1.What is osteoporosis? What is the current status of osteoporosis in China? Osteoporosis, as the name implies, is a phenomenon caused by the change of bone quality and the decrease of bone quantity. Domestic epidemiological surveys have found that about 2/3 to 3/4 of menopausal women over the age of 50 have bone loss, and more than 15% have reached the level of osteoporosis. The first-year mortality rate of hip fractures due to osteoporosis is as high as 18%. The human skeleton is maintained by the interaction of osteoclasts and osteoblasts. When the osteoclasts destroy more bone than osteoblasts, the loss of bone density will be accelerated. Once the amount of bone loss exceeds the critical value, it is called osteoporosis, which greatly increases the chance of fracture. 2.What are the manifestations of osteoporosis? (1) Pain is the most common symptom of primary osteoporosis, with low back pain being the most common, accounting for 70% to 80% of the patients with pain. The pain spreads along the spine to both sides, decreases when lying on the back or sitting, increases when posterior extension or prolonged standing or sitting, is light during the day, increases at night and when waking up in the morning, and increases when bending, muscle movement, coughing and bowel movement. Bone pain generally occurs when 12% or more of bone mass is lost. Compression fractures of the thoracolumbar spine can also produce acute pain, with strong pressure pain and percussion pain in the spinal spinous process of the corresponding area, which can be gradually reduced after 2-3 weeks, and some patients may have chronic low back pain. If the corresponding spinal nerve is compressed, radiating pain in the extremities, sensory-motor disorders in both lower extremities, intercostal neuralgia, retrosternal pain similar to angina pectoris, or epigastric pain similar to acute abdomen may occur. If the spinal cord and cauda equina are compressed, bladder and rectal function may also be affected. (2) Shortening of body length and hunchback, mostly after pain. The anterior part of the vertebrae of the spine is almost mostly composed of cancellous bone, and this part is the pillar of the body, with a large weight, it is easy to compress and deform, forming a hunchback, and as we age, osteoporosis increases and the curvature of the hunchback increases. Each person has 24 vertebrae, and vertebral compression in the elderly with osteoporosis shortens each vertebral body by about 2mm and reduces height by 3-6cm on average. (3) Fracture, which is the most common and serious complication of degenerative osteoporosis. Fractures mostly occur during daily indoor activities such as twisting the body, holding objects, opening windows, etc. Fractures can occur even without significant external forces. Fractures occur in the thoracic and lumbar vertebrae, the distal radius and the upper femur. (4) Decreased respiratory function, compression fractures of thoracic and lumbar vertebrae, backward curvature of the spine, and thoracic deformity can significantly reduce lung capacity and maximum air exchange, and patients can often experience chest tightness, shortness of breath, and dyspnea. 3.How to diagnose osteoporosis? To correctly diagnose osteoporosis, the bone mineral density of the lumbar spine and both hip bones should be examined with a dual-energy X-ray absorptiometry (DXA). A T value of bone mineral density greater than -1 indicates normal bone mass, between -1 and -2,5 indicates bone loss, while a T value < -2,5 is osteoporosis and requires active intervention. 4.How to prevent and treat osteoporosis? (2) Adequate and balanced nutrition: Calcium (1000-1200 mg/day) and vitamin D3 (800 IU/day) are essential and basic ingredients for bone formation, (3) Reduce the use of drugs that cause bone loss, such as steroids, (4) Adequate Sunshine. At present, the main types of drugs for the treatment of osteoporosis are as follows: (1) bisphosphonates that inhibit the action of osteoclasts, such as the familiar Fosamax, Fomega, etc., in addition to intravenous infusion of zoledronic acid, which only needs to be used once a year and is very convenient; (2) selective estrogen receptor modulating drugs; (3) traditional estrogens; (4) calcitonin (injection, nasal spray); (5) drugs to promote osteoblast osteogenesis and metal (5) drugs to promote osteoblast osteogenesis and elemental strontium metal preparations (oral). 5.What should I do if a hip fracture occurs in osteoporosis patients? Once a hip fracture occurs in an elderly patient, as long as the general condition of the patient can tolerate surgical anesthesia as assessed by a professional doctor, surgery should be performed as early as possible. Because of the high disability rate of conservative treatment of hip fracture in the elderly, and the long-term bed rest can easily lead to deep vein thrombosis, crushing pneumonia, urinary tract infection, decubitus ulcers and a series of other complications that may cause death and disability, and it is difficult to take care of them. If the fracture is clearly a femoral neck fracture, the patient can walk on the ground three days after hip arthroplasty, with rapid recovery and satisfactory results; if the fracture is a femoral ridge fracture, we currently use percutaneous minimally invasive internal fixation technology to treat this disease, with small incision, less bleeding, and the patient can walk on the ground in about three weeks, with definite efficacy.