Dr. Jason Tani, the new orthopedic surgeon for Banner Payson Medical Center, recently discussed a variety of topics at a Doc Talk program hosted by Banner High Country Seniors. He covered a wide range of topics. Among these were bone health; hip fractures; knees; and arthritis.
Bones give our bodies structure, allowing us to walk, ride a bike, and hold a child. They protect our organs and store our supply of calcium, a mineral necessary for building and maintaining strong bones.
Bones and the skeleton play many important roles in the body. They:
• Store and supply calcium as needed for all of the cells and organs of the body
• Give our bodies support and muscle attachments, which allow us to move and use our limbs
• Enclose and protect our vital organs
• Provide space for bone marrow, where all types of blood and bone cells are made
In addition, bone cells respond to their environment to strengthen the structure of individual bones to resist fracture.
These complex functions occur within what appears to be a solid structure. And yet, while the outside of a bone looks like a rock, the inside more closely resembles lacy coral surrounded by a hard thick shell. Unlike a rock, a bone is living tissue that is constantly changing.
Tani explained as strong as our bones may seem, they are susceptible to damage from illness and disease.
To keep bones healthy Tani recommends exercise. He said it keeps bones strong, joints limber and helps prolong the life of joints and strengthens muscles. It also nourishes cartilage, which covers bone ends in every joint, Tani said.
Types of exercise he recommends: walking; swimming; bicycling; and water aerobics. He also suggests working with a physical therapist for those in need of special assistance.
Tani said maintaining weight is also important to bone and joint health. He said extra weight places extra stress on your joints — 3 pounds of pressure is put on bones and joints for every pound of body weight, so a 150-pound person can place up to 450 pounds of pressure across each joint. Extra weight accelerates rate of cartilage destruction and makes it harder to exercise properly before and after surgery.
One of the most serious fall injuries is a broken hip. It is hard to recover from a hip fracture and afterward many people are not able to live on their own. As the U.S. population gets older, the number of hip fractures is likely to go up.
• Each year more than 300,000 older people — those 65 and older — are hospitalized for hip fractures.
• Women experience three-quarters of all hip fractures.
• Women fall more often than men.
• Women more often have osteoporosis, a disease that weakens bones and makes them more likely to break.
• The chances of breaking your hip go up as you get older.
(Statistics from Centers for
Disease Control and Prevention)
“Patients recover quicker by replacing a hip than by placing three screws (to repair it), but there can be complications with hip replacement. The goal is to get you back to how you used to live,” Tani said. He added he is happy to fix anything locally — in Payson — and he wants to keep patients here in Payson.
TYPES OF FRACTURES
In general, there are three different types of hip fractures, he said. The type of fracture depends on what area of the upper femur is involved.
The three types are: Intrascapula; Intertrochanteric; and Subtrochanteric.
This fracture occurs between the neck of the femur and a lower bony prominence called the lesser trochanter. The lesser trochanter is an attachment point for one of the major muscles of the hip. Intertrochanteric fractures generally cross in the area between the lesser trochanter and the greater trochanter. The greater trochanter is the bump you can feel under the skin on the outside of the hip. It acts as another muscle attachment point.
This fracture occurs below the lesser trochanter, in a region that is between the lesser trochanter and an area approximately 2-1/2 inches below.
Tani does partial knee replacements. He said replacing the inside portion of the knee leads to a faster recovery than total knee replacement.
The knee has three different components: ligaments, which connect bone to bone; tendons, connecting muscle to bone; and cartilage, which lubricates and cushions movement.
Tani explained cartilage covers bone ends in every joint and is a white, slippery tissue that is about a quarter-inch thick and can be damaged.
Tani said arthritis is common and it affects us all, especially as we get older.
Arthritis is defined as inflammation of the joint and there are more than 100 different types of the disease.
Arthritis affects 43 million Americans each year, impacting one in every six citizens. It is also the most common cause of disability in the U.S.
With arthritis there is pain, swelling, and loss of motion. There are two primary types of the disease: osteoarthritis and rheumatoid arthritis.
• Most common type of arthritis
• 23 million Americans affected annually
• It is a degenerative disease affecting joint cartilage through “wear and tear”
• May result from overuse or injury
• Knees, hips, back and hands most often affected
• Begins as small area
• Eventually results in bone-on-bone contact
•Results in swollen, painful and stiff joints
• Joints warm to the touch
• Joint swelling
• Joint pain and immobility — If having joint pain, Tani strongly encourages getting it checked out quickly with an X-ray to ensure that it is not cancer.
• Joint stiffness
• Decreased activity
• Impaired lifestyle
• Joint deformities
To get a proper diagnosis of osteoarthritis see an orthopedic physician. The affected joint will then be examined for range of motion, joint-line tenderness, joint deformities and then an X-ray will be given.
Tani shared a wide variety of treatments for arthritis from things as simple as ice and heat and over the counter medications to injections for pain management.
He said the use of ice decreases local circulation and swelling; acts as a local anti-inflammatory; decreases pain; and improves exercise tolerance.
Heat increases local circulation; promotes relaxation; helps muscles and joints stretch; and decreases joint and muscle aches.