What are the possible complications of Paget's disease?
In addition to fractures through weak bone, there are important complications to Pagets disease of bone. Because of the high rate of bone turnover, the demands on the heart are increased, and patients with Pagets disease tend to have more heart problems. Bony deformities can cause problems such as arthritis and spinal stenosis. Finally, certain types of Pagets disease have a risk of developing cancer of the bone. The risk is low (less than 1%), but must be observed.
What are the treatments for Paget's disease?
Treatment for Pagets diseases consists of medications that alter the rate of bone turnover. The two most common treatment medications are bisphosphonates and calcitonin. These are the same treatment medications used in individuals with osteoporosis. The bisphosphonates bind to the bone to stop is from being reabsorbed. Calcitonin inhibits the cells that absorb the bone. Both these Paget's disease treatment medications prevent the weak parts of bone that cause deformity and are at high risk for being fractured.
Sometimes surgery is needed if there is a significant bone deformity or if there is a break in the bone. Fractures are most common in the femur (thigh bone) and tibia (shin bone), and are usually treated with an intramedullary rod, a rod that is inserted within the marrow cavity in the center of the bone. Unfortunately, fractures often take a long time to heal in patients with Pagets disease because of the abnormalities in bone turnover.
Another common surgery in patients with Pagets disease is called an osteotomy. In this procedure a wedge of bone is removed to correct a malalignment. This procedure is often necessary when the bones of the legs become misshapen in the later stages of this disease.