What You Need to Know About Surgery and Osteoporosis

What is Osteoporosis?

Osteoporosis is a metabolic disease affecting both men and women as part of the aging process. It's more common in Caucasian and Asian women, but it can affect children. However, it's most prevalent in older people because bone mass decreases with age, making them more susceptible to fractures. The most commonly affected areas are typically the spine, wrists, and hips. The body has a continuous self-renewal capacity, involving the constant replacement of old bone cells with new ones. When we are young, our bones regenerate faster than they degrade. However, approaching our twenties, our bodies begin losing bone mass more quickly than they can create it. This process continues to accelerate with age. Osteoporosis often has no noticeable symptoms in the early stages, meaning patients may not realize they have the disease until they suffer a fracture from a minor injury.

When is Surgery Necessary for Osteoporosis?

If you suffer a serious fracture due to osteoporosis, you will likely require surgery. The areas most commonly affected by osteoporosis-related fractures are the hip, spine, and wrist. While osteoporosis can affect all bones, this article focuses on surgical techniques used for fractures most frequently affected by the disease.

Hip Fractures: What Surgical Treatments Are Available?

Femoral Neck Fractures

To better understand this fracture, it's important to understand the anatomy of the femur. The head of the femur, resembling a ball, is located at the junction of the hip joint. This part is essential in linking the femur and the hip. The femoral neck connects the head of the femur to the rest of the femoral body. Thus, if a fracture occurs in the femoral neck, the head can detach from the rest of the femoral body. In short, it's an injury occurring where the femur inserts into the hip joint.

Depending on the severity of your femoral neck fracture, you may need:

• Metal Screws: Your surgeon may use metal screws, known as internal fixation, to stabilize the bone and promote healing of your fracture;
• Hemiarthroplasty: The surgeon might decide to remove the head and neck of your femur and replace them with metal instrumentation;
• Hip Replacement: If you have hip problems, your surgeon may consider implanting a prosthesis after removing the top of the femur and the bone socket of your pelvis;

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Intertrochanteric Fractures

Like femoral neck fractures, intertrochanteric fractures are located in the upper part of the femur. However, they don't affect the same parts of the bone. Fortunately, these fractures are easier to repair than femoral neck fractures. Your surgeon will likely use a metal screw to stabilize the bone across the fracture. While surgery for hip fractures generally has a good success rate, it's important to consider a prolonged recovery period. Plus, there's no guarantee of complete recovery. One undeniable fact: achieving the same level of mobility after a hip fracture can be difficult. This serious injury often requires surgery and can take months, even a year, to heal completely. Unfortunately, people aged 65 and older are most affected by hip fractures, often caused by falls at the joint between the femur and the hip. If you suffer such a fracture, surgery will likely be necessary for your recovery. The choice of surgery depends on the severity and location of your hip fracture.

How Do Kyphoplasty and Vertebroplasty Relieve Pain Associated with Vertebral Osteoporosis?

Kyphoplasty

During this procedure, a small incision is made in the back, and a small tube is inserted. The tube is guided into the correct position, creating a pathway through the back to the fractured area. The surgeon uses X-rays to insert a balloon into the vertebra and then inflate it. Inflating the balloon pushes the fractured pieces back into a more appropriate position, relieving pain and creating a cavity. After removing the balloon, the doctor fills the cavity with a material that hardens and stabilizes the bone.

Vertebroplasty

This minimally invasive procedure involves injecting low-viscosity cement directly into the collapsed vertebral body to stabilize the fracture. It can also prevent further deformities, such as spinal curvature or height loss. Vertebroplasty differs from kyphoplasty because it generally does not involve manipulation before injection. For individuals experiencing pain due to vertebral osteoporosis, both procedures can significantly alleviate symptoms.

Wrist Fractures: What Treatment Options Exist for More Complex Fractures Related to Osteoporosis?

For women under 75, wrist fractures are very common; in fact, they are the most frequent. In addition to the small bones of the hand, the wrist is composed of two bones, the radius and the ulna. If you have suffered a wrist fracture, it is likely due to a fall on your hand with significant force. In the case of a simple fracture, a cast or splint will suffice to heal the broken bone. If you end up with a more complicated fracture, such as multiple broken bones or if the cartilage of the wrist joint is affected, you will most likely need surgery to realign and stabilize the broken bones. This injury can significantly impact your daily activities, especially if you are elderly or if it affects your dominant arm. If you are looking to regain mobility in your arm, physiotherapy can be a valuable ally. Keep in mind that healing can be a slow and patient process. Fortunately, there are many safe and effective surgical methods to repair fractures caused by osteoporosis. Don't hesitate to discuss with your doctor the options that could relieve your pain in the best possible way.

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