2. DEFINITION
Osteoporosis means “porous
bones” osteoporosis is a disorder in
which there is reduction in bone density
and change in bone structure. This is a
metabolic bone disorder characterized
by loss of bone density, change in bone
structure, increase bone fragility and
increased susceptibility to bone
fractures.
3. ANATOMY & PHYSIOLOGY
➢ The skeleton functions to provide structural
support to muscles and organs and to serve as a
depot for the bodies calcium and other essential
minerals. Skeletons consist of two types of
bones – Cortical Bone (80%) and Trabecular
Bone (20%).
➢ Bone resorption and production is associated
with the delicate actions of the two types of cells
found in the body tissues – OSTEOCLAST
CELLS & OSTEOBLAST CELLS.
4. OSTEOCLAST CELLS :
❖ Osteoclast cells mediate bone resorption and activated by
concentration of calcium, Phosphorus, Vitamin D and Parathyroid
Hormone as well as other systemic hormones.
❖ Estrogen receptor modulator Calcitonin and Bisphosphonates are
factors that inhibits bone resorption.
OSTEOBLAST CELLS :
❖ Osteoblast cells make up the part of bone that undergoes
mineralization. Under steady physiology circumstances the rate of
osteoclast mediated bone resorption is equal or coupled with
osteoblast stimulated bone formation.
5. Osteoporosis is conventionally
classified into following types :
➔ Primary Osteoporosis
◆ Type - I (P.M.O.)
◆ Type- II (S.O.)
➔ Secondary Osteoporosis
➔ Idiopathic Osteoporosis
➔ Juvenile Osteoporosis
CLASSIFICATION
6. RISK FACTORS
A. NON MODIFIED RISK FACTORS
● SEX
● AGE
● ETHNICITY
● GENETICS
● BONE STRUCTURE AND
BODY WEIGHT
● EATING DISORDER
● CERTAIN DISEASES
● FEMALE ATHELETES
● ENDOCRINE DISORDERS
● G.I. SURGERY
B. MODIFIABLE RISK
FACTORS
● INADEQUATE DIET
● SEDENTARY LIFE STYLE
● STEROIDS & OTHER
MEDICATIONS
● EXCESSIVE ALCOHOL
CONSUMPTION
● TOBACCO USE
8. CLINICAL MANIFESTATIONS
A person is often not aware that he or she has osteoporosis until a
fracture occurs. But there are occasionally symptoms of the disorder, they
could include : -
Backache Stooped Posture Kyphosis
Spine Fracture Dowager’s Hump Lordosis
10. THERAPEUTIC
MANAGEMENT
The aim of treatment for Osteoporosis is meditation &
avoidance of modifiable risk factors to prevent bone loss.
Therapeutic Management includes :-
❏ MEDICATIONS
❏ DIET
❏ EXERCISE
11. MEDICATION
● Calcium and Vitamin D
Supplement.
● Bisphosphonates
● Selective Estrogen Receptor
Modulator
● Teriparatide
● Denosumab
DIET
● Calcium and Vitamin D Enriched
Diet such as -
■ Milk
■ Cheese
■ Dairy Products
■ Steamed Broccoli
■ Spinach
■ Dark-Green Leafy Vegetables
■ Turnip
EXERCISE
● Weight bearing accessories specially walking stimulates bone building.
● Resistance accessories such as weight training or use of some of the equipment
available at fitness centres.
● Avoid falls.
12. Surgical Management
Fractures of the hip that occur as a consequence of osteoporosis are
managed surgically through:
Joint replacement : Joint replacement is a surgery to replace all or part of a
joint with a man-made joint called prosthesis.
Closed or open reduction with internal fixation. Open reduction, internal
fixation involves the implementation of implants to guide the healing process of a
bone, as well as the open reduction, or setting, of the bone, while closed reduction
is a procedure to set or reduce a broken bone without surgery.
13. NURSING MANAGEMENT OF PATIENTS WITH OSTEOPOROSIS
Nursing Assessment :
Health promotion, identification of people at risk for osteoporosis and
recognition of problems associated with osteoporosis from the basis for
nursing assessment.
❖ Health History : The health history includes questions concerning the
occurrence of osteopenia and osteoporosis and focuses on family history,
previous fractures, dietary consumption of calcium, exercise patterns, onset
of menopause, and use of corticosteroids as well as alcohol, caffeine, and
smoking.
❖ Symptoms : Any symptoms the patient is experiencing, such as back pain,
constipation, or altered body image, are explored.
❖ Physical examination : Physical exam may disclose a fracture, kyphosis of the
thoracic spine, or shortened stature.
