Skip to main content
SpringerLink
Log in

Rehabilitation Therapy After Surgery in Osteoporotic Patients

  • Chapter
  • First Online:
Multidisciplinary Approach to Osteoporosis

Abstract

Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fragility fractures that could induce long-term morbidity, functional limitation, decreased quality of life, and increase mortality. The most frequent sites of fragility fractures are the vertebrae, hip, wrist, proximal humerus, and ankle. In several cases, a surgical approach with subsequent rehabilitative treatment is required. The main aims of rehabilitation are restoring pre-fracture functioning and improving patients’ activities, participation level, and quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Piscitelli P, Brandi M, Cawston H, Gauthier A, Kanis JA, Compston J, Borgström F, Cooper C, McCloskey E. Epidemiological burden of postmenopausal osteoporosis in Italy from 2010 to 2020: estimations from a disease model. Calcif Tissue Int. 2014;95(5):419–27.

    Article  CAS  PubMed  Google Scholar 

  2. Gimigliano F, Iolascon G, Riccio I, Frizzi L, Gimigliano R. Post-surgical rehabilitative approach to fragility fractures. Aging Clin Exp Res. 2013;25(Suppl 1):S23–5.

    Article  PubMed  Google Scholar 

  3. CG146. Osteoporosis: fragility fracture risk: osteoporosis: assessing the risk of fragility fracture. National Clinical Guideline Centre (UK). London: Royal College of Physicians (UK). 2012. https://www.nice.org.uk/guidance/cg146/evidence/full-guideline-pdf-186818365. Accessed 17 May 2018.

    Google Scholar 

  4. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007;22(3):465–75.

    Article  PubMed  Google Scholar 

  5. Papaioannou A, Kennedy CC, Ioannidis G, Sawka A, Hopman WM, Pickard L, Brown JP, Josse RG, Kaiser S, Anastassiades T, Goltzman D, Papadimitropoulos M, Tenenhouse A, Prior JC, Olszynski WP, Adachi JD. The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study. Osteoporos Int. 2009;20(5):703–14.

    Article  CAS  PubMed  Google Scholar 

  6. Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E. Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int. 2001;12(4):271–8.

    Article  CAS  PubMed  Google Scholar 

  7. Lunt M, O’Neill TW, Felsenberg D, Reeve J, Kanis JA, Cooper C, Silman AJ. Characteristics of a prevalent vertebral deformity predict subsequent vertebral fracture: results from the European Prospective Osteoporosis Study (EPOS). Bone. 2003;33(4):505–13.

    Article  PubMed  Google Scholar 

  8. Pietri M, Lucarini S. The orthopaedic treatment of fragility fractures. Clin Cases Miner Bone Metab. 2007;4(2):108–16.

    PubMed  PubMed Central  Google Scholar 

  9. Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK. Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1992;7(4):449–56.

    Article  CAS  PubMed  Google Scholar 

  10. Fink HA, Ensrud KE, Nelson DB, Kerani RP, Schreiner PJ, Zhao Y, Cummings SR, Nevitt MC. Disability after clinical fracture in postmenopausal women with low bone density: the fracture intervention trial (FIT). Osteoporos Int. 2003;14(1):69–76.

    Article  CAS  PubMed  Google Scholar 

  11. Matthis C, Weber U, O’Neill TW, Raspe H. Health impact associated with vertebral deformities: results from the European Vertebral Osteoporosis Study (EVOS). Osteoporos Int. 1998;8(4):364–72.

    Article  CAS  PubMed  Google Scholar 

  12. Harrison RA, Siminoski K, Vethanayagam D, Majumdar SR. Osteoporosis- related kyphosis and impairments in pulmonary function: a systematic review. J Bone Miner Res. 2007;22(3):447–57.

    Article  PubMed  Google Scholar 

  13. Gold DT. The nonskeletal consequences of osteoporotic fractures. Psychologic and social outcomes. Rheum Dis Clin N Am. 2001;27(1):255–62.

    Article  CAS  Google Scholar 

  14. McCloskey EV, Spector TD, Eyres KS, Fern ED, O’Rourke N, Vasikaran S, Kanis JA. The assessment of vertebral deformity: a method for use in population studies and clinical trials. Osteoporos Int. 1993;3:138–47.

    Article  CAS  PubMed  Google Scholar 

  15. Sauer P, Leidig G. Spine deformity index versus other objective procedures in vertebral fractures identification in patients with osteoporosis: a comparative study. J Bone Miner Res. 1991;6:227–35.

    Article  CAS  PubMed  Google Scholar 

  16. Kendler DL, Bauer DC, Davison KS, Dian L, Hanley DA, Harris ST, McClung MR, Miller PD, Schousboe JT, Yuen CK, Lewiecki EM. Vertebral fractures: clinical importance and management. Am J Med. 2016;129(2):221.e1–10.

    Article  CAS  Google Scholar 

  17. Pfeifer M, Begerow B, Minne HW. Effects of a new spinal orthosis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil. 2004;83(3):177–86.

    Article  PubMed  Google Scholar 

  18. Stadhouder A, Buskens E, Vergroesen DA, Fidler MW, de Nies F, Oner FC. Nonoperative treatment of thoracic and lumbar spine fractures: a prospective randomized study of different treatment options. J Orthop Trauma. 2009;23(8):588–94.

    Article  PubMed  Google Scholar 

  19. Bonner FJ Jr, Sinaki M, Grabois M, Shipp KM, Lane JM, Lindsay R, Gold DT, Cosman F, Bouxsein ML, Weinstein JN, Gallagher RM, Melton LJ III, Salcido RS, Gordon SL. Health professional’s guide to rehabilitation of the patient with osteoporosis. Osteoporos Int. 2003;14(Suppl 2):S1–22.

    Article  PubMed  Google Scholar 

  20. Sinaki M, Mikkelsen BA. Postmenopausal spinal osteoporosis: flexion versus extension exercises. Arch Phys Med Rehabil. 1984;65(10):593–6.

    PubMed  CAS  Google Scholar 

  21. Tarantino U, Capone A, Planta M, D’Arienzo M, Letizia Mauro G, Impagliazzo A, Formica A, Pallotta F, Patella V, Spinarelli A, Pazzaglia U, Zarattini G, Roselli M, Montanari G, Sessa G, Privitera M, Verdoia C, Corradini C, Feola M, Padolino A, Saturnino L, Scialdoni A, Rao C, Iolascon G, Brandi ML, Piscitelli P. The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study. Arthritis Res Ther. 2010;12(6):R226.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Roche J, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005;331(7529):1374.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Magaziner J, Fredman L, Hawkes W, Hebel JR, Zimmerman S, Orwig DL, Wehren L. Changes in functional status attributable to hip fracture: a comparison of hip fracture patients to community-dwelling aged. Am J Epidemiol. 2003;157(11):1023–31.

    Article  PubMed  Google Scholar 

  24. Mears SC, Kates SL. A guide to improving the Care of Patients with fragility fractures, edition 2. Geriatr Orthop Surg Rehabil. 2015;6(2):58–120.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Healy WL, Iorio R. Total hip arthroplasty: optimal treatment for displaced femoral neck fractures in elderly patients. Clin Orthop Relat Res. 2004;429:43–8.

    Article  Google Scholar 

  26. Fagerson TL. Diseases and disorders of the hip. In: Fagerson TL, editor. The hip handbook. Boston: Butterworth-Heinemann; 1998.

    Google Scholar 

  27. Oldmeadow LB, Edwards ER, Kimmel LA, Kipen E, Robertson VJ, Bailey MJ. No rest for the wounded: early ambulation after hip surgery accelerates recovery. ANZ J Surg. 2006;76(7):607–11.

    Article  PubMed  Google Scholar 

  28. Kronborg L, Bandholm T, Palm H, Kehlet H, Kristensen MT. Feasibility of progressive strength training implemented in the acute ward after hip fracture surgery. PLoS One. 2014;9(4):e93332.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Overgaard J, Kristen MT. Feasibility of progressive strength training shortly after hip fracture surgery. World J Orthop. 2013;4(4):248–58.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Parkkari J, Kannus P, Palvanen M, Natri A, Vainio J, Aho H, Vuori I, Järvinen M. Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int. 1999;65:183–7.

    Article  CAS  PubMed  Google Scholar 

  31. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146. https://doi.org/10.1002/14651858.CD007146.pub3.

    Article  Google Scholar 

  32. El-Khoury F, Cassou B, Charles MA, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f6234.

    PubMed  PubMed Central  Google Scholar 

  33. Magee DJ, Zachazewski JE, Quillen WS. Pathology and intervention in musculoskeletal rehabilitation. 2nd edition. Elsevier; 2016. ISBN: 978-0-323-31072-7.

    Google Scholar 

  34. Iolascon G, Cervone M, Gimigliano R, Di Pietro G, Gimigliano F. Neuropsychiatric disorders in hip fracture. Clin Cases Miner Bone Metab. 2011;8(3):49–53.

    PubMed  PubMed Central  Google Scholar 

  35. Bitsch M, Foss N, Kristensen B, Kehlet H. Pathogenesis of and management strategies for postoperative delirium after hip fracture: a review. Acta Orthop Scand. 2004;75(4):378–89.

    Article  PubMed  Google Scholar 

  36. de Jonghe JF, Kalisvaart KJ, Dijkstra M, van Dis H, Vreeswijk R, Kat MG, Eikelenboom P, van der Ploeg T, van Gool WA. Early symptoms in the prodromal phase of delirium: a prospective cohort study in elderly patients undergoing hip surgery. Am J Geriatr Psychiatry. 2007;15(2):112–21.

    Article  PubMed  Google Scholar 

  37. Björkelund KB, Hommel A, Thorngren KG, Gustafson L, Larsson S, Lundberg D. Reducing delirium in elderly patients with hip fracture: a multi-factorial intervention study. Acta Anaesthesiol Scand. 2010;54(6):678–88.

    Article  PubMed  Google Scholar 

  38. Roberts KC, Brox WT. AAOS clinical practice guideline: management of hip fractures in the elderly. J Am Acad Orthop Surg. 2015;23(2):138–40.

    Article  PubMed  Google Scholar 

  39. Bell JJ, Bauer JD, Capra S, Pulle RC. Quick and easy is not without cost: implications of poorly performing nutrition screening tools in hip fracture. J Am Geriatr Soc. 2014;62(2):237–43.

    Article  PubMed  Google Scholar 

  40. Pioli G, Barone A, Giusti A, Oliveri M, Pizzonia M, Razzano M, Palummeri E. Predictors of mortality after hip fracture: results from 1-year follow-up. Aging Clin Exp Res. 2006;18(5):381–7.

    Article  CAS  PubMed  Google Scholar 

  41. Fredman L, Magaziner J, Hawkes W, Hebel JR, Fried LP, Kasper J, Guralnik J. Female hip fracture patients had poorer performance-based functioning than community-dwelling peers over 2-year follow-up period. J Clin Epidemiol. 2005;58(12):1289–98.

    Article  PubMed  Google Scholar 

  42. Alarcón T, González-Montalvo JI, Gotor P, Madero R, Otero A. Activities of daily living after hip fracture: profile and rate of recovery during 2 years of follow-up. Osteoporos Int. 2011;22(5):1609–13.

    Article  PubMed  Google Scholar 

  43. Hallberg I, Rosenqvist AM, Kartous L, Löfman O, Wahlström O, Toss G. Health-related quality of life after osteoporotic fractures. Osteoporos Int. 2004;15(10):834–41.

    Article  CAS  PubMed  Google Scholar 

  44. Centers for Disease Control and Prevention (CDC). Incidence and costs to medicare of fractures among Medicare beneficiaries aged greater than or equal to 65 years—United States, July 1991–June 1992. MMWR Morb Mortal Wkly Rep. 1996;45(41):877–83.

    Google Scholar 

  45. Brogren E, Petranek M, Atroshi I. Incidence and characteristics of distal radius fractures in a southern Swedish region. BMC Musculoskelet Disord. 2007;8:48.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Roth KM, Blazar PE, Earp BE, Han R, Leung A. Incidence of displacement after nondisplaced distal radial fractures in adults. J Bone Joint Surg Am. 2013;95(15):1398–402.

    Article  PubMed  Google Scholar 

  47. Lin C, Sun JS, Hou SM. External fixation with or without supplementary intramedullary Kirschner wires in the treatment of distal radial fractures. Can J Surg. 2004;47(6):431–7.

    PubMed  PubMed Central  Google Scholar 

  48. Katarincic JA. Fractures of the wrist and hand. Occup Med. 1998;13(3):549–68.

    PubMed  CAS  Google Scholar 

  49. Weinstock TB. Management of fractures of the distal radius: therapist’s commentary. J Hand Ther. 1999;12(2):99–102.

    Article  CAS  PubMed  Google Scholar 

  50. Bennett GL, Leeson MC, Smith BS. Intramedullary fixation of unstable distal radius fractures. A method of fixation allowing early motion. Orthop Rev. 1989;18(2):210–6.

    PubMed  CAS  Google Scholar 

  51. Raskin KB. Management of fractures of the distal radius: surgeon’s perspective. J Hand Ther. 1999;12(2):92–8.

    Article  CAS  PubMed  Google Scholar 

  52. Jo MJ, Gardner MJ. Proximal humerus fractures. Curr Rev Musculoskelet Med. 2012;5(3):192–8.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Court-Brown CM, Garg A, McQueen MM. The translated two part fracture of the proximal humerus. Epidemiology and outcome in the older patient. J Bone Joint Surg Br. 2001;83(6):799–804.

    Article  CAS  PubMed  Google Scholar 

  54. Hertel R, Hempfing A, Stiehler M, Leunig M. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elb Surg. 2004;13(4):427–33.

    Article  CAS  Google Scholar 

  55. Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M. Increasing number and incidence of low-trauma ankle fractures in elderly people: Finnish statistics during 1970-2000 and projections for the future. Bone. 2002;31(3):430–3.

    Article  CAS  PubMed  Google Scholar 

  56. Strauss EJ, Egol KA. The management of ankle fractures in the elderly. Injury. 2007;38(Suppl 3):S2–9.

    Article  PubMed  Google Scholar 

  57. Salai M, Dudkiewicz I, Novikov I, Amit Y, Chechick A. The epidemic of ankle fractures in the elderly—is surgical treatment warranted? Arch Orthop Trauma Surg. 2000;120(9):511–3.

    Article  CAS  PubMed  Google Scholar 

  58. Beckenkamp PR, Lin CC, Herbert RD, Haas M, Khera K, Moseley A. EXACT: exercise or advice after ankle fracture. Design of a randomised controlled trial. BMC Musculoskelet Disord. 2011;12:148.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Lin CW, Donkers NA, Refshauge KM, Beckenkamp PR, Khera K, Moseley AM. Rehabilitation for ankle fractures in adults. Cochrane Database Syst Rev. 2012;11:CD005595. https://doi.org/10.1002/14651858.CD005595.pub3. Review

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Francesca Gimigliano

  2. Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Alessandro de Sire, Antimo Moretti, Claudio Curci & Giovanni Iolascon

Authors
  1. Francesca Gimigliano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandro de Sire
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antimo Moretti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudio Curci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giovanni Iolascon
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

    Andrea Lenzi

  2. Department of Movement, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy

    Silvia Migliaccio

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gimigliano, F., de Sire, A., Moretti, A., Curci, C., Iolascon, G. (2018). Rehabilitation Therapy After Surgery in Osteoporotic Patients. In: Lenzi, A., Migliaccio, S. (eds) Multidisciplinary Approach to Osteoporosis. Springer, Cham. https://doi.org/10.1007/978-3-319-75110-8_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-75110-8_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-75108-5

  • Online ISBN: 978-3-319-75110-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation