Orthopedic doctors stress the importance of maintaining healthy bones through preventive care
By Brooke Spach | Photography by John Michael Simpson
Dr. Andrew Bush is big on bones. At his practice, Central Carolina Orthopaedic Associates, he sees around 15 to 20 patients per month who have sustained a bone fracture. With hopes to reduce that number, he’s integrated a preventive approach to bone health into his Pittsboro and Sanford offices that allows him to identify any issues with patients before surgery becomes necessary – providing an especially crucial service in these areas, considering a quarter of Chatham County’s population is over the age of 65.
“You don’t solve the problem with just titanium, but you actually try to prevent the problem from happening in the first place,” the orthopedic surgeon says.
Many folks’ knowledge about how to build and maintain healthy bones only goes as far as drinking dairy milk and soaking up the sun. While getting sufficient amounts of calcium and vitamin D are essential for taking care of your skeleton, that advice doesn’t capture the full picture, which includes factors like age, nutrition, exercise, alcohol intake and more.
This prevention program, which Andrew and his team have termed “The Bone Matrix,” is unique from the typical care offered by orthopedic specialists. Patients most often visit these specialists to receive secondary care after suffering a break, and treatment is localized to that area of the body. With preventive care, doctors will consider the patient’s full bill of health and their daily habits.
“When someone comes in to talk about bone health, I become more of a medical doctor,” he says. “It’s really a full, very thorough medical evaluation. Aspects related to bone health are generally related to health – there’s not a whole lot of difference between heart health and bone health and gut health.”
Dr. Jill Sylvester is another orthopedic expert who says she sees at least two or three patients per day with issues related to osteoporosis. As part of UNC’s Department of Orthopaedics’ nonoperative sports and musculoskeletal medicine team, she approaches the topic of bone health from a standpoint of making sure her patients are able to do the activities they enjoy, like running, playing catch with grandchildren or walking around their neighborhood. In addition to the other copious benefits of regular physical activity, the force signals to the skeletal system that it should build or maintain bone so that the body can withstand those challenges.
“Motion is lotion,” Jill says. “The body likes to move, and people who stay active and who continue to be able to exercise and do strength training tend to have better outcomes than people who stay more sedentary.”
The most important component of these preventive care visits is the ultrasound screening, a quick scan of the body to determine bone density and quality. The U.S. Preventive Services Task Force recommends that women 65 and older get screened, while the Endocrine Society recommends screening for men 70 and older. However, for those who smoke or have a family history of frequent fractures or osteoporosis, Jill says it’s worth a conversation with a primary care doctor about screening earlier. Women have an increased risk as bone density begins to decrease with the onset of menopause.
“Early 50s is when we’re at biggest risk for [density] losses, and that’s a place where we can really make some strides by making lifestyle changes,” Jill says.
The consequences of poor bone health can be life altering. Many people who sustain fragility fractures will lose their independence, or worse – studies show that the one-year mortality rate after a hip fracture is 21%.
After her X-rays showed a serious lack in bone density, Debra Harris, a 71-year-old Cary resident, visited Central Carolina Orthopaedic Associates for an ultrasound screening. She says she felt frightened by the results after having seen negative health outcomes in her family due to osteoporosis.
“That’s my fear – not being able to take care of myself and ending up in a facility,” Debra says. “And I just want to be as healthy as I can. I want to be able to play with my grandkids.”
Andrew’s main goal is to spread awareness so that this form of preventive care can become more accessible and routine. In his own words: “If you ignore your bones, they will go away.”
As Debra says, making the drive from Cary to Sanford was a no-brainer. “I didn’t even think twice about it,” she says. “This is an important procedure to have done. It’s just so easy and so simple.”
