We’ve all heard the stories; an older friend trips and falls resulting in a wrist fracture, an elderly relative falls and breaks a hip. When these kinds of fragility fractures happen to most people they have no idea they are suffering from an ever increasing silent disease in our country, Osteoporosis. At the Mid-Maryland Musculoskeletal Institute (MMI) orthopaedic surgeon, Dr. Frank Nisenfeld is leading a crusade to combat this silent disease with a new program called Save the Bone.
Dr. Nisenfeld explained, “I decided to enhance the standard screening protocol for our patients who might be at risk for fragility fractures and was surprised to find a significant under diagnosed population unaware that they suffer from Osteoporosis or Osteopenia.” Osteoporosis literally means silent weak bone disease. It is a condition where the individual’s bone mass deteriorates to a point making that person at risk for fractures of low energy. Osteopenia is a condition of silent weak bone that has not progressed to the severity of full blown Osteoporosis.
Historically Osteoporosis and Osteopenia have been considered conditions of women, but recent studies have indicated that men over the age of 60 have a 20% chance of developing this bone weakening condition as well. Osteoporosis and Osteopenia are known as silent conditions, because until pain or a fracture occurs, the individual has no symptoms. More than 2 million fragility fractures occur in this country each year at a cost of $22 billion. The misery and pain produced by these conditions, when fractures occur, are enormous and in some cases life threatening.
The MMI Save the Bone program involves surveying patients both in the office and in the hospital regarding their history and possible need for further screening. Dual Energy X-ray Absorptiometry, or DEXA scan for short, is a painless, non-invasive test that measures bone mineral density. Patients who have DEXA scans are evaluated and treatment is recommended if the scan indicates low bone density.
In partnership with MMI for the Save the Bone program is Frederick County’s largest primary care provider, Frederick Primary Care Associates (FPCA). Dr. Amy Jones, who heads up the Osteoporosis program for FPCA noted that, “We are very excited to join forces with MMI for Save the Bone. Between the doctors at MMI and all of our providers located at eight FPCA offices throughout Frederick County, we can capture a significant section of Frederick’s at risk population.”
As medical director of the MMI Save the Bone Program, Dr. Nisenfeld counsels patients regarding the need for a DEXA scan and evaluates the scan results. Dr. Jones will do the same for FPCA patients. Those patients who require further care are either treated at MMI or are referred to their primary care physician for treatment. MMI has two physicians on staff that are specialty trained to treat Osteopenia and Osteoporosis, Rheumatologists, Dr. Neeti Bhargava and Dr. Enrico Villanueva. For some, treatment may be nothing more than instructions to take calcium and vitamin D supplements. Others may be referred to physical therapy to learn weight bearing and muscle strengthening exercises. Still others may be prescribed medicines to help slow bone loss.
For many people these fragility fractures are the result of a low energy injury or fall. The MMI Save the Bone Program includes a comprehensive physical therapy program to assess the patient’s risk of falling and measures to correct and decrease that risk. This is done using a scientifically recognized fall risk analysis.
“I have great hopes for this program,” Dr. Nisenfeld said, “our goal for Save The Bone is to decrease the number of fragility fractures in Frederick County by:
1. Making the public aware of this silent bone weakening condition
2. Identifying patients with weak bones
3. Treating these patients
4. Assessing the patient’s risk of falling and promote good dietary and physical activity lifestyles which also work towards combating this condition.”