1, exercise: the most critical human bone density has a peak concept, that is, from birth to old age, the content of bone mineral is constantly changing, from less to more, and then from more to gradually reduce the process, the most amount of bone becomes the peak of the bone, the peak appears about 35 years old, after 40 years old, the amount of bone began to reduce, and with the growth of age, the rate of reduction is gradually accelerated. It can be seen that increasing the peak or slowing down the rate of bone loss is a very good way to prevent osteoporosis. How to increase the peak? Exercise can increase bone mass, and as mentioned earlier, a sufficient amount of exercise can increase the peak and reduce the loss of bone mass. Have you ever thought about what kind of sports state we were in when we were 10 years old? I remember when I was a kid, adults always said, “These kids are so energetic, they don’t know how to sleep in the middle of the day, they always have an inexhaustible energy, they know how to be naughty”; at the age of 20, they feel young and youthful, and they are not afraid of tigers; at the age of 35, they feel some energy. Weakened, can not run, the body is also blessed; 45 years old? In fact, after the age of 35, our exercise also reduced to 70 years old, many old comrades are old two to support each other to move forward, and then old only in a wheelchair, so that people live to old age, exercise to old age, life is not only, the movement does not rest. But how to exercise? The young people exercise since needless to say, for the elderly exercise in the end should follow what principle? The old saying is “shitting and drilling and saving the head to make a secret effort”, how to understand this phrase? The body joints do not look moving but the whole body with force, this kind of exercise is called isometric contraction exercise exercise. Some people say this can exercise, I’ll tell you why can reduce the loss of bone mass. We all know the sailboat, the sail can be pulled up, by the rope and mast, when we tighten the rope, the sail will rise, while the mast has a role in supporting the deck, then in the rope tension and relaxation process will produce a mast on the deck impact force changes, at this time the bone itself has a change in force, as long as the force of the change to the bone is not a waste, so it is also good to prevent the bone This is a good way to prevent bone wasting, especially after a person is bedridden. Secondly, most elderly people have joint pain, climbing and running exercises will aggravate the wear and tear of joint cartilage and cause joint pain, this isometric contraction exercise is very good to reduce joint wear and tear. In addition, osteoporosis itself is not terrible, what is terrible is the fracture caused by inadvertent fall after osteoporosis, so it is very important to prevent falls. Isometric contraction exercise is good for body coordination training and can prevent falls. Balance board, balance beam, golden chicken independence, taijiquan and so on these exercises are very good training the body’s coordination and balance ability, while not aggravate the damage to the joints. Think about when we were 20 years old, we tripped over a stone, we ran forward a few steps and we were fine; now we are 60 years old, the result of tripping over a stone can only be to use our hands to support the ground or sit directly on the ground. What is the reason? The body strength is poor, the coordination is poor, so usually we should increase the training of this kind of limb coordination, and it is very important to choose this kind of correct movement. 2, drugs If we have osteoporosis, in addition to exercise to prevent falls, we should also choose effective drugs. How do doctors consider the medication for osteoporosis? The point of action of these factors, such as disuse, old age, caffeine, low hormone level, etc., is in the key link of human bone transformation, i.e., the dynamic balance between osteogenic activity of osteoblasts and osteoclastic activity of osteoclasts, and osteoporosis will occur if osteogenic activity is stronger than osteogenic activity, and osteophyte will occur if osteogenic activity is stronger than osteoclastic activity. Therefore, the point of action of drug treatment is only on the osteoblast osteogenesis promotion, and also on the inhibition of osteoclast osteoclastic effect. China has a 5,000-year history of herbal treatment and is pleased that many studies have shown that some herbal medicines do have a clear effect on osteoblasts in promoting growth, proliferation and differentiation. Western medicine has also made some breakthroughs in this area of research, and recombinant human parathyroid hormone has been introduced and is already in phase III clinical use in the United States. In addition, the most researched and clinically proven effective is the inhibition of osteoclast osteoclastic effect. For example, sodium allantoin phosphate, salmon calcitonin, and norethisterol hydrochloride. You are advised to consult your doctor on how to choose the medication. 3, calcium Some people say I have osteoporosis, I am taking calcium supplements every day, calcium is not lost if you eat more. In fact, the simple supplementation of calcium and vitamin D is like pouring water into a bottomless bucket, just pouring water into the bucket but the bucket can not help water, that is to say, if you eat more calcium is not used by the osteoblasts, it can only be excreted. The role of osteoblasts is just like the bottom of the barrel we are talking about. Then someone said, since calcium supplementation is useless, why do you still supplement calcium? There is an old Chinese saying “A clever woman cannot cook without rice, a good cook without oil, salt, sauce and vinegar will not be able to make a fragrant banquet. So how much calcium do we need in a day? As shown in the table. And what calcium to take? Now the market can buy more than 100 kinds of calcium products, there are imported, there are domestic, too much, do not know how to choose. In fact, calcium is divided into two categories: one is inorganic calcium and inorganic acid calcium, high calcium content, low solubility, poor absorption, low bioavailability, <40%, but the gastrointestinal stimulation; the other is organic calcium, calcium by ligand bond chelation, high solubility, high bioavailability, >90%, stable blood calcium levels. In fact, milk contains a lot of calcium and is well absorbed, but some elderly people can’t drink milk because they run their belly when they drink it. Older people with these problems will need to choose some calcium to supplement properly. In addition foods such as tofu, shrimp, eggs, yogurt contain a lot of calcium. 4, what other role does orthopedics play in the prevention and treatment of osteoporosis? Professor Campbell, a leading academic in orthopedics, said, “A cardiologist treating heart disease should never wait until the patient has had severe heart failure before thinking about whether the patient has severe angina, arrhythmia and other primary heart disease; an orthopedic surgeon’s prevention and treatment of osteoporosis should never wait until the patient has had severe heart failure. The prevention and treatment of osteoporosis should not wait until the patient has already had an osteoporotic fracture before thinking about whether the patient has already suffered from serious osteoporosis. In other words, the elderly are like a car that has been driven for more than 70 years, and all the parts have been worn out to the limit, if we don’t change the oil and maintain it regularly, the car may break down in the countryside at any time. In addition, after the fracture, orthopedic surgeons have made new breakthroughs in the field of internal fixation, and have been able to use the most advanced means to enable the patient to resume walking and function in the shortest possible time, returning dignity to the patient, without the fatal complications of long-term bed rest. The fastest surgery time for a femoral neck fracture and femoral head replacement is 30 minutes, and the real surgery time is only 18 minutes if the cement hardening time of 12 minutes is excluded; moreover, the anesthesiologist invented local block anesthesia to minimize the impact of anesthesia on systemic hemodynamics. The oldest patient in our hospital who underwent head replacement surgery after a femoral neck fracture was 105 years old, and she walked on the ground with the assistance of a walker on the third day after the surgery. Patients with surgical neck fractures of the humerus started active functional exercises the day after surgery, preventing the occurrence of traumatic frozen shoulder; this was often the case 20 years ago because of poor fixation and the need to supplement it with some external fixation, so many patients had limited shoulder movement due to joint immobility. What about compression fractures of the vertebral body? Can the height of the vertebral body be restored after it is lost? And can the fracture heal afterwards? The truth is that it can recover and heal. This kind of compression fracture can restore the height through technology in the early stage, but after the height is restored, a hollow shell is often formed inside the vertebral body due to bone compression, so the height is restored but the strength of the bone cannot be restored, so we now inject artificial bone cement into the vertebral body through technology. This treatment method is like the Yangtze River flood in 1998, when our soldiers found that the Yangtze River embankment had a surge, they filled the cement to achieve the purpose of strengthening the embankment, the surge is the result of the water in the flow of the embankment filler hollow, flow away. Only the vertebral fracture with biological bone cement, and the dike flood control with the cement used to build the house just, with different items, but the principle is the same.