Osteoporosis: a condition in which there is a decrease in bone mass and there is a change in the microarchitecture of bone tissue which causes bone fragility and increases the risk of fracture. The incidence of fractures due to osteoporosis reaches 50% and is mostly found in women (after menopause), with the most frequent fractures of the spine, wrists and hips. To diagnose osteoporosis, bone mineral density can be examined with a DEXA (dual energy X-ray absorptiometry) tool, which shows a T-score below SD 2.5. One way to prevent osteoporosis is to get adequate intake of calcium and vitamin D, increase physical activity and exposure to sunlight, and avoid smoking and alcohol. In severe cases, treatment with biphosponates may be given. In handling, osteoporosis can be given treatment with consumption of calcium (1000 mg/day) and vitamin D (400 IU/day), biphosponate, estrogen replacement therapy. The goal is to prevent fractures from occurring.
Fractures in osteoporosis, sometimes caused by simple events, most often due to falling, slipping or sitting at home in parents. In conditions where a fracture has occurred, there are several treatment options. Here will be reassessed, the activity and condition of the patient before falling. If previously the patient was able to walk independently, then the patient is expected to be able to return to activities as before immediately. Patient preparation before surgery must be carefully prepared, with the collaboration of several specialists, such as internists, anaesthetists, cardiologists to ensure the maximum condition of geriatric patients. Not all operations require surgery, and not all surgeries require long treatment. If the patient's condition is optimal enough, then surgery can be carried out according to the condition of the fracture, for example in a hip fracture, then surgery such as hip joint replacement can be performed. If the patient's condition is good, then 1 day after surgery the patient can start walking with the help of a walker and 2-3 days after surgery, the patient can return home. In cases such as spinal or wrist fractures, sometimes surgery is not required, you can only use a brace or cast. All treatment options, of course, consider the patient's comfort and safety. The main goal of treatment is to return the patient to a good quality of life.
Osteoarthritis (OA) is different from osteoporosis. OA is a degenerative (aging) condition in the joints which is characterized by damage to the cartilage and proliferative changes in the surrounding bone. OA can occur in any joint, but especially in joints that receive a lot of weight-bearing such as hips, knees, ankles and lower back. Joint pain is mild at first, but over time it will slowly increase, and be triggered by activity, and relieved by rest. At an advanced stage, sometimes the pain is also felt during sleep. If left longer, eating will become increasingly burdensome and cause joint stiffness and movement disorders that will hinder daily activities. In the early stages, where there are no signs of calcification on radiology, preventive measures can be taken, such as maintenance of joint movement and muscle strength, and preventing joints from "overloading". At this stage, it can be helped by administering mild pain medication to reduce symptomatic symptoms and modify daily activities. Aerobic sports can be done routinely and also light massage. At a more advanced stage, it will be seen here that there will be a narrowing of the joint space and the appearance of cartilage growth on the edges of the joints. Here we can begin to carry out several interventions, such as pain management with injections, as well as minimal surgery such as realigning bones or arthroscopy. At an advanced stage, where the patient experiences joint stiffness and loss of movement and continuous pain, a reconstructive operation such as a joint replacement (arthroplasty) should be performed.
With advances in surgical and rehabilitation techniques, as well as public awareness, this OA can be prevented early so that invasive measures are not needed. Preventing joint damage early by keeping your body weight from being overweight and moving regularly and strengthening muscles can help prevent joint damage. Surgery is only performed at an advanced stage, where the patient is very painful and there is quite severe activity disturbance. Operations such as joint replacement are now quite sophisticated with relatively small incisions, and fast recovery times, so that patients do not need to be treated for a long time, so that recovery can be done at home with the help of their beloved family.
At EMC Pulomas Hospital, it is now possible to take preventive and treatment measures for osteoarthritis and osteoporosis. With interactive discussions with the orthopedic team, we can think together about a good and comfortable therapy for the patient. In the early stages, with a routine program to prevent the possibility of surgery, a good program can be arranged as preventive measures to get a better quality of life. In cases that require surgery, with maximum surgery preparation and sophisticated surgical techniques, patients no longer need to be hospitalized for long. If the patient's tolerance is good enough and the family can provide good support for postoperative care, then the patient can immediately start mobilizing and return to activities immediately.
Article written by dr. Steesy Benedicta, M.Ked.Klin, Sp.OT (Orthopedic & Traumatology Specialist at EMC Pulomas Hospital).