General Orthopaedic Archives - Orthopaedic Spine Surgery Singapore

Osteoporosis Risk Check

October 14, 2021 by Lenny Ariany

Could you be at risk of osteoporosis and fractures?

Are you 60 years old or older? Yes / No

Have you broken a bone after the age of 50? Yes / No

Are you underweight i.e. BMI < 19? Yes / No

After the age of 40, have you lost more than 4 cm in height? Yes / No / I don’t know

Have either of your parents had a hip fracture? Yes / No

Do you have any of the following disorders?

Rheumatoid arthritis
Digestive tract disease
Prostate or breast cancer
Diabetes
Chronic kidney disease
Hyper or hypothyroidism
Chronic lung disease
Low testosterone
Early menopause
Immobility

Have you been treated with long-term steroid or thyroid hormone? Yes / No

Do you drink excessive amounts of alcohol (more than 3 units a day) and/or currently smoke? Yes / No

If you have answered ‘yes’ to any of the questions, you may have risk factors for osteoporosis and fractures. You can discuss the status of your bone health with your doctor.

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

Could Long Run Lead to Osteoarthritis?

November 30, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Could Long Run Lead to Osteoarthritis?

Many people believe that running is bad for the knee and hip joints. In contrast to what many people believe, running is not only good for our hearts and lungs, it is great for our muscles, bones, and brains as well. In fact, people who run regularly are less likely to develop knee osteoarthritis compared to people with sedentary lifestyle.

Here are some of the benefits of running.

People who run regularly have more ideal body weight. Over weight puts a lot of pressure to the joint and muscles thus they wear out faster.
People who run regularly have stronger muscles. Quadriceps muscles are the stabiliser of the knee joint. The knee joint is more stable and has less wear and tear when the quadriceps muscles are strong.
Exercise helps to release the body anti-inflammatory substances. Osteoarthritis is caused by inflammation in the joint. Thus, exercise can slow down osteoarthritis by reducing the inflammation in the joint.
Exercises helps to produce greater supply of joint fluid (synovial fluid). It acts like a lubricant to the joint reducing the rate of osteoarthritis.

It does not mean that people who run regularly don’t get osteoarthritis. However, they are at a lower risk of getting one.

What can you do to reduce that chance of osteoarthritis if you like running?

Have adequate warm up before exercise so that you don’t strain your muscles
Have proper shoe wear appropriate for running
Run in even surface to reduce the risk of injury

Anak Saya Pendek | Apa Yang Bisa Dilakukan?

July 22, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Orang tua kuatir kalau anaknya tergolong pendek di kelas. Secara medis definisi tubuh pendek adalah ketinggian di bawah 3 percentile dibanding dengan anak dengan umur dan jenis kelamin yang sama. Secara awam artinya jika ada 100 anak dengan umur dan jenis kelamin yang sama, 3 orang terpendek, secara medis tergolong mempunyai tubuh pendek (short stature). Tetapi bukan berarti anak itu mempunyai masalah medis. Asal anak itu bertumbuh secara parallel, hal ini secara medis dianggap normal.

Apa yang mempengaruhi tinggi badan anak?

Genetik – Ketinggian anak juga tergantung ketinggian orang tuanya. Tinggi tubuh kita dipengaruhi genetik.
Late Bloomer – Kadang anak mengalami pertumbuhan terlambat. Anak ini terlihat kecil dibanding dengan teman-teman sekelasnya. Tapi saat dewasa anak dengan pertumbuhan terlambat sering kali lebih tinggi dibanding dengan mereka yang mengalami pertumbuhan lebih cepat. Ini terjadi karena anak ini masih bertumbuh tinggi di saat anak lain sudah berhenti bertumbuh tinggi.
Medical Problems – anak susah makan atau makan tidak bergizi, masalah pencernaan, masalah hormon, syndrome genetik, penyakit kronis.

Apa yang bisa dilakukan supaya pertumbuhan maximal?

Makan yang bergizi, olahraga yang teratur dan tidur yang cukup dapat membantu pertumbuhan secara maximal
Jika ada masalah medis, hal ini harus ditangani dengan baik supaya dampak terhadap pertumbuhan badan minimal.

Dr Tony Setiobudi adalah spesialis bedah tulang dan super-spesialis bedah tulang belakang di Mount Elizabeth Hospital (Orchard), Singapore. Dr Tony menangani masalah tulang, sendi, saraf, otot dan ligamen pada orang dewasa dan anak. Dr Tony mempunyai keahlian khusus dalam penanganan saraf terjepit (HNP & spinal stenosis) & masalah tulang belakang seperti nyeri punggung & leher, scoliosis, postur bungkuk (kyphosis), tumor & infeksi tulang belakang, cedera saraf besar (spinal cord) & patah tulang osteoporosis.

Osteoporotic Spine Fracture

February 21, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

When the bone is soft or osteoporotic, it can fracture with trivial injury or even without injury. Spine bone is one of the most commonly affected bones in osteoporotic fracture. It can be debilitating. But it doesn’t need to affect you. You can prevent osteoporosis by having regular screening and early treatment.

Mild fracture can heal by itself. The pain may not be too bad.

In severe fracture, the back pain can be very excruciating to the extent that the patient is unable to sit, stand and walk for a period of time. If the pain prevents the patient from getting out of bed, surgical treatment is required. The surgery depends on the stability of the spinal column. If the spine is stable, the patient needs cement injection (vertebroplasty) to strengthen the bone. If the spine is not stable, bigger surgery is required with the use of spinal implants. Surgical treatment for severe fracture has a high success rate. Immediate stability of the spinal column after surgery will result in significant reduction of pain.

Osteoporotic treatment to strengthen the bone is important regardless whether surgery is required. This is to reduce the risk of having another osteoporotic fracture.

Osteoporosis Screening | Treat It Before It breaks…

September 4, 2016 by Tony Setiobudi

Osteoporosis is common as the population is ageing. People don’t know that they have osteoporosis unless they do screening test. People with osteoporosis do not exhibit any symptoms unless they have fracture. By the time fracture occurs it is a little too late.

You can detect osteoporosis with a simple screening test called Bone Density Scan (BMD scan). It is recommended to do BMD scan for men and women above 50 or ladies after menopause. Early treatment can reduce the risk of osteoporotic fractures significantly.

You can approach your doctor regarding osteoporosis screening. Alternatively, Spring Hope Orthopaedic Spine Surgery provides screening for osteoporosis which includes BMD scan, Xrays and blood tests.

Author: Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), Orthopaedic and Spine Surgeon, Mount Elizabeth Hospital, Singapore

How to take Bisphosphonates? | Osteoporosis Treatment

September 3, 2016 by Tony Setiobudi

Osteoporosis Treatment Singapore | Bisphosphonate Medication

Osteoporosis Treatment Singapore and proper Bisphosphonate Medication

Fosamax and Actonel (bisphosphonate) are taken once a week (on the same day).
To be taken first thing in the morning with empty stomach 2 hours before eating or drinking anything other than plain water. If you take it with food or drink other than water, only a small amount of the medicine is absorbed.
You need to swallow the tablet with a full glass of water and sit upright for 30 minutes so that it does not irritate the esophagus.
Bisphosphonate is to be taken three to five years continuously after that it can be stopped for two years and the patients can continue to benefit from its use.

Calcium and vitamin D

You need to have adequate calcium and vitamin D in the blood when you take bisphosphonate.
Calcium and vitamin D are normally taken every day at a different time to the bisphosphonate.

What are the possible side-effects?

The most common side-effects (nausea, indigestion, tummy pain, diarrhoea or constipation) usually happen in the first month of treatment but usually go away after this.
Other common side-effects (joint and muscle pain) can happen a few days or a few months after you first start treatment and normally goes away after you stop taking a bisphosphonate.
Less commonly but more serious side-effects – inflammation or ulcers of the oesophagus or a narrowing of the oesophagus. If you have difficulty or painful swallowing, worsening heartburn or chest pain, you should stop the tablets and see your doctor.

You cannot take a bisphosphonate if:

You have low calcium levels in your blood
You have untreated vitamin D deficiency
You are pregnant or breast-feeding
Your kidneys do not work very well
You cannot sit upright or stand for 30 minutes after you have taken the tablet
You have problems with your oesophagus including narrowing of the oesophagus or Barrett’s oesophagus.

How do I keep my bones strong?

Regular weight-bearing exercise e.g. jogging, skipping, brisk walking, dancing
Stopping smoking
Limit alcohol intake
Eating adiet rich in calcium e.g. cow milk, cheese, green vegetables, broccoli, green beans, fish
Adequate sun exposure improves your vitamin D levels

Bone Mass Density & Bisphosphonate

The purpose of bisphosphonate therapy is to maintain the bone density.
Bone density scan (BMD) is the standard investigation to detect osteoporosis and monitor osteoporosis treatment.
BMD should be repeated yearly for monitoring.

Author: Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), Orthopaedic and Spine Surgeon, Mount Elizabeth Hospital, Singapore

Could you be at risk of osteoporosis and fractures?

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Osteoporosis Treatment Singapore and proper Bisphosphonate Medication

Spring Hope Orthopaedic Spine Surgery

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