admin

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.

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Is osteoporosis hereditary?

October 23rd — admin
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.

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.

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

September 11th — admin
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.

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

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