You and your doctor will work together to determine the best treatment for your bone disorder. While UR Medicine Bone Health can provide any course of treatment or protocol currently in use for your specific condition, the best way to go will be based on a number of factors: your age and health, the extent of the disease, your ability to tolerate certain medications, and your personal preference.
Assistive Devices: A cast, crutches, or a walker may help restore your ability to get around, return to school or work, or maintain your independence.
Calcium Supplementation: Calcium is the single most important nutrient for building healthy bones. You need to get calcium through food and supplements, because your body cannot make its own supply. Your doctor will help you determine which of the many supplements is best for your condition, and what dosage will have the most positive effect.
Diet: Changes in what and how much you eat can make an important difference in the nutrients that get into your system. You can increase or decrease potassium and calcium through your meal choices, and weight reduction can reduce the stress on your bones.
Drug Therapy:Osteoporosis, rheumatoid arthritis, and Paget's disease are all treatable through oral medications, a number of which have proved to be very effective for patients. Your doctor will discuss your options and the potential benefits and side effects with you, to help you make a decision about using these prescription medications.
Bone grafting: Bone grafts are sections of healthy bone that are surgically attached to other bones that need repair, or that have not healed properly because of a bone disease. The grafts are taken from another area of your body, and they are held in place by surgical hardware—screws, nails, or wire—while new bone grows and fuses them in place.
Core Decompression: When a bone in a joint loses its blood supply, the bone can die—a condition known as avascular necrosis. A surgeon can repair the dying bone and relieve the pain by removing the dead tissue (coring) and replacing it with a healthy bone graft. This procedure can delay the need for total replacement of the joint. Core decompression is most often used in the hip joint, though other joints may benefit from this procedure as well.
Fracture Fixation: Broken bones must be stabilized using surgical hardware until they are strong enough to support a person's weight again—especially if these fractures are in the ankles and feet. The surgeon will use plates, screws, rods, pins and/or wires (internal fixation) to repair the bones and hold the pieces in place. In some cases, a device called an external fixator may be used on the outside of your arm to hold the bone in the correct place.
Kyphoplasty: This repair procedure for spinal fractures can relieve back pain caused by the compression of vertebrae—the bones in the spine—through osteoporosis, cancer, or other bone disorders. The surgeon inserts a tiny balloon into the vertebra to clear the affected bone and make space. He or she then fills the space with special cement that stabilizes the bone.
Laminectomy: Used only if medical treatments have not worked, this procedure involves removing part or all of a vertebral bone called the lamina. Once this bone is removed, the pressure on the spinal cord or a nerve is gone. Your doctor may recommend a laminectomy if medication does not relieve your pain enough to allow you to perform normal activities of daily living.
Osteotomy: When a bone has been fractured and has not healed properly, a surgeon can perform this procedure to move the bone back into alignment. During an osteotomy, the surgeon cuts the bone to shorten or lengthen it, or to realign it so it can heal correctly. This surgery also may be appropriate to relieve the pain of osteoarthritis in the knee or hip, although most patients will benefit from joint replacement (which may have a shorter recovery period).
Surgical Treatment of Bone Tumors: Some benign (noncancerous) tumors can become malignant (cancerous), so your doctor may recommend that a tumor be removed surgically. If the tumor is malignant, a surgeon may be able to remove the cancerous section of bone while preserving the rest of the limb—keeping the muscles, tendons, nerves, and blood vessels, and replacing the bone with an implant. This will allow you to use the limb after surgery and rehabilitation. If the blood vessels and nerves are affected by the tumor, the surgeon may need to amputate the limb. UR Medicine's Orthopaedics will work with you to create the proper prosthetic as part of your recovery.
Traditional hip replacement: Surgeons at the Evarts Joint Center at Highland Hospital perform complete hip replacements on older patients and others who require this procedure.