ABSTRACT
ABSTRACT Objective: To evaluate the profile of patients with osteoporotic fractures treated at a tertiary orthopedic hospital. Methods: Using questionnaires, 70 patients with osteoporotic fractures (OF) were compared with 50 outpatients with multiple osteoarthritis (OA) followed through an outpatient clinic. Results: The OF group was older (p <0.001), less heavy (p=0.003), had lower BMI (p=0.006), was more likely to be white (p=0.011), was less likely to be married (p=0.008), and had previous falls, previous fractures, old fractures (>1 year), falls in the last 12 months, fractures due to falls, and needed more assistance (p<0.05). They also had lower Lawton & Brody Instrumental Activities of Daily Living scores (p <0.05) and reported less lower limb disability, foot pathology, muscle weakness, hypothyroidism, and vitamin D intake than patients in the OA group. White race, previous falls, and previous fractures increase the risk of osteoporotic fractures by 10.5, 11.4, and 4.1 times, respectively. The chance of fracture dropped 29% for each one-unit increase in Lawton & Brody IADL score. Married participants had fewer fractures than participants with other marital status. Conclusion: Together, race, marital status, previous falls, foot pathologies, previous fractures, and IADL scores define the profile of patients with osteoporotic fractures. Level of Evidence III; Case control study.
RESUMO Objetivo: Avaliar o perfil dos pacientes com fraturas osteoporóticas atendidos em hospital de atendimento terciário ortopédico. Métodos: Setenta pacientes com fraturas osteoporóticas (FO) foram comparados a 50 pacientes com acompanhamento ambulatorial de osteoartrite (OA) por meio de questionários. Resultados: O grupo FO apresentou média de idade maior (p < 0,001), menor peso (p = 0,003), menor IMC (p = 0,006), maior frequência de pacientes brancos (p = 0,011), menor frequência de casados (p = 0,008), mais quedas prévias, fraturas prévias, fratura antiga (> 1 ano), queda nos últimos 12 meses, fratura por causa da queda e necessitam de mais auxílio (p < 0,05); menor Lawton e Brody AIVD (Atividades instrumentais da vida diária, p < 0,05), reportando menos deficiência de membros inferiores, patologia nos pés, fraqueza muscular, hipotireoidismo e consumo de vitamina D do que pacientes do grupo OA. Raça branca, quedas e fraturas prévias aumentam o risco de fraturas osteoporóticas em 10,5, 11,4 e 4,1 vezes respectivamente. A chance de fratura foi reduzida em 29% a cada aumento de uma unidade no Lawton e Brody AIVD. Casados fraturam menos que outros estados civis. Conclusão: Conjuntamente, a raça, estado civil, quedas prévias, patologias nos pés, fraturas prévias e AIVD definem o perfil dos pacientes com fraturas osteoporóticas deste centro. Nível de Evidência III; Estudo de caso-controle.
ABSTRACT
Objective: To evaluate the prevalence of osteoporosis in patients awaiting total hip arthroplasty. Method: Twenty-nine patients diagnosed with hip osteoarthritis awaiting primary total arthroplasty of the hip answered WOMAC questionnaire, VAS and questions about habits, osteoporosis and related diseases. Bone mineral densitometry of the lumbar spine and hips and laboratory tests (complete blood count and examination of calcium metabolism) were performed. Weight and height were measured to calculate body mass index (BMI). The evaluated quantitative characteristics were compared between patients with and without osteoporosis using the Mann-Whitney tests. Results: Thirteen men and 16 women with a mean age of 61.5 years old, WOMAC 51.4; EVA 6.4 and BMI 27.6 were evaluated. The prevalence of osteoporosis was 20.7%, and 37.9% had osteopenia. Patients with osteoporosis were older than patients without osteoporosis (p=0.006). The mean bone mineral density of the femoral neck without hip osteoarthritis was lower than the affected side (p=0.007). Thirty-five percent of patients did not know what osteoporosis is. Of these, 30% had osteopenia or osteoporosis. Conclusion: osteoarthritis and osteoporosis may coexist and the population waiting for total hip arthroplasty should be considered at risk for the presence of osteoporosis. Level of Evidence III, Observational Study.