Coffee consumption and CYP1A2 genotype in relation to bone mineral density of the proximal femur in elderly men and women: a cohort study.

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Hallström, Helena; Melhus, Håkan; Glynn, Anders; Lind, Lars; Syvänen, Ann-Christine; Michaëlsson, Karl

2010-02-22

Drinking coffee has been linked to reduced calcium conservation, but it is less clear whether it leads to sustained bone mineral loss and if individual predisposition for caffeine metabolism might be important in this context. Therefore, the relation between consumption of coffee and bone mineral density (BMD) at the proximal femur in men and women was studied, taking into account, for the first time, genotypes for cytochrome P450 1A2 (CYP1A2) associated with metabolism of caffeine. Dietary intakes of 359 men and 358 women (aged 72 years), participants of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS), were assessed by a 7-day food diary. Two years later, BMD for total proximal femur, femoral neck and trochanteric regions of the proximal femur were measured by Dual-energy X-ray absorptiometry (DXA). Genotypes of CYP1A2 were determined. Adjusted means of BMD for each category of coffee consumption were calculated. Men consuming 4 cups of coffee or more per day had 4% lower BMD at the proximal femur (p = 0.04) compared with low or non-consumers of coffee. This difference was not observed in women. In high consumers of coffee, those with rapid metabolism of caffeine (C/C genotype) had lower BMD at the femoral neck (p = 0.01) and at the trochanter (p = 0.03) than slow metabolizers (T/T and C/T genotypes). Calcium intake did not modify the relation between coffee and BMD. High consumption of coffee seems to contribute to a reduction in BMD of the proximal femur in elderly men, but not in women. BMD was lower in high consumers of coffee with rapid metabolism of caffeine, suggesting that rapid metabolizers of caffeine may constitute a risk group for bone loss induced by coffee.

Vitamin K3 increased BMD at 1 and 2 months post-surgery and the maximum stress of the middle femur in the rat.

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Hong, You-jia; Liu, Sheng; Jiang, Ning-yi; Jiang, Sen; Liang, Jiu-gen

2015-02-01

The therapeutic effects of vitamin K3 (VK3) on osteoporosis are still unknown. In this study, we hypothesized that VK3 possesses therapeutic effects on osteoporosis; to verify this hypothesis, the ovariectomized rat was used as an osteoporosis model. Fifty-six Sprague-Dawley female rats aged 8 to 9 months were randomly assigned to 4 groups: sham surgery, ovariectomy with saline, ovariectomy with low-dose VK3, and ovariectomy with high-dose VK3. Intramuscular injection of VK3 was performed every other day beginning 1 month postoperatively. The therapeutic effects of VK3 on osteoporosis were evaluated by measurement of bone mineral density (BMD), bone biochemical markers, biomechanical properties, and bone morphometric parameters. The overall average BMD in VK3-treated groups increased to a level between those of the ovariectomy group and the sham surgery group. The procollagen I N-terminal peptide level peaked at 2 months after surgery in all groups except in the group that had undergone ovariectomy with low-dose VK3. The tartrate-resistant acid phosphatase 5b level increased more slowly at 4 months after surgery than at 2 months after surgery in the VK3-treated groups. The ovariectomy with high-dose VK3 group had the highest maximum stress of the middle femur of all groups. With VK3 treatment, the trabecular bone area percentage increased. All morphometric indicators for the middle tibia in the VK3-treated groups reached the levels found in the sham surgery group. In summary, VK3 therapy increased BMD at 1 and 2 months postsurgery and the maximum stress of the middle femur. In addition, VK3 therapy slowed the increase in bone turnover in ovariectomized rats. Furthermore, VK3 can improve morphometric indicators for the middle tibia. Our preliminary study indicates that VK3 has a potential therapeutic effect on osteoporosis and is worthy of further investigation. Copyright © 2015 Elsevier Inc. All rights reserved.

Relationship Between BMD and Prevalent Vertebral Fractures in Indian Women Older Than 50 Yr.

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Gupta, Yashdeep; Marwaha, Raman K; Kukreja, Subhash; Bhadra, Kuntal; Narang, Archana; Mani, Kalaivani; Mithal, Ambrish; Tandon, Nikhil

2016-01-01

The purpose of the study was to study the relationship of morphometric vertebral fractures with bone mineral density (BMD) in Indian women older than 50 yr. Four hundred fifteen healthy Indian women older than 50 yr (mean age: 62.8 yr) underwent lateral X-rays of the lumbar and thoracic spine. Genant's semiquantitative method was used to diagnose and classify morphometric vertebral fractures. BMD was measured by DXA at lumbar spine and total hip. Recruited subjects underwent anthropometric, biochemical, and hormonal evaluation. Vertebral fractures were present in 17.1% (95% confidence interval: 13.5, 20.8) subjects. Prevalence of osteoporosis based on BMD was 35.7%. By adding those with prevalent fractures, the number of women requiring therapy for osteoporosis would increase to 46.5%. The BMD measured at femur neck, total hip, and lumbar spine (L1eL4) was not found to be lower in women with vertebral fractures as compared with those without fractures. BMD was not found to be lower in women with vertebral fractures as compared with those without fractures. Significant number of additional subjects with BMD in the normal or osteopenic range become eligible for osteoporosis treatment when presence of vertebral fracture is used as an independent indication for such treatment. Copyright © 2016 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Bone density of the radius, spine, and proximal femur in osteoporosis

International Nuclear Information System (INIS)

Mazess, R.B.; Barden, H.; Ettinger, M.; Schultz, E.

1988-01-01

Bone mineral density (BMD) was measured in 140 normal young women (aged 20 to 39 years) and in 423 consecutive women over age 40 referred for evaluation of osteoporosis. Lumbar spine and proximal femur BMD was measured using dual-photon absorptiometry ( 153 Gd), whereas the radius shaft measurement used single-photon absorptiometry ( 125 I). There were 324 older women with no fractures, of which 278 aged 60 to 80 years served as age-matched controls. There were 99 women with fractures including 32 with vertebral and 22 with hip fractures. Subsequently, another 25 women with hip fractures had BMD measured in another laboratory; their mean BMD was within 2% of that of the original series. The mean age in both the nonfracture and fracture groups was 70 +/- 5 years. The BMD in the age-matched controls was 20% to 25% below that of normal young women for the radius, spine, and femur, but the Ward's triangle region of the femur showed even greater loss (35%). The mean BMD at all sites in the crush fracture cases was about 10% to 15% below that of age-matched controls. Spinal abnormality was best discriminated by spine and femoral measurements (Z score about 0.9). In women with hip fractures, the BMD was 10% below that of age-matched controls for the radius and the spine, and the BMD for the femoral sites was about 25% to 30% below that of age-matched control (Z score about 1.6). Femoral densities gave the best discrimination of hip fracture cases and even reflected spinal osteopenia. In contrast, neither the spine nor the radius reflected the full extent of femoral osteopenia in hip fracture

Status report on BMD studies as of 10th October 1996

International Nuclear Information System (INIS)

McCloskey, E.V.

1998-01-01

In this interim report, I have simply documented the current status of BMD measurements as reported in each of the working papers from the centres involved. Due to the uneven distribution of subjects within each of the age categories, no attempt has been made to make a statement about the age range of maximum bone density in young adults. Instead, I have analysed, where possible, the mean BMD at the spine in the age group 26-40 years. For ease of comparison, 1 have divided the data into that from centres using the different types of densitometer (Hologic and Lunar). In the Hologic data, the lumbar spine results reflect values of L1-L4 and this will mean that lower values would be reported compared to the Lunar results even if both scanners employed the exact same method of analysis, as the Lunar scans only include L2-L4. In addition, however, Lunar values will have a systematic difference of approximately 10% due to machine differences in edge detection algorithms etc. Where possible, values of total femur BMD have been shown in the Hologic tables and data for the femoral neck BMD in the Lunar tables. (author)

Changes in bone mineral density (BMD) around the cemented Exeter stem: a prospective study in 18 women with 5 years follow-up

DEFF Research Database (Denmark)

Damborg, Frank Lindhøj; Nissen, Nis; Jørgensen, Hans R I

2008-01-01

THA changes the pattern of strain distribution in the proximal femur. We quantified the changes in BMD for 5 years after insertion of the cemented Exeter stem in women.......THA changes the pattern of strain distribution in the proximal femur. We quantified the changes in BMD for 5 years after insertion of the cemented Exeter stem in women....

Is Total Femur Replacement a Reliable Treatment Option for Patients With Metastatic Carcinoma of the Femur?

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Sevelda, Florian; Waldstein, Wenzel; Panotopoulos, Joannis; Kaider, Alexandra; Funovics, Philipp Theodor; Windhager, Reinhard

2018-05-01

The majority of metastatic bone lesions to the femoral bone can be treated without surgery or with minimally invasive intramedullary nailing. In rare patients with extensive metastatic disease to the femur, total femur replacement may be the only surgical alternative to amputation; however, little is known about this approach. In a highly selected small group of patients with metastatic carcinoma of the femur, we asked: (1) What was the patient survivorship after this treatment? (2) What was the implant survivorship free from all-cause revision and amputation, and what complications were associated with this treatment? (3) What functional outcomes were achieved by patients after total femur replacement for this indication? Eleven patients (three men, eight women) with a mean age of 64 years (range, 41-78 years) received total femur replacements between 1986 and 2016; none were lost to followup. The most common primary disease was breast cancer. In general, during this period, our indications for this procedure were extensive metastatic disease precluding internal fixation or isolated proximal or distal femur replacement, and an anticipated lifespan exceeding 6 months. Our contraindication for this procedure during this time was expected lifespan less than 6 months. Patient survival was assessed by Kaplan-Meier analysis; implant survival free from revision surgery and amputation were assessed by competing risk analysis. Function was determined preoperatively and 6 to 12 weeks postoperatively with the Musculoskeletal Tumor Society (MSTS) score normalized to a 100-point scale, with higher scores representing better function from a longitudinally maintained institutional database. Eleven patients died at a median of 5 months (range, 1-31 months) after surgery. One-year revision-free and limb survival were 82% (95% CI, 51%-98%) and 91% (95% CI, 61%-99%), respectively. Reasons for reoperation were hip dislocation, infection and local recurrence in one patient each. The

Comparative element analysis on femur of antler hemo-treated ovariectomized wistar rats by SRXRF

International Nuclear Information System (INIS)

Yang Jianhong; Fei Yurong; Wang Ruilin; Cao Yi; Huang Yuying; He Wei

2007-01-01

To investigate the relationship between bone element contents and bone m/neral density (BMD), left femur of sham-operated rats (SHAM, n=5), ovariectomized rats (OVX, n=5) and antler hemo-treated ovariectomized rats (OVX + antler hemo, n=5) were analyzed by synchrotron radiation X-ray fluorescence (SRXRF) microprobe. The results showed that there were very good positive correlations among contents of Ca, P, Zn and Sr. In comparison to the SHAM group, decreased relative intensities of Ca, P, Zn and Sr (especially Ca and P, p<0.05) were observed in femur of the OVX group, which showed significant decrease (p<0.05) of the BMD. The results indicate that loss of Ca and P in bone will cause osteoporosis. On the other hand, increased relative intensities of Ca, P and Zn in femur, and the BMD (p<0.05), of the anlter hemo-treated OVX group were found, in comparison to the OVX group. This suggests that anlter hemo may help cure osteoporosis through maintaining bone contents of Zn, Ca and P, and increasing the BMD. (authors)

Bone mineral density of the proximal femur after hip resurfacing arthroplasty: 1-year follow-up study

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Anttila Esa

2011-05-01

Full Text Available Abstract Background Hip resurfacing arthroplasty (HRA is considered a bone-preserving procedure and may eliminate proximal femoral stress shielding and osteolysis. However, in addition to implant-related stress-shielding factors, various patient-related factors may also have an effect on bone mineral density (BMD of the proximal femur in patients with HRA. Thus, we studied the effects of stem-neck angle, demographic variables, and physical functioning on the BMD of the proximal femur in a one-year follow-up. Methods Thirty three patients (9 females and 24 males with a mean (SD age of 55 (9 years were included in the study. BMD was measured two days and 3, 6, and 12 months postoperatively and 10 regions of interest (ROI were used. Stem-neck angle was analyzed from anteroposterior radiographs. Results Three months postoperatively, BMD decreased in six out of 10 regions of interest (ROI on the side operated on and in one ROI on the control side (p Conclusions After an early drop, the BMD of the upper femur was restored and even exceeded the preoperative level at one year follow-up. From a clinical standpoint, the changes in BMD in these HRA patients could not be explained by stem-neck angle or patient related factors.

Mineral to matrix ratio determines biomaterial and biomechanical properties of rat femur--application of Fourier transform infrared spectroscopy.

Science.gov (United States)

Takata, Shinjiro; Yonezu, Hiroshi; Shibata, Akira; Enishi, Tetsuya; Sato, Nori; Takahashi, Mitsuhiko; Nakao, Shigetaka; Komatsu, Koji; Yasui, Natsuo

2011-08-01

We studied the changes of biomaterial and biomechanical properties of the rat femur during development. Thirty male Wistar rats were allocated to 6 groups: aged 6 weeks (n=5), 9 weeks (n=5), 12 weeks (n=5), 15 weeks (n=5), 24 weeks (n=5), and 36 weeks (n=5). The mineral to matrix ratio (M/M ratio) of rat femur by Fourier transform infrared spectroscopy was 0.97 ± 0.10 at the age of 6 weeks, and reached the maximum of 1.52 ± 0.17 at the age of 36 weeks. Total bone mineral density (BMD) by peripheral quantitative computed tomography of the femoral shaft aged 6 weeks was 479.1 ± 58.7 mg/cm(3), and reached the maximum of 1022.2 ± 42.3 mg/cm(3) at the age of 36 weeks. The ultimate load to failure of the femur of the rat aged 6 weeks by the three-point bending test was 29.6 ± 6.1 N. At the age of 36 weeks, the ultimate load to failure of the rat femur increased to the maximum of 283.5 ± 14.7 N. The results showed that the M/M ratio increased with development as total BMD and bone strength increased. The results suggest that the M/M ratio is one of the determinants of the biomaterial and biomechanical properties of bone.

Bone mineral density of lumbar spine and femur in acromegaly

International Nuclear Information System (INIS)

Huebsch, P.; Kotzmann, H.; Svoboda, T.; Kainberger, F.M.; Bankier, A.; Seidl, G.

1993-01-01

Acromegaly is regarded as a cause for secondary osteoporosis, whereas recent papers suggest that growth hormone increases bone mineral density (BMD). In 16 patients with active acromegaly we found an increased BMD compared to normal controls in the lumbar spine and the proximal femur by means of dual energy X-ray absoptiometry. This increase in BMD was statistically significant in the femoral neck and in Ward's triangle (P=0.05). Moreover, no signs of osteoporosis were found radiologically. (orig.) [de

Use of DXA-Based Structural Engineering Models of the Proximal Femur to Discriminate Hip Fracture

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Yang, Lang; Peel, Nicola; Clowes, Jackie A; McCloskey, Eugene V; Eastell, Richard

2011-01-01

Several DXA-based structural engineering models (SEMs) of the proximal femur have been developed to estimate stress caused by sideway falls. Their usefulness in discriminating hip fracture has not yet been established and we therefore evaluated these models. The hip DXA scans of 51 postmenopausal women with hip fracture (30 femoral neck, 17 trochanteric, and 4 unspecified) and 153 age-, height-, and weight-matched controls were reanalyzed using a special version of Hologic’s software that produced a pixel-by-pixel BMD map. For each map, a curved-beam, a curved composite-beam, and a finite element model were generated to calculate stress within the bone when falling sideways. An index of fracture risk (IFR) was defined over the femoral neck, trochanter, and total hip as the stress divided by the yield stress at each pixel and averaged over the regions of interest. Hip structure analysis (HSA) was also performed using Hologic APEX analysis software. Hip BMD and almost all parameters derived from HSA and SEM were discriminators of hip fracture on their own because their ORs were significantly >1. Because of the high correlation of total hip BMD to HSA and SEM-derived parameters, only the bone width discriminated hip fracture independently from total hip BMD. Judged by the area under the receiver operating characteristics curve, the trochanteric IFR derived from the finite element model was significant better than total hip BMD alone and similar to the total hip BMD plus bone width in discriminating all hip fracture and femoral neck fracture. No index was better than total hip BMD for discriminating trochanteric fractures. In conclusion, the finite element model has the potential to replace hip BMD in discriminating hip fractures. PMID:18767924

The study of bone mineral density and structure in proximal femur by quantitative CT in elderly Chinese women

International Nuclear Information System (INIS)

Cheng Xiaoguang; Liu Xia; Wang Yusheng; Li Jin; Qu Hui; Li Jing; Genant, H.; Lang, T.

2009-01-01

Objective: To evaluate the bone mineral density (BMD) and structure of proximal femur in elderly Chinese women by quantatitive computed tomography (QCT) and dual energy X-ray absorptiometry (DXA), and to further compare the results of these two methods. Methods: Sixty-six healthy Chinese women over 65 years old participated in this study. The left hips of all subjects were measured with DXA and the BMD of femoral neck and trochanteric region were calculated. With QCT, the BMD and tissue volume of cortical, trabecular and integral bone were calculated for femoral neck, trochanteric and total femur regions in both hips. Appropriate statistical analyses were performed with SPSS 11.5. Results: The BMD and structural parameters in different regions and different compartments of the proximal femur could be precisely assessed with QCT technique. The BMD of cortical bone in femoral neck [(0.52±0.04) g/cm 3 ], BMD of cortical bone in trochanteric region [(0.49±0.03) g/cm 3 ] and BMD of integral bone in troehanteric region [(0.22±0.04) g/cm 3 ] were greater in the fight than those in the left [(0.51±0.04), (0.48±0.03), (0.21±0.04)g/cm 3 ]. The difference had statistical signification (P 2 (0.78±0.13) g/cm 2 , 5.80 cm 3 (0.06±0.03) g/cm 3 , (5.19 ± 1.40) cm 3 , (0.25 ± 0.04)g/cm 3 , 15.66 cm 3 , (21.74±3.43) cm 3 , (0.08 ± 0.03)g/cm 3 , (34.27±6.09) cm 3 and (76.12±11.11) cm 3 respectively, in the fight the corresponding parameters being (0.52±0.10) g/cm 2 (0.78±0.13) g/cm 2 6.01 cm 3 , (0.06±0.02) g/cm 3 , (5.17±1.27) cm 3 , (0.25±0.04)g/cm 3 , 15.62 cm 3 , (22.12±3.60) cm 3 , (0.09±0.03) g/cm 3 , (34.17±5.94) cm 3 and (76.53±10.71) cm 3 respectively. There were no significant difference between the left and right parameters above (P>0.0 ). All QCT parameters of the right hip correlated well with their corresponding ones of left hip with correlation coefficients ranging from 0.656-0.955, P<0.05. QCT-derived simulated DXA femoral neck and trochanteric

Association of insulin resistance with near peak bone mass in the femur and lumbar spine of Korean adults aged 25-35: The Korean National Health and Nutrition Examination Survey 2008-2010

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Choo, Min Soo; Choi, Se Rin; Han, Jun Hyun; Lee, Seong Ho

2017-01-01

Objective This study aimed to evaluate the relationship between insulin resistance and the bone mineral density (BMD) of femur and lumbar spine in Korean adults who are expected to exhibit near peak bone mass. Methods Data from the Korean National Health and Nutrition Examination Survey 2008–2010 were analyzed. A total of 2,750 participants aged 25−35 years were included. Insulin resistance was assessed using a homeostatic model assessment of insulin resistance (HOMA-IR) and serum fasting insulin. Results In a multivariate linear regression analysis, the HOMA-IR was significantly inversely associated with the BMD of the total hip (TH, β = −0.052, P = 0.002), femoral neck (FN, β = −0.072, Pinsulin was significantly inversely associated with the BMD of the TH (β = −0.055, P = 0.001), FN (β = −0.072, Pinsulin resistance may be independently and inversely associated with the near peak bone mass of the femur and lumbar spine. PMID:28704413

Relationships between self-reported lifetime physical activity, estimates of current physical fitness, and aBMD in adult premenopausal women.

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Greenway, Kathleen G; Walkley, Jeff W; Rich, Peter A

2015-01-01

Osteoporosis is common, and physical activity is important in its prevention and treatment. Of the categories of historical physical activity (PA) examined, we found that weight-bearing and very hard physical activity had the strongest relationships with areal bone mineral density (aBMD) throughout growth and into adulthood, while for measures of strength, only grip strength proved to be an independent predictor of aBMD. To examine relationships between aBMD (total body, lumbar spine, proximal femur, tibial shaft, distal radius) and estimates of historical PA, current strength, and cardiovascular fitness in adult premenopausal women. One hundred fifty-two adult premenopausal women (40 ± 9.6 years) undertook aBMD (dual-energy X-ray absorptiometry (DXA)) and completed surveys to estimate historical physical activity representative of three decades (Kriska et al. [1]), while subsets underwent functional tests of isokinetic strength (hamstrings and quadriceps), grip strength (hand dynamometer), and maximum oxygen uptake (MaxV02; cycle ergometer). Historical PA was characterized by demand (metabolic equivalents, PA > 3 METS; PA > 7 METS) and type (weight-bearing; high impact). Significant positive independent predictors varied by decade and site, with weight-bearing exercise and PA > 3 METS significant for the tibial shaft (10-19 decade) and only PA > 7 METS significant for the final two decades (20-29 and 30-39 years; total body and total hip). A significant negative correlation between high impact activity and tibial shaft aBMD appeared for the final decade. For strength measures, only grip strength was an independent predictor (total body, total hip), while MaxV02 provided a significant independent prediction for the tibial shaft. Past PA > 7 METS was positively associated with aBMD, and such activity should probably constitute a relatively high proportion of all weekly PA to positively affect aBMD. The findings warrant more detailed investigations in a prospective

Relationship of total body fat mass to weight-bearing bone volumetric density, geometry, and strength in young girls.

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Farr, Joshua N; Chen, Zhao; Lisse, Jeffrey R; Lohman, Timothy G; Going, Scott B

2010-04-01

Understanding the influence of total body fat mass (TBFM) on bone during the peri-pubertal years is critical for the development of future interventions aimed at improving bone strength and reducing fracture risk. Thus, we evaluated the relationship of TBFM to volumetric bone mineral density (vBMD), geometry, and strength at metaphyseal and diaphyseal sites of the femur and tibia of young girls. Data from 396 girls aged 8-13 years from the "Jump-In: Building Better Bones" study were analyzed. Bone parameters were assessed using peripheral quantitative computed tomography (pQCT) at the 4% and 20% distal femur and 4% and 66% distal tibia of the non-dominant leg. Bone parameters at the 4% sites included trabecular vBMD, periosteal circumference, and bone strength index (BSI), while at the 20% femur and 66% tibia, parameters included cortical vBMD, periosteal circumference, and strength-strain index (SSI). Multiple linear regression analyses were used to assess associations between bone parameters and TBFM, controlling for muscle cross-sectional area (MCSA). Regression analyses were then repeated with maturity, bone length, physical activity, and ethnicity as additional covariates. Analysis of covariance (ANCOVA) was used to compare bone parameters among tertiles of TBFM. In regression models with TBFM and MCSA, associations between TBFM and bone parameters at all sites were not significant. TBFM explained very little variance in all bone parameters (0.2-2.3%). In contrast, MCSA was strongly related (p<0.001) to all bone parameters, except cortical vBMD. The addition of maturity, bone length, physical activity, and ethnicity did not alter the relationship between TBFM and bone parameters. With bone parameters expressed relative to total body mass, ANCOVA showed that all outcomes were significantly (p<0.001) greater in the lowest compared to the middle and highest tertiles of TBFM. Although TBFM is correlated with femur and tibia vBMD, periosteal circumference, and

Measurements of bone mineral density of the proximal femur by two commercially available dual energy X-ray absorptiometric systems

International Nuclear Information System (INIS)

Svendsen, O.L.; Marslew, U.; Hassager, C.; Christiansen, C.

1992-01-01

Two dual energy X-ray absorptiometric (DXA) instruments have recently become commercially available for local bone densitometry: the QDR-1000 (Hologic Inc.) and the DPX (Lunar Radiation Corp.). We report the precision, influence of femoral, rotation, correlation and agreement of bone mineral measurements of the proximal fermur by these two instruments. In vitro (femur phantom) short-term precision was 1.1%-3.5%, and the long-term precision was 1.2%-3.8%. In vivo (groups of 10 premenopausal and 10 postmenopausal women) short-term precision of duplicate measurements was 1.6%-4.7%, and long-term precision was 1.9%-5.5%. Overall, the precision for Ward's triangle was over 3% and that for the femoral neck and trochanter, 2%-3%. Rotation of the femur phantom produced a statistically significant change in the bone mineral density (BMD) of the femoral neck. Within a clinically relevant range of femoral rotation (20deg inward rotation ±5deg) the coefficient of variation (CV%) increased by a mean factor of 1.1-1.4. Although the correlation (r<0.9) between BMD measurements of the proximal femur by the DPX and QDR-1000 in 30 postmenopausal women was high, there was lack of agreement between the two instruments. We found no statistically significant differences between the right and left femur in 30 postmenopausal women. A bilateral femur scan took a mean total time of about 22 min. We conclude that with the introduction of DXA instruments, the precision of bone mineral measurments of the proximal femur has improved. However, for comparability between commercially available DXA instruments, it might be advantageous if units were standardized. (orig.)

Life-Course Genome-wide Association Study Meta-analysis of Total Body BMD and Assessment of Age-Specific Effects

NARCIS (Netherlands)

Medina-Gomez, Carolina; Kemp, John P.; Trajanoska, Katerina; Luan, Jian'an; Chesi, Alessandra; Ahluwalia, Tarunveer S.; Mook-Kanamori, Dennis O.; Ham, Annelies; Hartwig, Fernando P.; Evans, Daniel S.; Joro, Raimo; Nedeljkovic, Ivana; Zheng, Hou-Feng; Zhu, Kun; Atalay, Mustafa; Liu, Ching-Ti; Nethander, Maria; Broer, Linda; Porleifsson, Gudmar; Mullin, Benjamin H.; Handelman, Samuel K.; Nalls, Mike A.; Jessen, Leon E.; Heppe, Denise H. M.; Richards, J. Brent; Wang, Carol; Chawes, Bo; Schraut, Katharina E.; Amin, Najaf; Wareham, Nick; Karasik, David; van der Velde, Nathalie; Ikram, M. Arfan; Zemel, Babette S.; Zhou, Yanhua; Carlsson, Christian J.; Liu, Yongmei; McGuigan, Fiona E.; Boer, Cindy G.; Bønnelykke, Klaus; Ralston, Stuart H.; Robbins, John A.; Walsh, John P.; Zillikens, M. Carola; Langenberg, Claudia; Li-Gao, Ruifang; Williams, Frances M. K.; Harris, Tamara B.; Akesson, Kristina; Jackson, Rebecca D.; Sigurdsson, Gunnar; den Heijer, Martin; van der Eerden, Bram C. J.; van de Peppel, Jeroen; Spector, Timothy D.; Pennell, Craig; Horta, Bernardo L.; Felix, Janine F.; Zhao, Jing Hua; Wilson, Scott G.; de Mutsert, Renée; Bisgaard, Hans; Styrkársdóttir, Unnur; Jaddoe, Vincent W.; Orwoll, Eric; Lakka, Timo A.; Scott, Robert; Grant, Struan F. A.; Lorentzon, Mattias; van Duijn, Cornelia M.; Wilson, James F.; Stefansson, Kari; Psaty, Bruce M.; Kiel, Douglas P.; Ohlsson, Claes; Ntzani, Evangelia; van Wijnen, Andre J.; Forgetta, Vincenzo; Ghanbari, Mohsen; Logan, John G.; Williams, Graham R.; Bassett, J. H. Duncan; Croucher, Peter I.; Evangelou, Evangelos; Uitterlinden, Andre G.; Ackert-Bicknell, Cheryl L.; Tobias, Jonathan H.; Evans, David M.; Rivadeneira, Fernando

2018-01-01

Bone mineral density (BMD) assessed by DXA is used to evaluate bone health. In children, total body (TB) measurements are commonly used; in older individuals, BMD at the lumbar spine (LS) and femoral neck (FN) is used to diagnose osteoporosis. To date, genetic variants in more than 60 loci have been

Life-Course Genome-wide Association Study Meta-analysis of Total Body BMD and Assessment of Age-Specific Effects

DEFF Research Database (Denmark)

Medina-Gomez, Carolina; Kemp, John P.; Trajanoska, Katerina

2018-01-01

Bone mineral density (BMD) assessed by DXA is used to evaluate bone health. In children, total body (TB) measurements are commonly used; in older individuals, BMD at the lumbar spine (LS) and femoral neck (FN) is used to diagnose osteoporosis. To date, genetic variants in more than 60 loci have b...

Measurements of bone mineral density in the lumbar spine and proximal femur using lunar prodigy and the new pencil-beam dual-energy X-ray absorptiometry

International Nuclear Information System (INIS)

Choi, Dongil; Kim, Deog-Yoon; Han, Chung Soo; Kim, Seonwoo; Bok, Hae Sook; Huh, Wooseong; Ko, Jae-Wook; Hong, Sung Hwa

2010-01-01

We evaluated the correlation of the absolute bone mineral density (BMD) values of the lumbar spine and standard sites of the proximal femur obtained from a Lunar Prodigy and the newly developed pencil-beam dual-energy X-ray absorptiometry (Dexxum). Between June 2008 and December 2008, 79 Korean volunteers were enrolled. Measurements were obtained on the same day using both densitometers. The absolute BMD values (g/cm 2 ) from the two densitometers were evaluated using Pearson's correlation analysis with Bonferroni's correction for the three clinically important sites. In order to evaluate precision, we performed duplicate Dexxum measurements, and calculated the within-subject coefficient of variation (WSCV). The Pearson's correlation coefficient (r) of BMD values for the total proximal femur, femoral neck, and lumbar spine by the two densitometers were 0.926, 0.948, and 0.955 respectively, and the null hypotheses of r = 0.8 were all rejected (p < 0.001 by one-sided Z-test with Fisher's z-transformation for each site). The T-scores (r ≥ 0.842) and Z-scores (r ≥ 0.709) also showed strong positive correlations. The duplicate BMD values of Dexxum showed a high level of precision (WSCV ≤ 4.27%). Dexxum measurements of BMD, T-scores, and Z-scores showed a strong linear correlation with those measured on Lunar Prodigy. (orig.)

The relationship of total body composition with bone mineral density in postmenopausal women with type 2 diabetes

Directory of Open Access Journals (Sweden)

Vadim Valer'evich Klimontov

2015-03-01

Full Text Available AimTo determine the relationship between bone mineral density (BMD and total body composition in postmenopausal women with type 2 diabetes.Materials and MethodsThe study included 78 women, from 50 to 70 years of age (median 63 years. Twenty women had normal body mass index (BMI, 29 ones were overweight and 29 had obesity. The body composition and BMD was studied by dual-energy X-ray absorptiometry.ResultsWomen with normal BMD had higher BMI, total and truncal fat mass, as well lean mass as compared to women with osteoporosis and osteopenia (all p <0.05. Patients with osteoporosis had a lower fat mass at the hips, compared with those with normal BMD. Total and truncal fat mass, as well as lean mass were positively correlated with BMD in the lumbar spine and proximal femur, femoral neck and radius. In multivariate regression analysis fat mass was an independent predictor for total BMD, after adjusting for age, BMI, duration of menopause, HbA1c, glomerular filtration rate and other total body composition parameters.ConclusionsIn postmenopausal type 2 diabetic women BMI and fat mass is associated positively with BMD.

Associations of Age, BMI, and Years of Menstruation with Proximal Femur Strength in Chinese Postmenopausal Women: A Cross-Sectional Study.

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Kang, Huili; Chen, Yu-Ming; Han, Guiyuan; Huang, Hua; Chen, Wei-Qing; Wang, Xidan; Zhu, Ying-Ying; Xiao, Su-Mei

2016-01-23

This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD) and geometric parameters, including cross-sectional area (CSA), outer diameter (OD), cortical thickness (CT), section modulus (SM), buckling ratio (BR) at the narrow neck (NN), intertrochanter (IT), and femoral shaft (FS). Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p menstruation had the positive relationships with proximal femur strength (p menstruation were 0.14%-1.34%, 0.20%-2.70%, and 0.16%-0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women.

Dual-energy X-ray absorptiometry in the lumbar spine, proximal femur and distal radius in children

International Nuclear Information System (INIS)

Tsukahara, H.; Sudo, M.; Umezaki, M.; Hiraoka, M.; Yamamoto, K.; Ishii, Y.; Haruki, S.

1992-01-01

Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD) in the lumbar spine, proximal femur and distal radius in 48 Japanese children aged 3-18 years. In the normal children (n=32), BMD increased with age in all locations, with a nearly twofold increase from preschool age to adolescence. Most of the children with chronic diseases known to affect bone metabolism (e.g., steroid osteoporosis) (n=16) had low BMD in every region, indicating that these disease states probably affect multiple sites of the skeleton in children. (orig.)

Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis

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Ajay Puri

2012-01-01

Full Text Available Background: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP. We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods: Eight patients (four males and four females with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5, Ewing′s sarcoma (1, and chondrosarcoma (2. Mean followup was 33 months (9-72 months for all and 40 months (24-72 months in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%. The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

Associations of Age, BMI, and Years of Menstruation with Proximal Femur Strength in Chinese Postmenopausal Women: A Cross-Sectional Study

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Huili Kang

2016-01-01

Full Text Available This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD and geometric parameters, including cross-sectional area (CSA, outer diameter (OD, cortical thickness (CT, section modulus (SM, buckling ratio (BR at the narrow neck (NN, intertrochanter (IT, and femoral shaft (FS. Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p < 0.05, which indicated a weaker bone strength at the proximal femur. BMI and years of menstruation had the positive relationships with proximal femur strength (p < 0.05. Further analyses showed that the ranges of absolute value of change slope per year, per BMI or per year of menstruation were 0.14%–1.34%, 0.20%–2.70%, and 0.16%–0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women.

'Real world' imprecision of dual-energy x-ray absorptiometry (DEXA) at L2-4 and femur neck

International Nuclear Information System (INIS)

Phillipov, G.; Sigalas, V.; Seaborn, C.; Phillips, P.; Rowe, C.; Kitchener, M.

1998-01-01

Full text: While measurement of bone density (BMD) by DEXA is routinely used to diagnose osteoporosis and estimate future fracture risk, data on what constitutes a significant change between serial BMD measurements has received much less attention. The use of repeat BMD measurements is particularly important to either assess the rate of bone loss or treatment efficacy for individual patients. However to estimate a statistically significant change between consecutive bone mineral density (BMD) measurements requires an accurate knowledge of dual-energy x-ray absorptiometry (DEXA) imprecision under actual day-to-day working conditions. DEXA imprecision, based on in vitro models, such as manufacturers' phantoms, leads to a marked under-estimation of true imprecision, since significant sources of variance (patient positioning, inter- and intra-operator variability etc) are ignored. In an attempt to provide a robust estimate of imprecision for our Lunar DPXplus, 28 females and one male(age 72.8 + 7.8 yr)were recruited to have multiple DEXA scans at approximately four week intervals. The subjects were handled using exactly the same procedure as that for our referred patients. Initial findings after each subject has had am average of 6.6 DEXA scans showed that the within subject variability (CV w ) associated with the AP lumbar spine (L2-4)and femur-neck was 1.83 and 2.24% respectively. No significant correlation was found between BMD values and CV w at either site. Since instrument variability is about 0.7% (derived from phantom studies), it is apparent that operator variation accounts for the majority of total variability. From the derived imprecision, the percentage difference for a significant change at a predefined probability limit is 5.1 and 6.2% for the spine and femur-neck sites respectively, when the probability of a false alarm is 5% (bi-directional). Knowledge of the critical difference required between successive measurements, combined with the known rate of

Trabecular bone microstructure is impaired in the proximal femur of human immunodeficiency virus-infected men with normal bone mineral density.

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Kazakia, Galateia J; Carballido-Gamio, Julio; Lai, Andrew; Nardo, Lorenzo; Facchetti, Luca; Pasco, Courtney; Zhang, Chiyuan A; Han, Misung; Parrott, Amanda Hutton; Tien, Phyllis; Krug, Roland

2018-02-01

There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis. Eight HIV-infected men and 11 healthy age-matched controls were recruited and informed consent was obtained before each scan. High-resolution MRI of the proximal femur was performed using fully balanced steady state free precession (bSSFP) on a 3T system. Three volumes of interest at corresponding anatomic locations across all subjects were defined based on registrations of a common template. Four MR-based trabecular microstructural parameters were analyzed at each region: fuzzy bone volume fraction (f-BVF), trabecular number (Tb.N), thickness (Tb.Th), and spacing (Tb.Sp). In addition, the distal radius and distal tibia were imaged with HR-pQCT. Four HR-pQCT-based microstructural parameters were analyzed: trabecular bone volume fraction (BV/TV), Tb.N, Tb.Th, and Tb.Sp. Total hip and spine aBMD were determined from DXA. Microstructural bone parameters derived from MRI at the proximal femur and from HR-pQCT at the distal tibia showed significantly lower bone quality in HIV-infected patients compared to healthy controls. In contrast, DXA aBMD data showed no significant differences between HIV

Identify fracture-critical regions inside the proximal femur using statistical parametric mapping

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Li, Wenjun; Kornak, John; Harris, Tamara; Keyak, Joyce; Li, Caixia; Lu, Ying; Cheng, Xiaoguang; Lang, Thomas

2009-01-01

We identified regions inside the proximal femur that are most strongly associated with hip fracture. Bone densitometry based on such fracture-critical regions showed improved power in discriminating fracture patients from controls. Introduction Hip fractures typically occur in lateral falls, with focal mechanical failure of the sub-volumes of tissue in which the applied stress exceeds the strength. In this study, we describe a new methodology to identify proximal femoral tissue elements with highest association with hip fracture. We hypothesize that bone mineral density (BMD) measured in such sub-volumes discriminates hip fracture risk better than BMD in standard anatomic regions such as the femoral neck and trochanter. Materials and Methods We employed inter-subject registration to transform hip QCT images of 37 patients with hip fractures and 38 age-matched controls into a voxel-based statistical atlas. Within voxels, we performed t-tests between the two groups to identify the regions which differed most. We then randomly divided the 75 scans into a training set and a test set. From the training set, we derived a fracture-driven region of interest (ROI) based on association with fracture. In the test set, we measured BMD in this ROI to determine fracture discrimination efficacy using ROC analysis. Additionally, we compared the BMD distribution differences between the 29 patients with neck fractures and the 8 patients with trochanteric fractures. Results By evaluating fracture discrimination power based on ROC analysis, the fracture-driven ROI had an AUC (area under curve) of 0.92, while anatomic ROIs (including the entire proximal femur, the femoral neck, trochanter and their cortical and trabecular compartments) had AUC values between 0.78 and 0.87. We also observed that the neck fracture patients had lower BMD (p=0.014) in a small region near the femoral neck and the femoral head, and patients with trochanteric fractures had lower BMD in trochanteric regions

Relationships between bone strength and bone quality. Three-dimensional imaging analysis in ovariectomized mice

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Wakabayashi, Suguru; Sakurai, Takashi; Kashima, Isamu

2004-01-01

Low-energy trauma resulting in fractures of the distal femur is often observed in elderly patients with osteoporosis; such fractures are often associated with treatment difficulties and poor prognosis. The purpose of this study was to clarify the factors that affect the bone strength of the distal femur. We used ovariectomized mice to demonstrate bone quality factors associated with deterioration of the strength of the distal femur. Ten-week old ICR-strain mice were ovariectomized or sham-ovariectomized. Total bone mineral density (BMD), total bone area, cortical BMD, cortical thickness, and trabecular BMD were measured by peripheral quantitative computed tomography in the distal metaphyseal region of the femora. As three-dimensional architectural parameters, the trabecular number, trabecular thickness (Tb.Th), trabecular separation, and connectivity density were measured in the same region by micro-computed tomography. The maximum load measured by compression testing of the distal metaphyseal region was regarded as the bone strength of each sample. No significant differences in total bone area or in cortical BMD were found between the groups. Bone strength showed the closest relationship with total BMD (r=0.834). Multiple regression analysis demonstrated that total BMD greatly depended on cortical thickness. The addition of Tb.Th to trabecular BMD markedly reflected bone strength (R=0.857), suggesting that Tb.Th affected bone strength more significantly than trabecular BMD. These findings suggested that deterioration of bone strength of the distal femur (metaphysis) was not caused by a reduction in cortical BMD, but was related to reduced cortical thickness, which reduced total BMD, and to trabecular BMD and architecture, in particular to reduced Tb.Th. (author)

Testosterone Replacement and Bone Mineral Density in Male Pituitary Tumor Patients

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Min Jeong Lee

2014-03-01

Full Text Available BackgroundHypopituitarism is associated with osteoporosis and osteopenia especially when hypogonadotropic hypogonadism is present. Despite hypopituitarism being an important cause of secondary osteoporosis, osteoporosis in patients receiving surgery for pituitary tumors in Korea has not been studied. In this study, we evaluated the effects of testosterone replacement therapy (TRT on bone mineral density (BMD in postoperative hypogonadal patients with pituitary tumors.MethodsTo examine the effect of TRT on BMD, we performed a retrospective observational study in 21 postoperative male patients who underwent pituitary tumor surgery between 2003 and 2012 at the Ajou University Hospital. Testosterone was replaced in postoperative hypogonadal patients by regular intramuscular injection, daily oral medication, or application of transdermal gel. BMD (g/cm2 measurements of central skeletal sites (lumbar spine, femoral neck, and total femur were obtained using dual-energy X-ray absorptiometry (GE Lunar. For lumbar spine BMD, L1 to L4 values were chosen for analysis. Femur neck and total femur were also analyzed.ResultsDuring the follow-up period (mean, 56 months; range, 12 to 99 months serum testosterone levels increased with the administration of TRT (P=0.007. There was significant improvement (4.56%±9.81% in the lumbar spine BMD compared to baseline BMD. There were no significant changes in the femur neck BMD or total femur BMD. We did not find any statistically significant relationships between changes in testosterone levels and BMD using Spearman correlation analysis.ConclusionOur results indicated that TRT used in the postoperative period for hypogonadal pituitary tumor surgery patients may have beneficial effects on the BMD of the spine.

Testosterone and BMD in elite male lightweight rowers

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Vinther, A; Kanstrup, I-L; Christiansen, E

2008-01-01

The purpose of the present study was to investigate if a relationship between BMD and testosterone levels could be identified in elite male lightweight rowers. Thirteen male lightweight national team rowers had their BMD measured in a DEXA scanner. Plasma concentrations of total testosterone (TT)...

Testosterone and BMD in Elite Male Lightweight Rowers

DEFF Research Database (Denmark)

Vinther, A.; Christiansen, E.; Ekdahl, C.

2008-01-01

), free testosterone (IFT), dihydrotestosterone (DHT) and sex hormone binding globulin (SHBG) and additional parameters related to bone metabolism were measured. Plasma concentrations of TT, FT and DHT were in the lower part of the normal range, while BMD was close to or above normal. BMD of total body...

Changes in bone mineral density (BMD) around the cemented Exeter stem: a prospective study in 18 women with 5 years follow-up

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Damborg, Frank; Nissen, Nis; Jørgensen, Hans R I

2008-01-01

BACKGROUND AND PURPOSE: THA changes the pattern of strain distribution in the proximal femur. We quantified the changes in BMD for 5 years after insertion of the cemented Exeter stem in women. METHODS: 18 women aged 55-79 years, undergoing unilateral THA with the cemented Exeter stem, were included...

Mechanical torque measurement in the proximal femur correlates to failure load and bone mineral density ex vivo

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Stefan Grote

2013-06-01

Full Text Available Knowledge of local bone quality is essential for surgeons to determine operation techniques. A device for intraoperative measurement of local bone quality has been developed by the AO-Research Foundation (DensiProbe®. We used this device to experimentally measure peak breakaway torque of trabecular bone in the proximal femur and correlated this with local bone mineral density (BMD and failure load. Bone mineral density of 160 cadaver femurs was measured by ex situ dual-energy X-ray absorptiometry. The failure load of all femurs was analyzed by side-impact analysis. Femur fractures were fixed and mechanical peak torque was measured with the DensiProbe® device. Correlation was calculated whereas correlation coefficient and significance was calculated by Fisher’s Z-transformation. Moreover, linear regression analysis was carried out. The unpaired Student’s t-test was used to assess the significance of differences. The Ward triangle region had the lowest BMD with 0.511 g/cm2 (±0.17 g/cm2, followed by the upper neck region with 0.546 g/cm2 (±0.16 g/cm2, trochanteric region with 0.685 g/cm2 (±0.19 g/cm2 and the femoral neck with 0.813 g/cm2 (±0.2 g/cm2. Peak torque of DensiProbe® in the femoral head was 3.48 Nm (±2.34 Nm. Load to failure was 4050.2 N (±1586.7 N. The highest correlation of peak torque measured by Densi Probe® and load to failure was found in the femoral neck (r=0.64, P<0.001. The overall correlation of mechanical peak torque with T-score was r=0.60 (P<0.001. A correlation was found between mechanical peak torque, load to failure of bone and BMD in vitro. Trabecular strength of bone and bone mineral density are different aspects of bone strength, but a correlation was found between them. Mechanical peak torque as measured may contribute additional information about bone strength, especially in the perioperative testing.

Age-predicted values for lumbar spine, proximal femur, and whole-body bone mineral density: results from a population of normal children aged 3 to 18 years

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Webber, C.E. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Radiology, Hamilton, Ontario (Canada)]. E-mail: webber@hhsc.ca; Beaumont, L.F. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); Morrison, J. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); Sala, A. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Pediatrics, Hamilton, Ontario (Canada); Univ. of Milan-Bicocca, Monza (Italy); Barr, R.D. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Pediatrics, Hamilton, Ontario (Canada)

2007-02-15

We measured areal bone mineral density (BMD) with dual-energy X-ray absorptiometry (DXA) at the lumbar spine and the proximal femur and for the total body in 179 subjects (91 girls and 88 boys) with no known disorders that might affect calcium metabolism. Results are also reported for lumbar spine bone mineral content (BMC) and for the derived variable, bone mineral apparent density (BMAD). Expected-for-age values for each variable were derived for boys and girls by using an expression that represented the sum of a steady increase due to growth plus a rapid increase associated with puberty. Normal ranges were derived by assuming that at least 95% of children would be included within 1.96 population standard deviations (SD) of the expected-for-age value. The normal range for lumbar spine BMD derived from our population of children was compared with previously published normal ranges based on results obtained from different bone densitometers in diverse geographic locations. The extent of agreement between the various normal ranges indicates that the derived expressions can be used for reporting routine spine, femur, and whole-body BMD measurements in children and adolescents. The greatest difference in expected-for-age values among the various studies was that arising from intermanufacturer variability. The application of published conversion factors derived from DXA measurements in adults did not account fully for these differences, especially in younger children. (author)

Age-predicted values for lumbar spine, proximal femur, and whole-body bone mineral density: results from a population of normal children aged 3 to 18 years

International Nuclear Information System (INIS)

Webber, C.E.; Beaumont, L.F.; Morrison, J.; Sala, A.; Barr, R.D.

2007-01-01

We measured areal bone mineral density (BMD) with dual-energy X-ray absorptiometry (DXA) at the lumbar spine and the proximal femur and for the total body in 179 subjects (91 girls and 88 boys) with no known disorders that might affect calcium metabolism. Results are also reported for lumbar spine bone mineral content (BMC) and for the derived variable, bone mineral apparent density (BMAD). Expected-for-age values for each variable were derived for boys and girls by using an expression that represented the sum of a steady increase due to growth plus a rapid increase associated with puberty. Normal ranges were derived by assuming that at least 95% of children would be included within 1.96 population standard deviations (SD) of the expected-for-age value. The normal range for lumbar spine BMD derived from our population of children was compared with previously published normal ranges based on results obtained from different bone densitometers in diverse geographic locations. The extent of agreement between the various normal ranges indicates that the derived expressions can be used for reporting routine spine, femur, and whole-body BMD measurements in children and adolescents. The greatest difference in expected-for-age values among the various studies was that arising from intermanufacturer variability. The application of published conversion factors derived from DXA measurements in adults did not account fully for these differences, especially in younger children. (author)

Bone Morphology in 46 BXD Recombinant Inbred Strains and Femur-Tibia Correlation

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Yueying Zhang

2015-01-01

Full Text Available We examined the bone properties of BXD recombinant inbred (RI mice by analyzing femur and tibia and compared their phenotypes of different compartments. 46 BXD RI mouse strains were analyzed including progenitor C57BL/6J (n=16 and DBA/2J (n=15 and two first filial generations (D2B6F1 and B6D2F1. Strain differences were observed in bone quality and structural properties (P<0.05 in each bone profile (whole bone, cortical bone, or trabecular bone. It is well known that skeletal phenotypes are largely affected by genetic determinants and genders, such as bone mineral density (BMD. While genetics and gender appear expectedly as the major determinants of bone mass and structure, significant correlations were also observed between femur and tibia. More importantly, positive and negative femur-tibia associations indicated that genetic makeup had an influence on skeletal integrity. We conclude that (a femur-tibia association in bone morphological properties significantly varies from strain to strain, which may be caused by genetic differences among strains, and (b strainwise variations were seen in bone mass, bone morphology, and bone microarchitecture along with bone structural property.

Association between change in BMD and fragility fracture in women and men.

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Berger, Claudie; Langsetmo, Lisa; Joseph, Lawrence; Hanley, David A; Davison, K Shawn; Josse, Robert G; Prior, Jerilynn C; Kreiger, Nancy; Tenenhouse, Alan; Goltzman, David

2009-02-01

Our objective was to estimate the relationship between longitudinal change in BMD and fragility fractures. We studied 3635 women and 1417 men 50-85 yr of age in the Canadian Multicentre Osteoporosis Study who had at least two BMD measurements (lumbar spine, femoral neck, total hip, and trochanter) within the first 5 yr of the study and fragility fractures (any, main, forearm/wrist, ribs, hip) within the first 7 yr. Multiple logistic regression was used to model the relationship between baseline BMD, BMD change, and fragility fractures. We found that, among nonusers of antiresorptives, independent of baseline BMD, a decrease of 0.01 g/cm(2)/yr in total hip BMD was associated with an increased risk of fragility fracture with ORs of 1.15 (95% CI: 1.01; 1.32) in women and 1.34 (95% CI: 1.02; 1.78) in men. The risk of fragility fractures in subgroups such as fast losers and those with osteopenia was better estimated by models that included BMD change than by models that included baseline BMD but excluded BMD change. Although the association between baseline BMD and fragility fractures was similar in users and nonusers of antiresorptives, the association was stronger in nonusers compared with users. These results show that BMD change in both men and women is an independent risk factor for fragility fractures and also predicts fracture risk in those with osteopenia. The results suggest that BMD change should be included with other variables in a comprehensive fracture prediction model to capture its contribution to osteoporotic fracture risk.

High physiological prolactin induced by pituitary transplantation decreases BMD and BMC in the femoral metaphysis, but not in the diaphysis of adult female rats.

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Thongchote, Kanogwun; Charoenphandhu, Narattaphol; Krishnamra, Nateetip

2008-02-01

High physiological prolactin (PRL) stimulated intestinal calcium absorption and renal calcium uptake in mammals. Previous histomorphometric study revealed a significant increase in bone turnover in the trabecular part of the PRL-exposed long (cortical) bone; however, whole-bone densitometric analysis was unable to demonstrate such effect. We therefore studied differential changes in bone mineral density (BMD) and contents (BMC) of the femoral diaphysis and metaphysis in adult female rats exposed to high PRL induced by anterior pituitary (AP) transplantation. The estrogen-dependent effects of PRL on the femur were also investigated. We found that chronic exposure to PRL had no effect on BMD or BMC of the femoral diaphysis, which represented the cortical part of the long bone. It is interesting that 7 weeks after an AP transplantation, BMD and BMC of the femoral metaphysis were significantly decreased by 8% and 14%, respectively. Ovariectomy (Ovx) for 2, 5, and 7 weeks also decreased BMD and BMC in the femoral metaphysis, but not in the diaphysis. However, the AP transplantation plus Ovx (AP+Ovx) produced no additive effects. Nevertheless, 2.5 microg/kg 17beta-estradiol (E2) supplementation abolished the osteopenic effects of both Ovx and AP+Ovx on the femur. As for the L5-6 vertebrae, BMD and BMC were not affected by PRL exposure, but were significantly decreased by Ovx and AP+Ovx, and such decreases were completely prevented by E2 supplementation. It could be concluded that high physiological PRL induced a significant osteopenia in the trabecular part, i.e., the metaphysis, of the femora of adult female rats in an estrogen-dependent manner. Since PRL had no detectable effect on the vertebrae, the effects of PRL on bone appeared to be site-specific.

Sarcopenia as an Independent Risk Factor for Decreased BMD in COPD Patients: Korean National Health and Nutrition Examination Surveys IV and V (2008-2011)

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Lee, Dong-Won; Choi, Eun-Young

2016-01-01

Background A decrease in bone mineral density (BMD) is a systemic consequence of chronic obstructive pulmonary disease (COPD). Past reports have rarely examined any correlation between sarcopenia and BMD. We investigated the relationship cross-sectionally between the presence of sarcopenia and BMD reduction in COPD patients. Methods COPD patients aged 50 or older with qualifying spirometry and dual-energy X-ray absorptiometry data were from participants in the Korean National Health and Nutrition Examination Surveys IV and V (2008–2011). Results There were 286 (33.3%) subjects in the sarcopenia group and 572 (66.7%) in the non-sarcopenia group. The sarcopenia group had lower T-scores than the non-sarcopenia group (femur: -0.73±0.88 vs. -0.18±0.97, p sarcopenia group and 45.6% and 13.3% in the non-sarcopenia group (both p sarcopenia associated with increased the risk of osteopenia, osteoporosis, and a low BMD (OR = 3.227, 95% CI = 2.125–4.899, p sarcopenia was associated with increased the risk for decreased BMD in COPD. PMID:27749901

Hand bone mineral density reference values in a Turkish healthy female population.

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Alioglu, Kenan; Dogu, Beril; Sirzai, Hulya; Yilmaz, Figen; Kuran, Banu

2017-12-01

In this study we aimed at identifying the bone mineral density (BMD) reference values of hands, according to age, measured by dual-energy X-ray absorptiometry (DEXA) and assessing the correlation of these values with lumbar and femoral BMD values. A total of 403 healthy women aged between 20 and 70 participated in our study. All BMD measurements are performed by DEXA method on both hands, anteroposterior lumbar spine (L2-L4) and right femur (femoral neck, total femur) regions. BMD results of all the patients were divided to 10-year age categories and evaluated in five subgroups in total (20-30 to 61-70). Among the 10-year age categories we found both dominant and non-dominant hand peak bone mass values in the 31-40 years age group (0.423 ± 0.039 g/cm², 0.410 ± 0.043 g/cm², respectively). Statistically significant positive correlation was defined between dominant and non-dominant hand BMD values and L2-L4 spine, femur neck and total femur values (for dominant hand r = 0.636, P = 0.0001; r = 0.645, P = 0.0001; r = 0.623; P = 0.0001; for non-dominant hand r = 0.624, P = 0.0001; r = 0.637, P = 0.0001, r = 0.623, P = 0.0001, respectively). Regarding the relationship of age and menopause with BMD results, a negative statistical relationship was observed among dominant and non-dominant hand, L2-L4 spine, femoral neck and total femur BMD values (P = 0.0001). Our study has provided hand BMD reference values in women aged between 20-70 years; further studies are needed to investigate the role of these values in identifying diseases causing osteoporosis in the hand and in evaluating treatment. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Association of insulin resistance with near peak bone mass in the femur and lumbar spine of Korean adults aged 25-35: The Korean National Health and Nutrition Examination Survey 2008-2010.

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Min Soo Choo

Full Text Available This study aimed to evaluate the relationship between insulin resistance and the bone mineral density (BMD of femur and lumbar spine in Korean adults who are expected to exhibit near peak bone mass.Data from the Korean National Health and Nutrition Examination Survey 2008-2010 were analyzed. A total of 2,750 participants aged 25-35 years were included. Insulin resistance was assessed using a homeostatic model assessment of insulin resistance (HOMA-IR and serum fasting insulin.In a multivariate linear regression analysis, the HOMA-IR was significantly inversely associated with the BMD of the total hip (TH, β = -0.052, P = 0.002, femoral neck (FN, β = -0.072, P<0.001, femoral trochanter (FTr, β = -0.055, P = 0.003, femoral intertrochanter (FITr, β = -0.041, P = 0.015, and lumbar spine (LS, β = -0.063, P = 0.001 among all study subjects after adjustment for gender, age, height, weight, whole body fat mass percentage, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, vitamin D, smoking, alcohol intake, physical activity, education level, and household income in both genders as well as labor, the use of oral contraceptives, and age at menarche in females. The serum fasting insulin was significantly inversely associated with the BMD of the TH (β = -0.055, P = 0.001, FN (β = -0.072, P<0.001, FTr (β = -0.055, P = 0.003, FITr (β = -0.045, P = 0.009, and LS (β = -0.064, P = 0.001 among all subjects in a multivariate linear regression analysis.Our results suggest that insulin resistance may be independently and inversely associated with the near peak bone mass of the femur and lumbar spine.

Gender disparity in BMD conversion: a comparison between Lunar and Hologic densitometers.

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Ganda, Kirtan; Nguyen, Tuan V; Pocock, Nicholas

2014-01-01

Female-derived inter-conversion and standardised BMD equations at the lumbar spine and hip have not been validated in men. This study of 110 male subjects scanned on Hologic and Lunar densitometers demonstrates that published equations may not applicable to men at the lumbar spine. Male inter-conversion equations have also been derived. Currently, available equations for inter-manufacturer conversion of bone mineral density (BMD) and calculation of standardised BMD (sBMD) are used in both males and females, despite being derived and validated only in women. Our aim was to test the validity of the published equations in men. One hundred ten men underwent lumbar spine (L2-4), femoral neck (FN) and total hip (TH) dual X-ray absorptiometry (DXA) using Hologic and Lunar scanners. Hologic BMD was converted to Lunar using published equations derived from women for L2-4 and FN. Actual Lunar BMD (A-Lunar) was compared to converted (Lunar equivalent) Hologic BMD values (H-Lunar). sBMD was calculated separately using Hologic (sBMD-H) and Lunar BMD (sBMD-L) at L2-4, FN and TH. Conversion equations in men for Hologic to Lunar BMD were derived using Deming regression analysis. There was a strong linear correlation between Lunar and Hologic BMD at all skeletal sites. A-Lunar BMD was however significantly higher than derived H-Lunar BMD (p Lunar BMD to Hologic BMD, and formulae for lumbar spine sBMD, derived in women may not be applicable to men.

Lateral Cortical Thickening and Bone Heterogeneity of the Subtrochanteric Femur Measured With Quantitative CT as Indicators for Early Detection of Atypical Femoral Fractures in Long-Term Bisphosphonate Users.

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Lee, Seung Hyun; Lee, Young Han; Suh, Jin-Suck

2017-10-01

The objective of our study was to compare subtrochanteric femur bone mineral density (BMD) and bone quality of long-term bisphosphonate (BP) users who sustained an atypical femoral fracture (AFF) with BP users who did not sustain a femoral fracture and BP-naïve patients with no history of femoral fracture using quantitative CT (QCT). Fourteen female BP users with an AFF (mean age, 72.6 years; mean duration of BP use, 6.2 years; mean body mass index, 21.9) who had undergone QCT before fracture events were sex-, age-, BP use duration-, and body mass index-matched to 14 BP users who did not sustain a fracture and 14 BP-naïve patients. The lateral cortical thickness index (CTI) and the mean BMD (BMD mean ) and SD of the BMD (BMD SD ) within the lateral cortex and within the entire cross-sectional area of the subtrochanteric femur were measured on axial QCT. Femoral neck-shaft angles were measured on the QCT scout image. Parameters were analyzed using the Kruskal-Wallis test. Lateral CTIs were greater in the BP users with an AFF (median, 0.28) than in the BP users without a femoral fracture (median, 0.21) (p = 0.038) and the BP-naïve group (median, 0.21) (p = 0.009). The lateral cortex BMD SD was significantly higher in the BP users with an AFF (median, 59.59 mg/cm 3 ) than the BP users without a femoral fracture (median, 39.27 mg/cm 3 ; p = 0.049) and the BP-naïve group (median, 31.02 mg/cm 3 ; p = 0.037). There was no significant difference among groups in lateral cortex BMD mean , BMD mean and BMD SD of the entire cross-sectional area, and femoral neck-shaft angle. Long-term BP users with a subsequent AFF had a thicker lateral cortex and higher lateral cortex BMD SD at the subtrochanteric area before the fracture on QCT than BP users who did not sustain a femoral fracture and BP-naïve patients.

[Individual difference of coronal bowing of femur and its influence on the lower limbs alignment after the total knee arthroplasty].

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Wu, W; Guo, W S; Cheng, L M; Liu, Z H; Zhang, Q D; Zhang, N F

2017-04-04

Objective: To disclose the correlation between the femur bowing angle(FBA) and vulgas correction angle(VCA), anlysys its influence on the total knee arthroplasty and the lower limbs alignment. Methods: From Janurary 2013 to December 2015, 699 patients who had received total knee arthroplasty(TKA)were collected in the Department of Joint Surgery, China-Japan Friendship. The FBA, VCA, offset of the proximal femur, the lengh of the femur, the neck shaft angle of the femur of the eligible cases from the long leg X-ray were measured.All the data were analysed for the following steps: the FBA's mean value and characteristics of distributation of all the cases; the VCA's mean value and characteristics of distributation of all the cases; correlations between the VCA and the other parameters; divide all the cases into four groups based on the value of FBA : group A(FBA3°, 236)and then plan to cut the distal femur with 5° and 6°, respectively. The percent of ideal alignmental outcome's percentage of every group were compared. Results: The mean Value of the FBA is -7.1--12.1(1.4±2.4)°; the mean Value of the VCA is 2.5--11.9(6.5±1.3)°. The correlation index between VCA and FBA, the neck shaft angle of the femur , offset of the hip joint, the lengh of the femur is 0.72, -0.26, 0.45 and -0.08, perspectively. The theoretical ideal alignment percentage of the 5 degree-valgus-bone cut and 6 degree-valgus-bone cut in every group is group A: 89.7% and 66.5%; group B: 93.7% and 95.7%; group C: 71.9% and 94.6%; group D: 21.2% and 50.8%, respectively. Conclusion: The cases whose femur bowing angles are outliers are common in daily medical practice, so the vulgas correction angles need be ajusted for its significant correlation with FBA. 5 degree-valgus-bone cut or 6 degree-valgus-bone cut could not get the ideal alignment some times.

Sarcopenia as an Independent Risk Factor for Decreased BMD in COPD Patients: Korean National Health and Nutrition Examination Surveys IV and V (2008-2011.

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Dong-Won Lee

Full Text Available A decrease in bone mineral density (BMD is a systemic consequence of chronic obstructive pulmonary disease (COPD. Past reports have rarely examined any correlation between sarcopenia and BMD. We investigated the relationship cross-sectionally between the presence of sarcopenia and BMD reduction in COPD patients.COPD patients aged 50 or older with qualifying spirometry and dual-energy X-ray absorptiometry data were from participants in the Korean National Health and Nutrition Examination Surveys IV and V (2008-2011.There were 286 (33.3% subjects in the sarcopenia group and 572 (66.7% in the non-sarcopenia group. The sarcopenia group had lower T-scores than the non-sarcopenia group (femur: -0.73±0.88 vs. -0.18±0.97, p < 0.001; femur neck: -1.44±0.98 vs. -0.99±1.06, p < 0.001; lumbar: -1.38±1.36 vs. -0.84±1.38, p < 0.001. The prevalences of osteopenia and osteoporosis were 60.8% and 22.0%, respectively, in the sarcopenia group and 45.6% and 13.3% in the non-sarcopenia group (both p < 0.001. After adjusting for multiple variables, the presence of sarcopenia associated with increased the risk of osteopenia, osteoporosis, and a low BMD (OR = 3.227, 95% CI = 2.125-4.899, p < 0.001, OR = 6.952, 95% CI = 3.418-14.139, p < 0.001, and OR = 3.495, 95% CI = 2.315-5.278, p < 0.001, respectively. In a subgroup analysis, similar OR changes were confirmed in the high-body-weight group (n = 493 (OR = 2.248, 95% CI = 1.084-4.665, p = 0.030, OR = 4.621, 95% CI = 1.167-18.291, p = 0.029, and OR = 2.376, 95% CI = 1.158-4.877, p = 0.018, respectively.The presence of sarcopenia was associated with increased the risk for decreased BMD in COPD.

A method for assessment of the shape of the proximal femur and its relationship to osteoporotic hip fracture.

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Gregory, J S; Testi, D; Stewart, A; Undrill, P E; Reid, D M; Aspden, R M

2004-01-01

The shape of the proximal femur has been demonstrated to be important in the occurrence of fractures of the femoral neck. Unfortunately, multiple geometric measurements frequently used to describe this shape are highly correlated. A new method, active shape modeling (ASM) has been developed to quantify the morphology of the femur. This describes the shape in terms of orthogonal modes of variation that, consequently, are all independent. To test this method, digitized standard pelvic radiographs were obtained from 26 women who had suffered a hip fracture and compared with images from 24 age-matched controls with no fracture. All subjects also had their bone mineral density (BMD) measured at five sites using dual-energy X-ray absorptiometry. An ASM was developed and principal components analysis used to identify the modes which best described the shape. Discriminant analysis was used to determine which variable, or combination of variables, was best able to discriminate between the groups. ASM alone correctly identified 74% of the individuals and placed them in the appropriate group. Only one of the BMD values (Ward's triangle) achieved a higher value (82%). A combination of Ward's triangle BMD and ASM improved the accuracy to 90%. Geometric variables used in this study were weaker, correctly classifying less than 60% of the study group. Logistic regression showed that after adjustment for age, body mass index, and BMD, the ASM data was still independently associated with hip fracture (odds ratio (OR)=1.83, 95% confidence interval 1.08 to 3.11). The odds ratio was calculated relative to a 10% increase in the probability of belonging to the fracture group. Though these initial results were obtained from a limited data set, this study shows that ASM may be a powerful method to help identify individuals at risk of a hip fracture in the future.

Constitutive melanin density is associated with higher 25-hydroxyvitamin D and potentially total body BMD in older Caucasian adults via increased sun tolerance and exposure.

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Thompson, M J W; Jones, G; Aitken, D A

2018-06-01

Greater skin pigmentation reduces dose equivalent cutaneous vitamin D3 production, potentially impacting lifetime vitamin D status and fracture risk. We show that melanin density was positively associated with 25-hydroxyvitamin D and total body bone mineral density. These relationships were partially explained by greater sun exposure due to more permissive skin phenotype. Higher cutaneous melanin reduces vitamin D3 production. This may impact lifetime vitamin D status and increase fracture risk. This study aimed to describe the relationship between spectrophotometrically determined constitutive melanin density, osteoporotic risk factors and potential intermediaries in a cohort of exclusively older Caucasian adults. One thousand seventy-two community-dwelling adults aged 50-80 years had constitutive melanin density quantified using spectrophotometry. Sun exposure, skin phenotype, non-melanoma skin cancer (NMSC) prevalence and smoking status were assessed by questionnaire. Bone mineral density (BMD), falls risk, physical activity and 25-hydroxyvitamin D were measured using DXA, the short form Physiological Profile Assessment, pedometer and radioimmunoassay, respectively. Higher melanin density was independently associated with greater ability to tan (RR = 1.27, p density and sun exposure (RR = 1.05-1.11, p density (β = 1.71-2.05, p = 0.001). The association between melanin density and total body BMD (β = 0.007, p = 0.04) became non-significant after adjustment for 25-hydroxyvitamin D. There was no association between melanin density and physical activity, falls risk or BMD at other sites. Our data support a model of higher constitutive melanin density underpinning a less photosensitive skin phenotype, permitting greater sun exposure with fewer sequelae and yielding higher 25-hydroxyvitamin D and, potentially, total body BMD.

The association between major depressive disorder, use of antidepressants and bone mineral density (BMD) in men.

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Rauma, P H; Pasco, J A; Berk, M; Stuart, A L; Koivumaa-Honkanen, H; Honkanen, R J; Hodge, J M; Williams, L J

2015-06-01

Both depression and use of antidepressants have been negatively associated with bone mineral density (BMD) but mainly in studies among postmenopausal women. Therefore, the aim of this study was to investigate these relationships in men. Between 2006 and 2011, 928 men (aged 24-98 years) from the Geelong Osteoporosis Study completed a comprehensive questionnaire, clinical measurements and had BMD assessments at the forearm, spine, total hip and total body. Major depressive disorder (MDD) was identified using a structured clinical interview (SCID-I/NP). The cross-sectional associations between BMD and both MDD and antidepressant use were analyzed using multivariable linear regression. Of the study population, 84 (9.1%) men had a single MDD episode, 50 (5.4%) had recurrent episodes and 65 (7.0%) were using antidepressants at the time of assessment. Following adjustments, recurrent MDD was associated with lower BMD at the forearm and total body (-6.5%, P=0.033 and -2.5%, P=0.033, respectively compared to men with no history of MDD), while single MDD episodes were associated with higher BMD at the total hip (+3.4%, P=0.030). Antidepressant use was associated with lower BMD only in lower-weight men (depression and use of antidepressants should be taken into account as possible risk factors for osteoporosis in men.

Bone mineral density in lifelong trained male football players compared with young and elderly untrained men

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Marie Hagman

2018-04-01

Full Text Available Purpose: The purpose of the present controlled cross-sectional study was to investigate proximal femur and whole-body bone mineral density (BMD, as well as bone turnover profile, in lifelong trained elderly male football players and young elite football players compared with untrained age-matched men. Methods: One hundred and forty healthy, non-smoking men participated in the study, including lifelong trained football players (FTE, n = 35 aged 65–80 years, elite football players (FTY, n = 35 aged 18–30 years, as well as untrained age-matched elderly (UE, n = 35 and young (UY, n = 35 men. All participants underwent a regional dual-energy X-ray Absorptiometry (DXA scan of the proximal femur and a whole-body DXA scan to determine BMD. From a resting blood sample, the bone turnover markers (BTMs osteocalcin, carboxy-terminal type-1 collagen crosslinks (CTX-1, procollagen type-1 amino-terminal propeptide (P1NP, and sclerostin were measured. Results: FTE had 7.3%–12.9% higher (p < 0.05 BMD of the femoral neck, wards, shaft, and total proximal femur in both legs compared to UE, and 9.3%–9.7% higher (p < 0.05 BMD in femoral trochanter in both legs compared to UY. FTY had 24.3%–37.4% higher (p < 0.001 BMD in all femoral regions and total proximal femur in both legs compared to UY. The whole-body DXA scan confirmed these results, with FTE showing similar whole-body BMD and 7.9% higher (p < 0.05 leg BMD compared to UY, and with FTY having 9.6% higher (p < 0.001 whole-body BMD and 18.2% higher (p < 0.001 leg BMD compared to UY. The plasma concentration of osteocalcin, CTX-1, and P1NP were 29%, 53%, and 52% higher (p < 0.01, respectively, in FTY compared to UY. Conclusion: BMD of the proximal femur and whole-body BMD are markedly higher in lifelong trained male football players aged 65–80 years and young elite football players aged 18–30 years compared to age-matched untrained men. Elderly football

Age-related proximal femur bone mineral loss in South Indian women: a dual energy X-ray absorptiometry study.

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Anburajan, M; Rethinasabapathi, C; Korath, M P; Ponnappa, B G; Kumar, K S; Panicker, T M; Govindan, A; Jagadeesan, G N

2001-04-01

i) To collect normative data for proximal femur bone mineral density (BMD) in South Indian women using dual energy X-ray absorptiometry (DXA) and ii) to study the rate and significance of hip bone mineral loss with advancing age in this population. Forty five women, whose age ranged from 16 to 84 years were studied. This sample was drawn randomly from general medical practice at KJ Hospital, Chennai, South India during November, 1997 to April, 1998. Of these 45 cases, 21 were pre-menopausal (mean +/- SD age = 30.9+/-8.8 years) and 24 post-menopausal (mean +/- SD age = 62.1+/-11.0 years). Subjects with secondary bone diseases were excluded. Also excluded were those taking any drugs known to affect calcium metabolism e.g., thiazide diuretics, oestrogen and calcium. Subjects were divided into seven decadal age groups from 15-24 years to 75-84 years. BMD of the right proximal femur was evaluated using a QDR-1000 DXA bone densitometer (Hologic Inc., Waltham, Massachusetts, USA). Data analysis was done with SPSS/PC statistical software package. Linear regression analysis showed significant (p India women have been evaluated and it may prove useful for diagnosing osteoporosis in the women of South India.

The role of hip and chest radiographs in osteoporotic evaluation among south Indian women population: a comparative scenario with DXA.

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Kumar, D Ashok; Anburajan, M

2014-05-01

Osteoporosis is recognized as a worldwide skeletal disorder problem. In India, the older as well as postmenopausal women population suffering from osteoporotic fractures has been a common issue. Bone mineral density measurements gauged by dual-energy X-ray absorptiometry (DXA) are used in the diagnosis of osteoporosis. (1) To evaluate osteoporosis in south Indian women by radiogrammetric method in a comparative perspective with DXA. (2) To assess the capability of KJH; Anburajan's Empirical formula in the prediction of total hip bone mineral density (T.BMD) with estimated Hologic T.BMD. In this cross-sectional design, 56 south Indian women were evaluated. These women were randomly selected from a health camp. The patients with secondary bone diseases were excluded. The standard protocol was followed in acquiring BMD of the right proximal femur by DPX Prodigy (DXA Scanner, GE-Lunar Corp., USA). The measured Lunar Total hip BMD was converted into estimated Hologic Total hip BMD. In addition, the studied population underwent chest and hip radiographic measurements. Combined cortical thickness of clavicle has been used in KJH; Anburajan's Empirical formula to predict T.BMD and compared with estimated Hologic T.BMD by DXA. The correlation coefficients exhibited high significance. The combined cortical thickness of clavicle and femur shaft of total studied population was strongly correlated with DXA femur T.BMD measurements (r = 0.87, P < 0.01 and r = 0.45, P < 0.01) and it is also having strong correlation with low bone mass group (r = 0.87, P < 0.01 and r = 0.67, P < 0.01) KJH; Anburajan's Empirical formula shows significant correlation with estimated Hologic T.BMD (r = 0.88, P < 0.01) in total studied population. The empirical formula was identified as better tool for predicting osteoporosis in total population and old-aged population with a sensitivity (88.8 and 95.6 %), specificity (89.6 and 90.9 %), positive predictive value (88.8 and 95.6 %) and negative

Bone mineral density in midlife women: the Study of Women's Health in Qatar.

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Gerber, L M; Bener, A; Al-Ali, H M; Hammoudeh, M; Liu, L Q; Verjee, M

2015-04-01

The aim of this study is to investigate bone mineral density (BMD) for a large cross-section of midlife Arab women living in Qatar and to evaluate the association of body mass index (BMI), menopause status, and nationality, on BMD of the spine and femur. A cross-sectional study was conducted among women aged 40-60 years recruited from nine primary-care health centers in Qatar. BMD (g/m(2)) was assessed at the lumbar spine and the femur. The combined prevalence of osteopenia and osteoporosis was 4% at the femur and 16.2% at the spine. BMI and menstrual status were both independently associated with BMD at the spine and at the femur (all p values < 0.001). As BMI increased, BMD increased at both the spine and femur. Women who menstruated in the past 12 months had 0.82 g/cm(2) and 0.61 g/cm(2) greater BMD at the spine and femur, respectively, compared with women who had not menstruated in 12 months. Nationality was not associated with mean BMD of the spine or the femur. No significant differences were observed between Qatari and non-Qatari women in terms of mean BMD values at the spine and the femur except for the femur in the age group 55-60, where values were lower among non-Qataris (p = 0.04). Multivariable analyses showed that BMI and menstrual status were found to be strongly associated with BMD levels at the spine and femur. The high prevalence of obesity observed in this sample may explain the low levels of osteopenia and osteoporosis observed.

Total femur arthroplasty for revision hip failure in osteogenesis imperfecta: limits of biology

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Pablo Sanz-Ruiz, PhD, MD

2017-09-01

Full Text Available Osteogenesis imperfecta (OI is a rare congenital disease characterized by alterations in bone quality, with susceptibility to fractures, instability, deformities, and osteoarthrosis. Prosthetic surgery in these patients is associated with an abnormally high rate of implant failures. On the other hand, abnormal bone fragility adds to the complexity of revision surgery in such individuals—thus representing a genuine challenge for the orthopaedic surgeon. We present a case of femoral reconstruction in a patient with OI and prosthetic loosening after reconstruction secondary to femoral septic pseudoarthrosis. Intramedullary total femoral reconstruction was carried out after exceeding the biological reconstruction limits. This is the first reported instance of the use of an intramedullary total femur arthroplasty as salvage technique in an OI patient. This technique should be considered when we have exceeded biological limits for femoral fixation.

Correlation between bone mineral density of jaws and skeletal sites in an Iranian population using dual X-ray energy absorptiometry.

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Esfahanizadeh, Nasrin; Davaie, Sotoudeh; Rokn, A R; Daneshparvar, Hamid Reza; Bayat, Noushin; Khondi, Nasrin; Ajvadi, Sara; Ghandi, Mostafa

2013-07-01

The aim of the present study was to evaluate the relationship between the bone density of various regions of jaws and skeletal bones. A total of 110 patients with a mean age of 55.01 ± 10.77 years were selected for the purpose of the present descriptive study. Dual X-ray Energy Absorptiometry (DXA) was carried out to determine bone mineral density (BMD) of the femur and lumbar vertebrae. Then all the subjects underwent DXA of the jaw bones and BMD values were determined at four jaw regions. Data were analyzed by SPSS 16 statistical software, and the correlation between the various BMD values was determined by Pearson's correlation coefficient. The results showed that 42.7% of females had normal BMD values in the femur, and in vertebrae, 20% were osteopenic and 37.3% suffered from osteoporosis, with statistically significant differences in the BMD values of the jaws between the three above-mentioned groups (P < 0.001). There was an increasing tendency toward osteopenia and osteoporosis with age. There was a positive correlation between BMD values of the femur and lumbar vertebrae and those of all the jaw regions under study (P < 0.005). There was a negative correlation (P < 0.01) between age and the BMD values of the femur, lumbar vertebrae and anterior maxilla. The bone density of the maxilla and mandible and presence of osteoporosis or osteopenia in these bones might reflect the same problem in skeletal bones.

Evaluation of Bone Mineral Density in Children with Thalassemia Major

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Betül Bakan

2012-12-01

Full Text Available Aim: Fragile bones develop due to various factors in thalassemic patients. Even with optimum management, osteoporosis occurs, contributing to morbidity in majority of patients with thalassemia major (TM. Our aim was to evaluate bone health of thalassemic children using biochemical parameters and bone mineral density (BMD, and to emphasize the precautionary measures and early diagnosis of osteoporosis. Material and Methods: Thirteen children (5 females, 8 males, age <18 years with TM were included in the study. Age, duration, weight, height, transfusion frequency, medication use were recorded. Following laboratory analysis were obtained: Whole blood count, fasting blood glucose, ferritin, alanine aminotransferase, aspartate aminotransferase, calcium, phosphorus, alkaline phosphatase, thyroid stimulating hormone, free thyroxin, and intact parathyroid hormone (iPTH. BMD was determined using dual energy X-ray absorptiometry (DXA from femur and lumbar vertebrae. Patients with DXA Z-score <-2 was defined as osteoporotic. Results: The mean age was 7.85±3.17 years and body mass index (BMI was 14.68±1.93 kg/m2. The rest of the results were as follows: Lumbar BMD 0.464±0.108 g/cm2; total femur BMD 0.581± 0.114 g/cm2; lumbar DEXA Z-score 2.44±1.60; total femur DEXA -0.93±1.19. Osteoporosis ratio was determined as 69% in the lumbar vertebrae and 10% in the femur. A significant positive correlation was found between lumbar-femoral BMD and BMI, and a significant negative correlation was observed between femoral BMD and iPTH. Conclusion: BMD is low in thalassemic children. Despite regular transfusions and chelation therapy, osteoporosis starts early in life. (Turkish Journal of Osteoporosis 2012;18: 72-7

Treatment of Unstable Trochanteric Femur Fractures: Proximal Femur Nail Versus Proximal Femur Locking Compression Plate.

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Singh, Ashutosh Kumar; Narsaria, Nidi; G R, Arun; Srivastava, Vivek

Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients). Perioperative data and complications were recorded. All cases were followed up for 2 years. The groups did not differ significantly (P > .05) in operative time, reduction quality, complications, hospital length of stay, union rate, or time to union. Compared with the PFLCP group, the PFN group had shorter incisions and less blood loss. Regarding functional outcomes, there was no significant difference in mean Harris Hip Score (P = .48) or Palmer and Parker mobility score (P = .58). Both PFN and PFLCP are effective in internal fixation of unstable trochanteric femur fractures.

BONE MINERAL DENSITY IN MIDLIFE WOMEN: THE STUDY OF WOMEN’S HEALTH IN QATAR

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Gerber, Linda M.; Bener, Abdulbari; Al-Ali, Hala M.; Hammoudeh, Mohammed; Liu, Lyn Q.; Verjee, Mohamud

2015-01-01

Objectives The aim of this study is to investigate bone mineral density (BMD) for a large cross-section of midlife Arab women living in Qatar and to evaluate the association of body mass index, menopause status, and nationality, on BMD of the spine and femur. Study design A cross-sectional study was conducted among women aged 40–60 recruited from nine primary care health centers in Qatar. BMD (g/m2) was assessed at the lumbar spine and the femur. Results The combined prevalence of osteopenia and osteoporosis was 4% at the femur and 16.2% at the spine. BMI and menstrual status were both independently associated with BMD at the spine and at the femur (all p values Nationality was not associated with mean BMD of the spine or the femur. Conclusions No significant differences were observed between Qatari and non-Qatari women in terms of mean BMD values at the spine and the femur except for femur in the age group 55–60, where values were lower among non-Qataris (p=0.04). Multivariate analysis showed that BMI and menstrual status were found to be strongly associated with BMD levels at the spine and femur. The high prevalence of obesity observed in this sample may explain the low levels of osteopenia and osteoporosis observed. PMID:25032729

Bone mineral density change during adjuvant chemotherapy in pediatric osteosarcoma

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Ju Hyun Ahn

2015-09-01

Full Text Available PurposeOsteoporosis is currently receiving particular attention as a sequela in survivors of childhood osteosarcoma. The aim of this study was to evaluate bone mineral density (BMD changes during methotrexate-based chemotherapy in children and adolescents with osteosarcoma.MethodsNine patients with osteosarcoma were included in this retrospective study and compared with eight healthy controls. BMD of the lumbar spine and unaffected femur neck of patients was serially measured by dual-energy x-ray absorptiometry (DXA before and just after chemotherapy and compared with controls.ResultsFour patients (44% showed decreased lumbar spine BMD and seven patients (78% showed decreased femur neck BMD, while all controls showed increased lumbar and femur BMD (P=0.024 and P=0.023. The femur neck BMD z-scores decreased from -0.49±1.14 to -1.63±1.50 (P=0.032. At the end of therapy, five patients (56% showed femur neck BMD z-scores below -2.0.ConclusionThe bone metabolism is disturbed during therapy in children with osteosarcoma, resulting in a reduced BMD with respect to healthy controls. Since a reduced BMD predisposes to osteoporosis, specific attention and therapeutic interventions should be considered.

Correlation between bone mineral density of jaws and skeletal sites in an Iranian population using dual X-ray energy absorptiometry

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Nasrin Esfahanizadeh

2013-01-01

Full Text Available Background: The aim of the present study was to evaluate the relationship between the bone density of various regions of jaws and skeletal bones. Materials and Methods: A total of 110 patients with a mean age of 55.01 ± 10.77 years were selected for the purpose of the present descriptive study. Dual X-ray Energy Absorptiometry (DXA was carried out to determine bone mineral density (BMD of the femur and lumbar vertebrae. Then all the subjects underwent DXA of the jaw bones and BMD values were determined at four jaw regions. Data were analyzed by SPSS 16 statistical software, and the correlation between the various BMD values was determined by Pearson′s correlation coefficient. Results: The results showed that 42.7% of females had normal BMD values in the femur, and in vertebrae, 20% were osteopenic and 37.3% suffered from osteoporosis, with statistically significant differences in the BMD values of the jaws between the three above-mentioned groups (P < 0.001. There was an increasing tendency toward osteopenia and osteoporosis with age. There was a positive correlation between BMD values of the femur and lumbar vertebrae and those of all the jaw regions under study (P < 0.005. There was a negative correlation (P < 0.01 between age and the BMD values of the femur, lumbar vertebrae and anterior maxilla. Conclusion: The bone density of the maxilla and mandible and presence of osteoporosis or osteopenia in these bones might reflect the same problem in skeletal bones.

PTHR1 polymorphisms influence BMD variation through effects on the growing skeleton

DEFF Research Database (Denmark)

Vilariño-Güell, Carles; Miles, Lisa J; Duncan, Emma L

2007-01-01

. A cohort of 634 families, including 1,236 men (39%) and 1,926 women (61%) ascertained with probands with low BMD (Z... most informative SNPs (minor allele frequency >5%) and the tetranucleotide repeat. In our osteoporosis families, association was noted between lumbar spine BMD and alleles of a known functional tetranucleotide repeat (U4) in the PTHR1 promoter region (P = 0.042) and between two and three marker...... haplotypes of PTHR1 polymorphisms with lumbar spine, femoral neck, and total hip BMD (P = 0.021-0.047). This association was restricted to the youngest tertile of the population (age 16-39 years, P = 0.013-0.048). A similar association was found for the ALSPAC cohort: two marker haplotypes of SNPs A48609T...

The characteristic of rBMD distribution in lumbar vertebral body

International Nuclear Information System (INIS)

Wang Chenguang; Xiao Xiangsheng; Chen Xingrong; Shen Tianzhen; Liu Guanghua; Hong Qingjian; Ji Rongming; Zhou Weiming

1998-01-01

Purpose: To determine the distribution and variation of rBMD in human lumbar vertebral body. Methods: The BMD and rBMD of 28 samples of lumbar body were measured with QCT. The rBMD was measured in the regions of anterior, anterolateral, posterolateral and central, superior-level, middle-level and inferior-level of the vertebral bodies. The relationship between BMD and rBMD were statistically analysed with multiple regression. Results: The rBMD of the inferior vertebral body was higher than that of the superior and middle portions (P<0.05); the central and posterolateral higher than the anterior and anterolateral (P<0.05). The rBMD of posterioinferior vertebral body was the highest. The multiple regression showed that the standard partial regression coefficient of inferior was larger than the superior and middle; the anterior and central were larger than the other regions of the vertebra. Variations of the BMD of vertebral body were mostly related to the rBMD of anterior and central parts. Conclusion: The distribution of BMD are heterogeneous in vertebral body. The anterior and central part of vertebral body are most sensitive to bone loss in osteoporosis. It is emphasized that the rBMD of anterior and central part of vertebral body should be measured for following the osteoporosis

Bone Mineral Density, Mechanical, Microstructural Properties and Mineral Content of the Femur in Growing Rats Fed with Cactus Opuntia ficus indica (L.) Mill. (Cactaceae) Cladodes as Calcium Source in Diet.

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Hernández-Becerra, Ezequiel; Gutiérrez-Cortez, Elsa; Del Real, Alicia; Rojas-Molina, Alejandra; Rodríguez-García, Mario; Rubio, Efraín; Quintero-García, Michelle; Rojas-Molina, Isela

2017-02-04

Mechanical, microstructural properties, mineral content and bone mineral density (BMD) of the femur were evaluated in growing rats fed with Opuntia ficus indica (L.) Mill. (Cactaceae) cladodes at different maturity stages as calcium source. Male weanling rats were fed with cladodes at early maturity stage (25 and 60 days of age, belonging to groups N-60 and N-200, respectively) and cladodes at late maturity stage (100 and 135 days of age, belonging to groups N-400 and N-600, respectively) for 6 weeks. Additionally, a control group fed with calcium carbonate as calcium source was included for comparative purposes. All diets were fitted to the same calcium content (5 g/kg diet). The failure load of femurs was significantly lower ( p ≤ 0.05) in groups N-60 and N-200 in comparison to N-400, N-600 and control groups. The cortical width (Ct.Wi) and trabecular thickness (Tb.Th) of the femurs in control and N-600 groups were significantly higher ( p ≤ 0.05) than Ct.Wi and Tb.Th of femurs in groups N-60 and N-200. Trabecular separation of the femurs in N-60 and N-200 groups showed the highest values compared with all experimental groups. The highest calcium content in the femurs were observed in control, N-600 and N-400 groups; whereas the lowest phosphorus content in the bones were detected in N-200, N-600 and N-400 groups. Finally, the BMD in all experimental groups increased with age; nevertheless, the highest values were observed in N-600 and control groups during pubertal and adolescence stages. The results derived from this research demonstrate, for the first time, that the calcium found in Opuntia ficus indica cladodes is actually bioavailable and capable of improving mineral density and mechanical and microstructural properties of the bones. These findings suggest that the consumption of cladodes at late maturity stage within the diet might have a beneficial impact on bone health.

Bone Mineral Density, Mechanical, Microstructural Properties and Mineral Content of the Femur in Growing Rats Fed with Cactus Opuntia ficus indica (L. Mill. (Cactaceae Cladodes as Calcium Source in Diet

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Ezequiel Hernández-Becerra

2017-02-01

Full Text Available Mechanical, microstructural properties, mineral content and bone mineral density (BMD of the femur were evaluated in growing rats fed with Opuntia ficus indica (L. Mill. (Cactaceae cladodes at different maturity stages as calcium source. Male weanling rats were fed with cladodes at early maturity stage (25 and 60 days of age, belonging to groups N-60 and N-200, respectively and cladodes at late maturity stage (100 and 135 days of age, belonging to groups N-400 and N-600, respectively for 6 weeks. Additionally, a control group fed with calcium carbonate as calcium source was included for comparative purposes. All diets were fitted to the same calcium content (5 g/kg diet. The failure load of femurs was significantly lower (p ≤ 0.05 in groups N-60 and N-200 in comparison to N-400, N-600 and control groups. The cortical width (Ct.Wi and trabecular thickness (Tb.Th of the femurs in control and N-600 groups were significantly higher (p ≤ 0.05 than Ct.Wi and Tb.Th of femurs in groups N-60 and N-200. Trabecular separation of the femurs in N-60 and N-200 groups showed the highest values compared with all experimental groups. The highest calcium content in the femurs were observed in control, N-600 and N-400 groups; whereas the lowest phosphorus content in the bones were detected in N-200, N-600 and N-400 groups. Finally, the BMD in all experimental groups increased with age; nevertheless, the highest values were observed in N-600 and control groups during pubertal and adolescence stages. The results derived from this research demonstrate, for the first time, that the calcium found in Opuntia ficus indica cladodes is actually bioavailable and capable of improving mineral density and mechanical and microstructural properties of the bones. These findings suggest that the consumption of cladodes at late maturity stage within the diet might have a beneficial impact on bone health.

Reproducibility of central lumbar vertebral BMD

International Nuclear Information System (INIS)

Chan, F.; Pocock, N.; Griffiths, M.; Majerovic, Y.; Freund, J.

1997-01-01

Full text: Lumbar vertebral bone mineral density (BMD) using dual X-ray absorptiometry (DXA) has generally been calculated from a region of interest which includes the entire vertebral body. Although this region excludes part of the transverse processes, it does include the outer cortical shell of the vertebra. Recent software has been devised to calculate BMD in a central vertebral region of interest which excludes the outer cortical envelope. Theoretically this area may be more sensitive to detecting osteoporosis which affects trabecular bone to a greater extent than cortical bone. Apart from the sensitivity of BMD estimation, the reproducibility of any measurement is important owing to the slow rate of change of bone mass. We have evaluated the reproducibility of this new vertebral region of interest in 23 women who had duplicate lumbar spine DXA scans performed on the same day. The patients were repositioned between each measurement. Central vertebral analysis was performed for L2-L4 and the reproducibility of area, bone mineral content (BMC) and BMD calculated as the coefficient of variation; these values were compared with those from conventional analysis. Thus we have shown that the reproducibility of the central BMD is comparable to the conventional analysis which is essential if this technique is to provide any additional clinical data. The reasons for the decrease in reproducibility of the area and hence BMC requires further investigation

Evaluation of Cerebral Cortex Function in Clients with Bipolar Mood Disorder I (BMD I Compared With BMD II Using QEEG Analysis

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Ali Khaleghi

2015-10-01

Full Text Available Objective: Early diagnosis of type I and type II bipolar mood disorder is very challenging particularly in adolescence. Hence, we aimed to investigate the cerebral cortex function in these patients, using quantitative electroencephalography analysis to obtain significant differences between them.Methods: Thirty- eight adolescents (18 patients with bipolar disorder I and 20 with BMD II participated in this study. We recorded the electroencephalogram signals based on 10-20 international system by 21 electrodes in eyes open and eyes closed condition resting conditions. Forty seconds segments were selected from each recorded signals with minimal noise and artifacts. Periodogram Welch was used to estimate power spectrum density from each segment. Analysis was performed in five frequency bands (delta, theta, alpha, beta and gamma, and we assessed power, mean, entropy, variance and skewness of the spectrums, as well as mean of the thresholded spectrum and thresholded spectrogram. We only used focal montage for comparison. Eventually, data were analyzed by independent Mann-Whitney test and independent t test.Results: We observed significant differences in some brain regions and in all frequency bands. There were significant differences in prefrontal lobe, central lobe, left parietal lobe, occipital lobe and temporal lobe between BMD I and BMD II (P < 0.05. In patients with BMD I, spectral entropy was compared to patients with BMD II. The most significant difference was observed in the gamma frequency band. Also, the power and entropy of delta frequency band was larger in the left parietal lobe in the BMD I patients compared to BMD II patients (P < 0.05. In the temporal lobe, significant differences were observed in the spectrum distribution of beta and gamma frequency bands (P < 0.05.Conclusion: The QEEG and entropy measure are simple and available tools to help detect cerebral cortex deficits and distinguish BMD I from BMD II.

CTXA hip--an extension of classical DXA measurements using quantitative CT.

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Cann, Christopher E; Adams, Judith E; Brown, J Keenan; Brett, Alan D

2014-01-01

Bone mineral density (BMD) estimates for the proximal femur using Dual Energy X-ray Absorptiometry (DXA) are currently considered the standard for making a diagnosis of osteoporosis in an individual patient using BMD alone. We have compared BMD results from a commercial Quantitative CT (QCT) BMD analysis system, "CTXA Hip", which provides clinical data for the proximal femur, to results from DXA. We have also used CTXA Hip to determine cortical and trabecular contributions to total BMD. Sixty-nine patients were scanned using 3D QCT and DXA. CTXA Hip BMD measurements for Total Hip and Femoral Neck were compared to DXA results. Twenty-two women were scanned at 0, 1, 2 years and CTXA Hip and DXA results analyzed for long-term reproducibility. Long-term reproducibility calculated as root-mean-square averages of SDs in vivo was 0.012 g/cm2 (CV = 1.8%) for CTXA Total Hip and 0.011 g/cm2 (CV = 2.0%) for CTXA Femoral Neck compared to 0.014 g/cm2 (CV = 2.0%) and 0.016 g/cm2 (CV = 2.7%), respectively, for DXA. The correlation of Total Hip BMD CTXA vs. DXA was R = 0.97 and for Femoral Neck was R = 0.95 (SEE 0.044 g/cm2 in both cases). Cortical bone comprised 62±5% (mean ± SD) of total hipbone mass in osteoporotic women. CTXA Hip provides substantially the same clinical information as conventional DXA and in addition provides estimates of BMD in separate cortical and trabecular bone compartments, which may be useful in evaluation of bone strength.

CTXA hip--an extension of classical DXA measurements using quantitative CT.

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Christopher E Cann

Full Text Available Bone mineral density (BMD estimates for the proximal femur using Dual Energy X-ray Absorptiometry (DXA are currently considered the standard for making a diagnosis of osteoporosis in an individual patient using BMD alone. We have compared BMD results from a commercial Quantitative CT (QCT BMD analysis system, "CTXA Hip", which provides clinical data for the proximal femur, to results from DXA. We have also used CTXA Hip to determine cortical and trabecular contributions to total BMD. Sixty-nine patients were scanned using 3D QCT and DXA. CTXA Hip BMD measurements for Total Hip and Femoral Neck were compared to DXA results. Twenty-two women were scanned at 0, 1, 2 years and CTXA Hip and DXA results analyzed for long-term reproducibility. Long-term reproducibility calculated as root-mean-square averages of SDs in vivo was 0.012 g/cm2 (CV = 1.8% for CTXA Total Hip and 0.011 g/cm2 (CV = 2.0% for CTXA Femoral Neck compared to 0.014 g/cm2 (CV = 2.0% and 0.016 g/cm2 (CV = 2.7%, respectively, for DXA. The correlation of Total Hip BMD CTXA vs. DXA was R = 0.97 and for Femoral Neck was R = 0.95 (SEE 0.044 g/cm2 in both cases. Cortical bone comprised 62±5% (mean ± SD of total hipbone mass in osteoporotic women. CTXA Hip provides substantially the same clinical information as conventional DXA and in addition provides estimates of BMD in separate cortical and trabecular bone compartments, which may be useful in evaluation of bone strength.

Bone mineral density in lifelong trained male football players compared with young and elderly untrained men

DEFF Research Database (Denmark)

Hagman, Marie; Helge, Eva Wulff; Hornstrup, Therese

2018-01-01

001) BMD in all femoral regions and total proximal femur in both legs compared to UY. The whole-body DXA scan confirmed these results, with FTE showing similar whole-body BMD and 7.9% higher (p 0.05) leg BMD compared to UY, and with FTY having 9.6% higher (p 001) whole-body BMD and 18.2...... men. Methods: One hundred and forty healthy, non-smoking men participated in the study, including lifelong trained football players (FTE, n = 35) aged 65-80 years, elite football players (FTY, n = 35) aged 18-30 years, as well as untrained age-matched elderly (UE, n = 35) and young (UY, n = 35) men....... All participants underwent a regional Dual-Energy X-ray Absorptiometry (DXA) scan of the proximal femur and a whole-body DXA scan to determine BMD. From a resting blood sample, the bone turnover markers (BTMs) osteocalcin, carboxy-terminal type-1 collagen crosslinks (CTX-1), procollagen type-1 amino...

CT evaluation of bone mineral density (BMD) of lumbar spine in patients after gastrectomy

International Nuclear Information System (INIS)

Ito, Masako; Hayashi, Kuniaki; Uetani, Masataka; Eto, Toshifumi; Matsumoto, Teiji; Yamada, Naoyuki.

1990-01-01

The late postoperative complications in patients after gastrectomy include anemia and metabolic bone disorders. We studied to determine whether gastric surgery is associated with metabolic bone disease. Vertebral BMD was measured in 55 patients after gastric resection by using DEQCT (dual energy quantitative CT). Forty patients were symptomatic, having bone or joint pain, history of bone fracture, or dental caries. The control group consisted of 161 patients without metabolic bone disorders. Forty percent of the patients with either the symptoms or history of bone fracture or dental caries, and 20% of the patients without the symptoms or the history showed decreased BMD. BMD was significantly lower in males in their 60s and in females in their 50s and 70s than BMD in age-matched control groups. When male subjects were grouped according to the years following the operation (1-5, 6-10, 11-15, 16-20 years), BMD was found to be decreased in 27%, 29%, 40% and 50% of the patients in each group, respectively, and the degree of the decrease tended to be greater with increasing time after surgery. Higher incidence of decreased BMD was found in the patients after total gastrectomy when compared with those after subtotal gastrecotmy. Among the patients with subtotal gastrectomy, the incidence of decreased BMD was higher in patients with Billroth II anastomosis than in those with Billroth I anastomosis. In cases with compression fracture on thoracolumbar radiographs, BMD was significantly lower in comparison with cases with no fracture. It was difficult to differentiate between osteomalacia and osteoporosis only by the thoracolumbar radiographs. While the clinical information such as patients' complaints, histories of fracture and laboratory findings are important to evaluate the bone changes following gastric resection. BMD measurement is most useful in quantitatively determining the degree of bone loss after gastrectomy. (author)

CT evaluation of bone mineral density (BMD) of lumbar spine in patients after gastrectomy

Energy Technology Data Exchange (ETDEWEB)

Ito, Masako; Hayashi, Kuniaki; Uetani, Masataka; Eto, Toshifumi; Matsumoto, Teiji (Nagasaki Univ. (Japan). School of Medicine); Yamada, Naoyuki

1990-11-01

The late postoperative complications in patients after gastrectomy include anemia and metabolic bone disorders. We studied to determine whether gastric surgery is associated with metabolic bone disease. Vertebral BMD was measured in 55 patients after gastric resection by using DEQCT (dual energy quantitative CT). Forty patients were symptomatic, having bone or joint pain, history of bone fracture, or dental caries. The control group consisted of 161 patients without metabolic bone disorders. Forty percent of the patients with either the symptoms or history of bone fracture or dental caries, and 20% of the patients without the symptoms or the history showed decreased BMD. BMD was significantly lower in males in their 60s and in females in their 50s and 70s than BMD in age-matched control groups. When male subjects were grouped according to the years following the operation (1-5, 6-10, 11-15, 16-20 years), BMD was found to be decreased in 27%, 29%, 40% and 50% of the patients in each group, respectively, and the degree of the decrease tended to be greater with increasing time after surgery. Higher incidence of decreased BMD was found in the patients after total gastrectomy when compared with those after subtotal gastrecotmy. Among the patients with subtotal gastrectomy, the incidence of decreased BMD was higher in patients with Billroth II anastomosis than in those with Billroth I anastomosis. In cases with compression fracture on thoracolumbar radiographs, BMD was significantly lower in comparison with cases with no fracture. It was difficult to differentiate between osteomalacia and osteoporosis only by the thoracolumbar radiographs. While the clinical information such as patients' complaints, histories of fracture and laboratory findings are important to evaluate the bone changes following gastric resection. BMD measurement is most useful in quantitatively determining the degree of bone loss after gastrectomy. (author).

Factors in relation to bone mineral density in Korean middle-aged and older men: 2008-2010 Korea National Health and Nutrition Examination Survey.

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Yang, Yoon Jung; Kim, Jihye

2014-01-01

Studies on determinants of bone mineral density (BMD) among Asian middle-aged and older men are very limited. The aim of this study was to investigate general determinants and dietary factors influencing BMD in Korean middle-aged and older men. This study was conducted using data from the 2008-2010 Korea National Health and Nutrition Examination Survey. A total of 2,305 male subjects aged 50-79 years were included. Whole-body, total femur, femoral neck, and lumbar spine BMDs were measured by dual-energy X-ray absorptiometry. Dietary intake was estimated by 24-hour dietary recall. A food frequency questionnaire for 63 food items was also administered. Proportions of osteoporosis at the total femur, femoral neck, and lumbar spine were 0.7, 3.3 and 7.0%, respectively. Age, height, weight, body mass index, fat mass, lean body mass, waist circumference, serum vitamin D, parathyroid hormone, and exercise were related to BMD, but the relationships were site specific. Diet quality and intake of vegetables, fruits, and calcium were associated with BMD. These results suggest that a high-quality diet, an adequate intake of fruits, vegetables, and calcium, as well as exercise, high serum vitamin D and weight maintenance might be determinants of BMD among middle-aged and older Asian men.

A hospital based study of biochemical markers of bone turnovers & bone mineral density in north Indian women

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Kumar, Ashok; Devi, Salam Gyaneshwori; Mittal, Soniya; Shukla, Deepak Kumar; Sharma, Shashi

2013-01-01

Background & objectives: The osteoporotic risk for women increases soon after menopause. Bone turnover markers are known to be associated with bone loss and fracture risk. This study was aimed to assess bone turnover using bone markers and their correlation with bone mineral density (BMD) in pre- and post-menopausal women. Methods: A total of 255 healthy women (160 pre- and 95 post-menopausal) were enrolled. Serum bone alkaline phosphatase (sBAP) and serum N-terminal telopeptide of type I collagen (NTX) were measured to evaluate the bone formation and resorption, respectively. Bone mineral density was determined at lumbar spine (L2-L4) anteroposteriorly, femoral neck and Ward's triangle using Prodigy dual-energy X-ray absorptiometry (DXA) system. The comparison of years since menopause with respect to BMD and bone markers was also evaluated. Results: NTX and sBAP showed significant negative correlation with BMD of femur neck and Ward's triangle in postmenopausal women. BMD of all three sides were significant variables for NTX and BMD of femur neck and Ward's triangle for sBAP in postmenopausal women. BMD lumbar spine was a significant variable for sBAP in premenopausal women. The mean values of NTX increased significantly with increase in the duration of years since menopause. The BMD of all three sides decreased significantly with increase in the duration of years since menopause. Interpretation & conclusions: Serum NTX and sBAP were inversely correlated to BMD of femur neck and Ward's triangle in post-menopausal women. Simultaneous measurements of NTX and BMD in the north Indian women, suggest that bone resorption in women with low BMD remains high after menopause. PMID:23481051

Pediatric femur fractures, epidemiology and treatment

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Petković Lazar

2011-01-01

Full Text Available Background/Aim. Femur fractures in children most often occur as a consequence of traffic accidents, during play and sport activities, and due to different pathological states. Diagnosis is rather simple and it includes physical and radiographycal examination. Femur fractures treatment in children can be operative and unoperative, depending on several facts: age, localisation and type of fracture, joint injuries of soft tissues, the presence of other injuries (in polytrauma, economical and social aspects, ect. The aim of this study was to present epidemiological characteristics of pediatric femur fractures, that is in the stage of development, including a special analysis of the used treatment techniques, as well as the comparison of the obtained data with those from the literature. Methods. The evaluation included following parameters: age, gender, cause, localisation and type of femur fracture, applied treatment and hospitalisation duration. Results. Among the presented 143 patients with femur fracture, 109 were boys and 34 were girls (3.2 : 1 ratio; p = 0.0001. Average age for both genders was 8.6 years, and no difference between boys and girls were found for the age (p = 0.758. In total, the most common fracture was diaphyseal fracture of femur in 93 (65.03% patients. The second was proximal fracture in 30 (20.98% patients, and the last distal fracture of the femur in 20 (13.99% patients (p = 0.0001. Three main causes of femur fracture can be distinguished: during play and sport activities in 67 (46.8% children, in traffic accidents in 64 (44.8% children, and pathological fractures in 12 (8.4% children. Inoperative treatment was applied in 82 (57.3% patients, and operative one in 61 (42.7% patients. The most common tretament was traction, in 71 (49.6% patients, followed by immobilization by hip spica cast mostly in young children. Intramedullar elastic nailing was applied in 16 (11.2% cases, and intramedullar rigid nailing (Küntscher in 19

Bone mineral density across a range of physical activity volumes: NHANES 2007-2010.

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Whitfield, Geoffrey P; Kohrt, Wendy M; Pettee Gabriel, Kelley K; Rahbar, Mohammad H; Kohl, Harold W

2015-02-01

The association between aerobic physical activity volume and bone mineral density (BMD) is not completely understood. The purpose of this study was to clarify the association between BMD and aerobic activity across a broad range of activity volumes, particularly volumes between those recommended in the 2008 Physical Activity Guidelines for Americans and those of trained endurance athletes. Data from the 2007-2010 National Health and Nutrition Examination Survey were used to quantify the association between reported physical activity and BMD at the lumbar spine and proximal femur across the entire range of activity volumes reported by US adults. Participants were categorized into multiples of the minimum guideline-recommended volume based on reported moderate- and vigorous-intensity leisure activity. Lumbar and proximal femur BMD were assessed with dual-energy x-ray absorptiometry. Among women, multivariable-adjusted linear regression analyses revealed no significant differences in lumbar BMD across activity categories, whereas proximal femur BMD was significantly higher among those who exceeded the guidelines by 2-4 times than those who reported no activity. Among men, multivariable-adjusted BMD at both sites neared its highest values among those who exceeded the guidelines by at least 4 times and was not progressively higher with additional activity. Logistic regression estimating the odds of low BMD generally echoed the linear regression results. The association between physical activity volume and BMD is complex. Among women, exceeding guidelines by 2-4 times may be important for maximizing BMD at the proximal femur, whereas among men, exceeding guidelines by ≥4 times may be beneficial for lumbar and proximal femur BMD.

BMD improvements after operation for primary hyperparathyroidism

DEFF Research Database (Denmark)

Rolighed, Lars; Vestergaard, Peter; Heickendorff, Lene

2013-01-01

PURPOSE: This study aims to quantify bone mineral density (BMD) changes following surgery in patients with primary hyperparathyroidism (PHPT) and to assess their relationship with clinical and biochemical variables. METHODS: A historic cohort of 236 PHPT patients with DXA scans pre- and 1-year...... postoperatively, clinical data, and biochemical data was analyzed. RESULTS: The mean age was 60 years (range 19-86) and 81 % of the patients were women. A significant postoperative 2.6 % (95 % CI, 2.1; 3.1) increase in lumbar spine BMD was seen. The increase in BMD was positively associated with preoperative...

The Effects of Liver Transplantation on the Bone Metabolism and Gonadal Functions

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Funda Atamaz

2005-06-01

Full Text Available The present study was designed to evaluate the effects of liver transplantation (LT on the bone mineral density (BMD, characteristics of bone turnover, mineral metabolism and sex hormons. Fifty one patients (34 men, 11 women aged 43.5 ± 12.1, who underwent LT were studied, assessing the following parameters: lumbar spine and proximal femur BMD, osteocalcin, deoxypyridinoline (DPD, parathyroid hormone (PTH, free testesterone (FT, gonadotropins (FSH, LH, tyroid hormones, growth hormone (GH and blood/ 24-hours urine Ca and P. All the measures were obtained at baseline and at 3rd month after LT. At baseline, 12 patients (%23.5 had osteoporosis, 22 patients (%43.1 had osteopenia and the mean BMD was 0.892 ± 0.1 for lumbar spine. Whereas, osteoporosis was seen less at femoral neck and total femur: 5 (%9.8 and 4 (%7.8, respectively. Three months after LT, 3.9% drop for lumbar spine, 5.3% drop for femur neck, 6.3% drop for total femur were observed, in BMD these decreases were statistically significant for all sites (p<0.05. The thyroid hormones, GH, PTH, blood Ca, P and osteocalcin levels and urinary DPD excretion were within normal range, while the levels of FSH and LH in women and level of FT in men were lower than normal range. After LT, statistically significant increases were observed in the PTH, osteocalcin, DPD, FSH, LH and FT levels (p<0.05. There was a highly significant negative correlation between duration of liver disease and all the BMD measures (p<0.01. Consequently, the increased osteoporosis ratio which was characterized by high bone turnover was found in patients who underwent LT in this study. The normalization of liver functions following LT was characterized by an early rise in sex hormones.

A comparison of bone mineral density in osteoporotic fracture of the proximal femur using dual energy X-ray absorptiometry

International Nuclear Information System (INIS)

Lee, Jong Seok; Yoo, Beong Gyu; Kim, Keung Sik

2000-01-01

There were some controversies about direct cause of hip fracture. We attempted to look at 40 osteoporotic proximal femur fractures in women over 50 years between March in 1999 and February in 2000. The bone density of the fracture group and the healthy 85 control group was measured by Dual Energy X-ray absorptiometry (DEXA). The result was compared using age matched paired T test. The results were as follows: The femoral neck fractures were 14 cases and the trochanteric fractures were 26 cases. Mean age at a fracture was 67.1 years in neck fracture group and 76.5 years in trochanteric fracture. In the control group, the bone density of both side of the proximal femur was measured and it showed statistically no difference between both sides in same person. The bone density of neck, Ward's triangle, trochanter (P<0.05) and lumbar spine (P<0.001) was significantly reduced in the proximal femoral fracture group comparing with the control group. The bone density of neck, Ward's triangle, trochanter (P<0.05) was significantly reduced in the proximal femoral neck fracture group comparing with the control group, but there was no statistical difference in lumbar spine comparing with the control group. The bone density of neck, Ward's triangle, trochanter and lumbar spine (P<0.001) was significantly reduced in the proximal femoral neck fracture group comparing with the control group. We concluded that the bone mineral densities (BMD) of proximal femur and lumbar spine had decreased in hip fractures but that the bone mineral density and T-score % of the proximal femur were statistically lower than that of the lumbar spine. We suggest that measuring the bone mineral density of the proximal femur may reflect the weakness of the proximal femur more precisely than measuring the bone mineral density of the lumbar spine

A comparison of bone mineral density in osteoporotic fracture of the proximal femur using dual energy X-ray absorptiometry

Energy Technology Data Exchange (ETDEWEB)

Lee, Jong Seok; Yoo, Beong Gyu [Wonkwang Health Science College, Iksan (Korea, Republic of); Kim, Keung Sik [Yonsei University Yong Dong Severance Hospital, Seoul (Korea, Republic of)

2000-04-15

There were some controversies about direct cause of hip fracture. We attempted to look at 40 osteoporotic proximal femur fractures in women over 50 years between March in 1999 and February in 2000. The bone density of the fracture group and the healthy 85 control group was measured by Dual Energy X-ray absorptiometry (DEXA). The result was compared using age matched paired T test. The results were as follows: The femoral neck fractures were 14 cases and the trochanteric fractures were 26 cases. Mean age at a fracture was 67.1 years in neck fracture group and 76.5 years in trochanteric fracture. In the control group, the bone density of both side of the proximal femur was measured and it showed statistically no difference between both sides in same person. The bone density of neck, Ward's triangle, trochanter (P<0.05) and lumbar spine (P<0.001) was significantly reduced in the proximal femoral fracture group comparing with the control group. The bone density of neck, Ward's triangle, trochanter (P<0.05) was significantly reduced in the proximal femoral neck fracture group comparing with the control group, but there was no statistical difference in lumbar spine comparing with the control group. The bone density of neck, Ward's triangle, trochanter and lumbar spine (P<0.001) was significantly reduced in the proximal femoral neck fracture group comparing with the control group. We concluded that the bone mineral densities (BMD) of proximal femur and lumbar spine had decreased in hip fractures but that the bone mineral density and T-score % of the proximal femur were statistically lower than that of the lumbar spine. We suggest that measuring the bone mineral density of the proximal femur may reflect the weakness of the proximal femur more precisely than measuring the bone mineral density of the lumbar spine.

In healthy elderly postmenopausal women variations in BMD and BMC at various skeletal sites are associated with differences in weight and lean body mass rather than by variations in habitual physical activity, strength or VO2max.

Science.gov (United States)

Schöffl, I; Kemmler, W; Kladny, B; Vonstengel, S; Kalender, W A; Engelke, K

2008-01-01

The objective of this study was an integrated cross-sectional investigation for answering the question whether differences in bone mineral density in elderly postmenopausal women are associated with differences in habitual physical activity and unspecific exercise levels. Two hundred and ninety nine elderly women (69-/+3 years), without diseases or medication affecting bone metabolism were investigated. The influence of weight, body composition and physical activity on BMD was measured at multiple sites using different techniques (DXA, QCT, and QUS). Physical activity and exercise level were assessed by questionnaire, maximum strength of the legs and aerobic capacity. Variations in physical activity or habitual exercise had no effect on bone. The only significant univariate relation between strength/VO(2)max and BMD/BMC that remained after adjusting for confounding variables was between arm BMD (DXA) and hand-grip strength. The most important variable for explaining BMD was weight and for cortical BMC of the femur (QCT) lean body mass. Weight and lean body mass emerge as predominant predictors of BMD in normal elderly women, whereas the isolated effect of habitual physical activity, unspecific exercise participation, and muscle strength on bone parameters is negligible. Thus, an increase in the amount of habitual physical activity will probably have no beneficial impact on bone.

[Early total care pattern for intertrochanteric fracture of femur in the elderly].

Science.gov (United States)

Gu, Jie; Kang, Xin-yong; Xu, Hong-wei; Li, Yong-fu; Zahng, Bin; Guo, Jian; He, Zhen-nian

2016-06-01

To evaluate clinical results of early total care (ETC) treatment for elderly patients with intertrochanteric femur fractures. Clinical data of 106 elderly patients with intertrochanteric fracture treated from January 2012 and February 2015 were retrospectively studied. According to whether receiving the early total care mode, the patients were divided into 2 groups, 34 cases were diagnosed and treated with early total care pattern (ETC group), including 14 males and 20 females with an average age of (74.88 ± 4.38) years old ranging from 70 to 86. According to Evans types, 4 cases were type I, 5 cases were type II, 13 cases were type III, 11 cases were type IV, 1 case was type V. Seventy-two patients were treated with conventional trauma method (conventional group), including 35 males and 37 females with an average age of (74.46 ± 3.63) years old ranging from 70 to 85. According to Evans type, 8 cases were type I ,13 cases were type II, 25 cases were type III, 25 cases were type IV, and 1 case was type V. All fractures were treated with proximal femoral nails anti-rotation (PFNA). Operative time, hospital stays, leaving bed time, complications, cases of death at 1 year after operation, postoperative Harris score at 12 months were observed and compared. All patients were followed up, the time of ETC group ranged from 9 to 18 months with an average of 13.29 ± 1.51, and the time in conventional group ranged from 12 to 16 months with an average 12.93 ± 1.15, while there was no significant difference between two groups in time of following-up (t = 1.368, P = 0.174). There was no significant meaning in cases of death between ETC group (2 cases) and conventional group (8 cases). Three cases occurred complications in ETC group, and 20 cases in conventional group,there was obvious meaning between two groups (χ² = 0.739, P = 0.318). Operative time,hospital stays,leaving bed time in ETC group respectively was (2.03 ± 0.67) d, (15.41 ± 2.87) d and (3.62 ± 0.74) d

Evaluation of measurement precision errors at different bone density values

International Nuclear Information System (INIS)

Wilson, M.; Wong, J.; Bartlett, M.; Lee, N.

2002-01-01

Full text: The precision error commonly used in serial monitoring of BMD values using Dual Energy X Ray Absorptometry (DEXA) is 0.01-0.015g/cm - for both the L2 L4 lumbar spine and total femur. However, this limit is based on normal individuals with bone densities similar to the population mean. The purpose of this study was to systematically evaluate precision errors over the range of bone density values encountered in clinical practice. In 96 patients a BMD scan of the spine and femur was immediately repeated by the same technologist with the patient taken off the bed and repositioned between scans. Nine technologists participated. Values were obtained for the total femur and spine. Each value was classified as low range (0.75-1.05 g/cm ) and medium range (1.05- 1.35g/cm ) for the spine, low range (0.55 0. 85 g/cm ) and medium range (0.85-1.15 g/cm ) for the total femur. Results show that the precision error was significantly lower in the medium range for total femur results with the medium range value at 0.015 g/cm - and the low range at 0.025 g/cm - (p<0.01). No significant difference was found for the spine results. We also analysed precision errors between three technologists and found a significant difference (p=0.05) occurred between only two technologists and this was seen in the spine data only. We conclude that there is some evidence that the precision error increases at the outer limits of the normal bone density range. Also, the results show that having multiple trained operators does not greatly increase the BMD precision error. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Plate fixation in periprosthetic femur fractures Vancouver type B1-Trochanteric hook plate or subtrochanterical bicortical locking?

Science.gov (United States)

Lenz, Mark; Stoffel, Karl; Kielstein, Heike; Mayo, Keith; Hofmann, Gunther O; Gueorguiev, Boyko

2016-12-01

Proximal plate fixation in periprosthetic femur fractures can be improved by plate anchorage in the greater trochanter (lateral tension band principle) or bicortical locking screw placement beside the prosthesis stem in an embracement configuration. Both concepts were compared in a biomechanical test using a femoral hook plate (hook) or a locking attachment plate (LAP). After bone mineral density (BMD) measurement in the greater trochanter, six pairs of fresh frozen human femora were assigned to two groups and instrumented with cemented hip endoprostheses. A transverse osteotomy was set distal to the tip of the prosthesis, simulating a Vancouver B1 fracture. Each pair was instrumented using a plate tensioner with either hook or LAP construct. Cyclic testing (2Hz) with physiologic profile and monotonically increasing load was performed until catastrophic failure. Plate stiffness was compared in a four-point-bending-test. Paired student's-t-test was used for statistical evaluation (pTrochanteric fixation is highly BMD dependent and may be restricted to major greater trochanteric involvement requiring stabilization. Copyright © 2016 Elsevier Ltd. All rights reserved.

Trends in osteoporosis and low bone mass in older US adults, 2005-2006 through 2013-2014.

Science.gov (United States)

Looker, A C; Sarafrazi Isfahani, N; Fan, B; Shepherd, J A

2017-06-01

This study examined trends in osteoporosis and low bone mass in older US adults between 2005 and 2014 using bone mineral density (BMD) data from the National Health and Nutrition Examination Survey (NHANES). Osteoporosis and low bone mass appear to have increased at the femur neck but not at the lumbar spine during this period. Recent preliminary data from Medicare suggest that the decline in hip fracture incidence among older US adults may have plateaued in 2013-2014, but comparable data on BMD trends for this time period are currently lacking. This study examined trends in the prevalence of osteoporosis and low bone mass since 2005 using BMD data from NHANES. The present study also updated prevalence estimates to 2013-2014 and included estimates for non-Hispanic Asians. Femur neck and lumbar spine BMD by DXA were available for 7954 adults aged 50 years and older from four NHANES survey cycles between 2005-2006 and 2013-2014. Significant trends (quadratic or linear) were observed for the femur neck (mean T-score and osteoporosis in both sexes; low bone mass in women) but not for the lumbar spine. The trend in femur neck status was somewhat U-shaped, with prevalences being most consistently significantly higher (by 1.1-6.6 percentage points) in 2013-2014 than 2007-2008. Adjusting for changes in body mass index, smoking, milk intake, and physician's diagnosis of osteoporosis between surveys did not change femur neck trends. In 2013-2014, the percent of older adults with osteoporosis was 6% at the femur neck, 8% at the lumbar spine, and 11% at either site. There was some evidence of a decline in femur neck BMD between 2005-2006 and 2013-2014, but not in lumbar spine BMD. Changes in the risk factors that could be examined did not explain the femur neck BMD trends.

The lumbar spine age-related degenerative disease influences the BMD not the TBS: the Osteolaus cohort.

Science.gov (United States)

Padlina, I; Gonzalez-Rodriguez, E; Hans, D; Metzger, M; Stoll, D; Aubry-Rozier, B; Lamy, O

2017-03-01

We evaluated the influence of degenerative disease and fractured vertebra on lumbar spine bone mineral density (BMD) and trabecular bone score (TBS) in 1500 women aged 50-80 years. TBS was not affected by a degenerative disease. While BMD increases after 62.5 years, TBS continues to decline. TBS should play a leading role in lumbar spine evaluation. After menopause, lumbar spine (LS) BMD and TBS values decrease. Degenerative disease (DD) increases with age and affect LS BMD. The aim of this study was to measure changes in LS BMD and TBS in women 50 to 80 years old, taking into account the impact of fractured vertebrae and DD. LS BMD, TBS, and vertebral fracture assessment were evaluated in the OsteoLaus cohort (1500 women, 50-80 years old). The exams were analyzed following ISCD guidelines to identify vertebrae with fractures or DD (Vex). 1443 women were enrolled: mean age 66.7 ± 11.7 years, BMI 25.7 ± 4.4. LS BMD and TBS were weakly correlated (r2 = 0.16). The correlation (Vex excluded) between age and BMD was +0.03, between age and TBS -0.34. According to age group, LS BMD was 1.2 to 3.2% higher before excluding Vex (p < 0.001). TBS had an insignificant change of <1% after excluding Vex. LS BMD (Vex) decreased by 4.6% between 52.5 and 62.5 years, and increased by 2.6% between 62.5 and 77.5 years. TBS (Vex excluded) values decreased steadily with age with an overall loss of 8.99% between 52.5 and 77.5 years. Spine TBS, femoral neck, and total hip BMD gradually decreased with age, reaching one SD between the oldest and youngest group. TBS is not affected by DD. While BMD increases after 62.5 years, TBS continues to decline. For lumbar spine evaluation, in view of its independence from DD, TBS should play a leading role in the diagnosis in complement to BMD.

Causal relationship between the AHSG gene and BMD through fetuin-A and BMI: multiple mediation analysis.

Science.gov (United States)

Sritara, C; Thakkinstian, A; Ongphiphadhanakul, B; Chailurkit, L; Chanprasertyothin, S; Ratanachaiwong, W; Vathesatogkit, P; Sritara, P

2014-05-01

Using mediation analysis, a causal relationship between the AHSG gene and bone mineral density (BMD) through fetuin-A and body mass index (BMI) mediators was suggested. Fetuin-A, a multifunctional protein of hepatic origin, is associated with bone mineral density. It is unclear if this association is causal. This study aimed at clarification of this issue. A cross-sectional study was conducted among 1,741 healthy workers from the Electricity Generating Authority of Thailand (EGAT) cohort. The alpha-2-Heremans-Schmid glycoprotein (AHSG) rs2248690 gene was genotyped. Three mediation models were constructed using seemingly unrelated regression analysis. First, the ln[fetuin-A] group was regressed on the AHSG gene. Second, the BMI group was regressed on the AHSG gene and the ln[fetuin-A] group. Finally, the BMD model was constructed by fitting BMD on two mediators (ln[fetuin-A] and BMI) and the independent AHSG variable. All three analyses were adjusted for confounders. The prevalence of the minor T allele for the AHSG locus was 15.2%. The AHSG locus was highly related to serum fetuin-A levels (P Multiple mediation analyses showed that AHSG was significantly associated with BMD through the ln[fetuin-A] and BMI pathway, with beta coefficients of 0.0060 (95% CI 0.0038, 0.0083) and 0.0030 (95% CI 0.0020, 0.0045) at the total hip and lumbar spine, respectively. About 27.3 and 26.0% of total genetic effects on hip and spine BMD, respectively, were explained by the mediation effects of fetuin-A and BMI. Our study suggested evidence of a causal relationship between the AHSG gene and BMD through fetuin-A and BMI mediators.

Anthropometry of the distal femur in a Kenyan population and its ...

African Journals Online (AJOL)

Background: No local study has been done to determine the anthropometric features of the distal femur, compared it with other studied populations and some of the total knee replacement implants available. Objective: To determine the Medio-Lateral (ML) width of the condyles of the femur, the anteroposterior (AP) diameter ...

BMI levels with MS Bone mineral density levels in adults with multiple sclerosis: a meta-analysis.

Science.gov (United States)

Huang, Zhongming; Qi, Yiying; Du, Shaohua; Chen, Guangnan; Yan, Weiqi

2015-01-01

Multiple sclerosis (MS) and osteoporosis (OP) affect a substantial proportion of the population. Accumulating evidence suggests that MS patients are at high risk for OP. We performed a meta-analysis to identify risk factors for lowered bone mineral density (BMD) in MS patients. We searched for articles within the Medline, Embase and Cochrane Library databases, published up to March 2014, pertaining to associations between MS and BMD. A total of 11 studies was included in the meta-analysis. The analysis indicated that MS patients have reduced lumbar spine, femur neck, and hip BMD compared with healthy controls (lumbar spine, standardized mean difference (SMD) = -0.76, 95% CI: -1.07, -0.45; femur neck, SMD = -0.56, 95% CI: -0.84, -0.29; and hip, SMD = -0.62, 95% CI: -0.96, -0.29). Further subgroup analysis revealed that a disease duration of >7 years, total steroid dose during the disease of >15 g, and an Expanded Disability Status Scale (EDSS) score of > 3, increased the risk of reduced BMD in the lumbar spine and femoral neck, but not in the hip. Meta-regression analysis did not explain the heterogeneity in the clinical characteristics or outcome definitions. Our meta-analysis suggests that MS patients have reduced overall BMD compared with healthy controls. Furthermore, disease duration (>7 years), total steroid dose (>15 g), and EDSS score (>3) are risk factors for reduced BMD in MS patients.

Physical exercise associated with improved BMD independently of sex and vitamin D levels in young adults

DEFF Research Database (Denmark)

Tønnesen, Rune; Schwarz, Peter; Hovind, Peter Hambak

2016-01-01

-scan sites (p trend = 0.0001) and with equal benefit; there was no interaction between exercise and the DXA-scan site (p = 0.09). The male participants did not have a systematically higher BMD than the female participants for all scan sites; only for hips total and femoral neck bilaterally, while......PURPOSE: Young men and women accrue the majority of their bone mass in their teens and twenties, where their bone mass peaks (PBM), yet little is known about the roles of physical exercise, vitamin D levels and bone mineral density (BMD) near PBM. METHODS: To comparatively examine the effect...... of physical exercise and two vitamin D levels (insufficient s-25[OH]D 80 nmol/L) on the BMD measured at the femoral neck, total hip (bilaterally) and the lumbar spine (L2-L4) in male and female participants approaching PBM. RESULTS: The insufficient s-25[OH]D group, median...

Influence of nutrition and lifestyle on bone mineral density in children from adoptive and biological families.

Science.gov (United States)

Cvijetic, Selma; Baric, Irena Colic; Satalic, Zvonimir; Keser, Irena; Bobic, Jasminka

2014-01-01

The precise contributions of hereditary and environmental factors to bone density are not known. We compared lifestyle predictors of bone density among adopted and biological children. The study comprised 18 adopted children (mean [SD] age, 14.0 [4.1] years) with their non-biological parents and 17 children with their biological parents. Bone mineral density (BMD; g/cm(2)) was measured at the lumbar spine, total femur, and distal radius. Nutritional intake was assessed by food frequency questionnaire. Information on smoking and physical activity was obtained by questionnaire. Intakes of all nutrients, corrected for energy intake, and all lifestyle characteristics except sleep duration were similar in biological children and their parents. As compared with their parents, adopted children had significantly different energy, protein, and calcium intakes and physical activity levels. In a regression model, BMD z scores of adopted children and their parents were significantly inversely associated at the spine and total femur, whereas BMD z scores of biological children and their parents were significantly positively associated at all measurement sites. The greatest proportion of total variance in BMD was accounted for by calcium intake among adopted children and by parental BMD among biological children. For some lifestyle characteristics and nutrient intakes, the differences between parents and children were more obvious among adoptive families than among biological families. The most important lifestyle predictor of bone density was calcium intake.

BMD T-score discriminates trochanteric fractures from unfractured controls, whereas geometry discriminates cervical fracture cases from unfractured controls of similar BMD.

Science.gov (United States)

Pulkkinen, P; Partanen, J; Jalovaara, P; Jämsä, T

2010-07-01

The ability of bone mineral density (BMD) to discriminate cervical and trochanteric hip fractures was studied. Since the majority of fractures occur among people who are not diagnosed as having osteoporosis, we also examined this population to elucidate whether geometrical risk factors can yield additional information on hip fracture risk beside BMD. The study showed that the T-score criterion was able to discriminate fracture patients from controls in the cases of trochanteric fractures, whereas geometrical measures may discriminate cervical fracture cases in patients with T-score >-2.5. Low bone mineral density (BMD) is a well-established risk factor for hip fracture. However, majority of fractures occur among people not diagnosed as having osteoporosis. We studied the ability of BMD to discriminate cervical and trochanteric hip fractures. Furthermore, we examined whether geometrical measures can yield additional information on the assessment of hip fracture risk in the fracture cases in subjects with T-score >-2.5. Study group consisted of postmenopausal females with non-pathologic cervical (n = 39) or trochanteric (n = 18) hip fracture (mean age 74.2 years) and 40 age-matched controls. BMD was measured at femoral neck, and femoral neck axis length, femoral neck and shaft cortex thicknesses (FNC and FSC), and femoral neck-shaft angle (NSA) were measured from radiographs. BMD T-score threshold of -2.5 was able to discriminate trochanteric fractures from controls (p trochanteric fractures occurred in individuals with T-score fractures. Twenty of these fractures (51.3%) occurred in individuals with BMD in osteoporotic range and 19 (48.7%) in individuals with T-score >-2.5. Within these non-osteoporotic cervical fracture patients (N = 19) and non-osteoporotic controls (N = 35), 83.3% were classified correctly based on a model including NSA and FNC (p trochanteric fractures could be discriminated based on a BMD T-score fracture cases would remain under-diagnosed if

Skeletal Effects of the Saturated 3-Thia Fatty Acid Tetradecylthioacetic Acid in Rats

Directory of Open Access Journals (Sweden)

Astrid Kamilla Stunes

2011-01-01

Full Text Available This study explores the skeletal effects of the peroxisome proliferator activated receptor (PPARpan agonist tetradecylthioacetic acid (TTA. Rats, without (Study I and with ovariectomy (OVX or sham operation (Study II, were given TTA or vehicle daily for 4 months. Bone markers in plasma, whole body and femoral bone mineral density and content (BMD and BMC, and body composition were examined. Histomorphometric and biomechanical analyses (Study I and biomechanical and μCT analyses (Study II of the femur were performed. Normal rats fed TTA had higher femoral BMD and increased total and cortical area in femur compared to controls. The ovariectomized groups had decreased BMD and impaired microarchitecture parameters compared to SHAM. However, the TTA OVX group maintained femoral BMC, trabecular thickness in the femoral head, and cortical volume in the femoral metaphysis as SHAM. TTA might increase BMD and exert a light preventive effect on estrogen-related bone loss in rats.

Forecasting Proximal Femur and Wrist Fracture Caused by a Fall to the Side during Space Exploration Missions to the Moon and Mars

Science.gov (United States)

Lewandowski, Beth E.; Myers, Jerry G.; Sulkowski, C.; Ruehl, K.; Licata, A.

2008-01-01

The possibility of bone fracture in space is a concern due to the negative impact it could have on a mission. The Bone Fracture Risk Module (BFxRM) developed at the NASA Glenn Research Center is a statistical simulation that quantifies the probability of bone fracture at specific skeletal locations for particular activities or events during space exploration missions. This paper reports fracture probability predictions for the proximal femur and wrist resulting from a fall to the side during an extravehicular activity (EVA) on specific days of lunar and Martian exploration missions. The risk of fracture at the proximal femur on any given day of the mission is small and fairly constant, although it is slightly greater towards the end of the mission, due to a reduction in proximal femur bone mineral density (BMD). The risk of wrist fracture is greater than the risk of hip fracture and there is an increased risk on Mars since it has a higher gravitational environment than the moon. The BFxRM can be used to help manage the risk of bone fracture in space as an engineering tool that is used during mission operation and resource planning.

Standardization of spine and hip BMD measurements in different DXA devices

Energy Technology Data Exchange (ETDEWEB)

Ozdemir, Aysegul [Gazi University, Department of Radiology, Besevler, Ankara 06510 (Turkey)]. E-mail: aysozd@gazi.edu.tr; Ucar, Murat [Gazi University, Department of Radiology, Besevler, Ankara 06510 (Turkey)

2007-06-15

Aim: To compare BMD values of lumbar and hip regions measured in two different DXA scanners in one laboratory, and to investigate the efficiencies of implemented and specifically derived standardization formulas. Materials and methods: PA lumbar (L2-L4) and right femoral neck BMD values were obtained in 100 women (aged 26-75), consecutively in GE-Lunar DPX-NT and Hologic QDR 4500 C DXA scanners. Standardization of BMD values obtained in two different DXA devices was done according to the method developed by International DXA Standardization Committee (IDSC), using the European Spine Phantom (ESP) to obtain the specific constant value. Mean corrected standardized BMD (sBMD) values in two scanners have been compared with each other and with the mean reported sBMD values, respectively. Results: The mean lumbar BMD values were 0.950 {+-} 0.117 g/cm{sup 2} for Hologic and 1.068 {+-} 0.135 g/cm{sup 2} for GE-Lunar (p < 0.05); mean corrected sBMD values were 1.035 {+-} 0.128 g/cm{sup 2} for Hologic and 1.035 {+-} 0.131 g/cm{sup 2} for GE-Lunar (p > 0.05). The mean femoral neck BMD values were 0.798 {+-} 0.114 g/cm{sup 2} for Hologic and 0.895 {+-} 0.111 g/cm{sup 2} for GE-Lunar (p < 0.05); mean corrected sBMD values were 0.869 {+-} 0.124 g/cm{sup 2} for Hologic and 0.867 {+-} 0.108 g/cm{sup 2} for GE-Lunar (p > 0.05). The difference between the mean values of BMD and sBMD, both corrected and reported, were statistically important in each scanner (p < 0.05). The mean values of corrected and reported sBMD were also statistically different in each scanner (p < 0.05; mean standard error in the spine was 1.3 for GE-Lunar and 1.8 for the Hologic device). Conclusion: The originally proposed standardization formulae may not optimally correct for manufacturer, model and device-specific differences. Therefore, use of sBMD is not recommended to compare results of individual patients obtained on scanners of different type and brand. The residual error of reported sBMD, however, is

Fractures of the proximal femur: correlation with vitamin D receptor gene polymorphism

Directory of Open Access Journals (Sweden)

A.C. Ramalho

1998-07-01

Full Text Available Fractures are the feared consequences of osteoporosis and fractures of the proximal femur (FPF are those that involve the highest morbidity and mortality. Thus far, evaluation of bone mineral density (BMD is the best way to determine the risk of fracture. Genetic inheritance, in turn, is one of the major determinants of BMD. A correlation between different genotypes of the vitamin D receptor (VDR and BMD has been recently reported. On this basis, we decided to determine the importance of the determination of VDR genotype in the presence of an osteoporotic FPF in a Brazilian population. We studied three groups: group I consisted of 73 elderly subjects older than 65 years (78.5 ± 7.2 years hospitalized for nonpathological FPF; group II consisted of 50 individuals older than 65 years (72.9 ± 5.2 years without FPF and group III consisted of 98 young normal Brazilian individuals aged 32.6 ± 6.6 years (mean ± SD. Analysis of VDR gene polymorphism by restriction fragment length polymorphism (RFLP was performed by PCR amplification followed by BsmI digestion of DNA isolated from peripheral leukocytes. The genotype distribution in group I was 20.5% BB, 42.5% Bb and 37% bb and did not differ significantly from the values obtained for group II (16% BB, 36% Bb and 48% bb or for group III (10.2% BB, 47.6% Bb and 41.8% bb. No differences in genotype distribution were observed between sexes or between the young and elderly groups. We conclude that determination of VDR polymorphism is of no practical use for the prediction of FPF. Other nongenetic factors probably start to affect bone mass, the risk to fall and consequently the occurrence of osteoporotic fractures with advancing age.

Evaluation of bone mineral density in premenopausal women with type-2 diabetes mellitus in Zahedan, Southeast Iran

International Nuclear Information System (INIS)

Zakeri, Z.

2011-01-01

To determine the BMD in premenopausal women with type-2 diabetes mellitus. Methods: This case-control study was performed on 60 premenopausal women with type-2 diabetes mellitus and 60 normal premenopausal subjects. The groups were not completely matched regarding BMI; but they were in the range of obesity. Bone mineral density was determined using dual energy X-ray absorptiometry (DXA) to define bone mineral density (BMD) in second to fourth lumbar vertebrae and the neck of the femur (g/cm/sup 2/). Results: The results showed that BMD, T- and Z-score of femoral neck, total femur, L2, and Ward's were not significantly different between type 2 diabetic and normal premenopausal women (p>0.5). A significant increase of L3 BMD and L2-L4 Z-score was observed in diabetic group (p<0.05). In addition BMD, T- and Z-score of L4 were significantly higher in type 2 diabetic women than normal premenopausal women (P<0.05). Conclusion: Higher BMD was noted over the spine in diabetic group which may be due to higher BMI in this group. (author)

Association of the presence of bone bars on radiographs and low bone mineral density

International Nuclear Information System (INIS)

Pitt, Michael J.; Morgan, Sarah L.; Lopez-Ben, Robert; Steelman, Rebecca E.; Nunnally, Nancy; Burroughs, Leandria; Fineberg, Naomi

2011-01-01

Bone bars (BB) are struts of normal trabecular bone that cross the medullary portions of the metaphysis and diaphysis at right angles to the long axis of the shaft. The purpose of this investigation was to determine whether the presence of bone bars (BB) identified on radiographs of the proximal femurs and tibia, predict lower bone mineral density (BMD) as evaluated with dual-energy x-ray absorptiometry (DXA) in the lumbar spine, total hip, or femoral neck. A total of 134 sequential DXA patients underwent radiography of the pelvis, hips, and both knees. The radiographs were evaluated for the presence of BB by two musculoskeletal radiologists who were blinded to DXA results. A t test was used to evaluate the relationship of BB to BMD and a Chi-square test was used to determine if BB were equally distributed among the categories of normal BMD, low bone mass (osteopenia), and osteoporosis. BB were associated with lower BMD at all measured sites. BB at the intertrochanteric and proximal tibial sites were the most predictive of low BMD while supraacetabular and distal femur BB were less predictive. Osteoporosis or osteopenia is seen in 60-91% of those with BB depending on the side and reader. It is only seen in about 40% of those without BB. We conclude that the presence of BB suggest decreased BMD and when correlated with other clinical information, might support further evaluation of BMD. (orig.)

Association of the presence of bone bars on radiographs and low bone mineral density

Energy Technology Data Exchange (ETDEWEB)

Pitt, Michael J. [University of Alabama at Birmingham, Department of Radiology, School of Medicine, Birmingham (United Kingdom); Morgan, Sarah L. [Schools of Health Professions, Medicine, and Dentistry, Departments of Nutrition Sciences and Medicine, Birmingham (United Kingdom); Lopez-Ben, Robert [University of Alabama at Birmingham, Department of Radiology, School of Medicine, Birmingham (United Kingdom); Steelman, Rebecca E. [University of Alabama, Birmingham (United Kingdom); Nunnally, Nancy; Burroughs, Leandria [UAB Osteoporosis Prevention and Treatment Clinic, Birmingham (United Kingdom); Fineberg, Naomi [University of Alabama at Birmingham, Department of Biostatistics, School of Public Health, Birmingham (United Kingdom)

2011-07-15

Bone bars (BB) are struts of normal trabecular bone that cross the medullary portions of the metaphysis and diaphysis at right angles to the long axis of the shaft. The purpose of this investigation was to determine whether the presence of bone bars (BB) identified on radiographs of the proximal femurs and tibia, predict lower bone mineral density (BMD) as evaluated with dual-energy x-ray absorptiometry (DXA) in the lumbar spine, total hip, or femoral neck. A total of 134 sequential DXA patients underwent radiography of the pelvis, hips, and both knees. The radiographs were evaluated for the presence of BB by two musculoskeletal radiologists who were blinded to DXA results. A t test was used to evaluate the relationship of BB to BMD and a Chi-square test was used to determine if BB were equally distributed among the categories of normal BMD, low bone mass (osteopenia), and osteoporosis. BB were associated with lower BMD at all measured sites. BB at the intertrochanteric and proximal tibial sites were the most predictive of low BMD while supraacetabular and distal femur BB were less predictive. Osteoporosis or osteopenia is seen in 60-91% of those with BB depending on the side and reader. It is only seen in about 40% of those without BB. We conclude that the presence of BB suggest decreased BMD and when correlated with other clinical information, might support further evaluation of BMD. (orig.)

Nontraumatic femur fracture in an oligomenorrheic athlete.

Science.gov (United States)

Dugowson, C E; Drinkwater, B L; Clark, J M

1991-12-01

Exercise-associated amenorrhea is the cessation of menses in a woman following onset of training or an increase in training intensity. Its physiologic basis is characterized by consistently low levels of gonadotropin and ovarian hormones, but the underlying cause of this phenomenon is unknown. Although osteopenia has been described in amenorrheic women athletes, it has been primarily a laboratory diagnosis. Several recent studies have described a significantly lower bone mineral density (BMD) in the lumbar spine of amenorrheic athletes. Marcus et al. also reported an increased number of metatarsal and tibial stress fractures in a group of amenorrheic women. We report here the first case of a nontraumatic femur fracture in an amenorrheic athlete. A 32-yr-old white female, with four prior fibular stress fractures, suffered a left femoral shaft fracture during the 13th mile of a half-marathon. The fracture was successfully internally fixed. Biochemical studies showed no metabolic abnormality. Bone mineral density of the lumbar spine, femoral neck, tibia, and fibula were below the mean for both eumenorrheic and amenorrheic female athletes. Exercise-associated amenorrhea is a medical problem that may have serious implications for both competitive and high-intensity recreational female athletes.

Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool.

Science.gov (United States)

Toelly, Andrea; Bardach, Constanze; Weber, Michael; Gong, Rui; Lai, Yanbo; Wang, Pei; Guo, Yulin; Kirschke, Jan; Baum, Thomas; Gruber, Michael

2017-06-01

Aim  To evaluate the differences in phantom-less bone mineral density (BMD) measurements in contrast-enhanced routine MDCT scans at different contrast phases, and to develop an algorithm for calculating a reliable BMD value. Materials and Methods  112 postmenopausal women from the age of 40 to 77 years (mean age: 57.31 years; SD 9.61) who underwent a clinically indicated MDCT scan, consisting of an unenhanced, an arterial, and a venous phase, were included. A retrospective analysis of the BMD values of the Th12 to L4 vertebrae in each phase was performed using a commercially available phantom-less measurement tool. Results  The mean BMD value in the unenhanced MDCT scans was 79.76 mg/cm³ (SD 31.20), in the arterial phase it was 85.09 mg/cm³ (SD 31.61), and in the venous phase it was 86.18 mg/cm³ (SD 31.30). A significant difference (p Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool. Fortschr Röntgenstr 2017; 189: 537 - 543. © Georg Thieme Verlag KG Stuttgart · New York.

Epistatic effects contribute to variation in BMD in Fischer 344 x Lewis F2 rats.

Science.gov (United States)

Koller, Daniel L; Liu, Lixiang; Alam, Imranul; Sun, Qiwei; Econs, Michael J; Foroud, Tatiana; Turner, Charles H

2008-01-01

To further delineate the factors underlying the complex genetic architecture of BMD in the rat model, a genome screen for epistatic interactions was conducted. Several significant interactions were identified, involving both previously identified and novel QTLs. The variation in several of the risk factors for osteoporotic fracture, including BMD, has been shown to be caused largely by genetic differences. However, the genetic architecture of BMD is complex in both humans and in model organisms. We have previously reported quantitative trait locus (QTL) results for BMD from a genome screen of 595 female F(2) progeny of Fischer 344 and Lewis rats. These progeny also provide an excellent opportunity to search for epistatic effects, or interaction between genetic loci, that contribute to fracture risk. Microsatellite marker data from a 20-cM genome screen was analyzed along with weight-adjusted BMD (DXA and pQCT) phenotypic data using the R/qtl software package. Genotype and phenotype data were permuted to determine a genome-wide significance threshold for the epistasis or interaction LOD score corresponding to an alpha level of 0.01. Novel loci on chromosomes 12 and 15 showed a strong epistatic effect on total BMD at the femoral midshaft by pQCT (LOD = 5.4). A previously reported QTL on chromosome 7 was found to interact with a novel locus on chromosome 20 to affect whole lumbar BMD by pQCT (LOD = 6.2). These results provide new information regarding the mode of action of previously identified rat QTLs, as well as identifying novel loci that act in combination with known QTLs or with other novel loci to contribute to the risk factors for osteoporotic fracture.

Study on Oneself Developed to Apparatus Position of Measurement of BMD in the Distal Radius

International Nuclear Information System (INIS)

Han, Man Seok; Song, Jae Yong; Lee, Hyun Kuk; Yu, Se Jong; Kim, Yong Kyun

2009-01-01

The aim of this study was to evaluate the difference of bone mineral density according to distal radius rotation and to develop the supporting tool to measure rotation angles. CT scanning and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 20 males. Twenty healthy volunteers without any history of operations, anomalies, or trauma were enrolled. The CT scan was used to evaluate the cross sectional structure and the rotation angle on the horizontal plane of the distal radius. The rotational angle was measured by the m-view program on the PACS monitor. The DXA was used in 20 dried radii of cadaveric specimens in pronation and supination with five and ten degrees, respectively, including a neutral position (zero degrees) to evaluate the changes of BMD according to the rotation. The mean rotation angle of the distal radius on CT was 7.4 degrees of supination in 16 cases (80%), 3.3 degrees of pronation in three cases (15%), and zero degree of neutral in one case (9%), respectively. The total average rotation angle in 20 people was 5.4 degrees of supination. In the cadaveric study, the BMD of the distal radius was different according to the rotational angles. The lowest BMD was obtained at 3.3 degrees of supination. In the case of the measurement of BMD in the distal radius with a neutral position, the rotational angle of the distal radius is close to supination. Pronation is needed for the constant measurement of BMD in the distal radius with the rotation angle measuring at the lowest BMD and about five degrees of pronation of the distal radius is recommended.

Low Preoperative BMD Is Related to High Migration of Tibia Components in Uncemented TKA-92 Patients in a Combined DEXA and RSA Study With 2-Year Follow-Up.

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Andersen, Mikkel R; Winther, Nikkolaj S; Lind, Thomas; Schrøder, Henrik M; Flivik, Gunnar; Petersen, Michael M

2017-07-01

The fixation of uncemented tibia components in total knee arthroplasty may rely on the bone quality of the tibia; however, no previous studies have shown convincing objective proof of this. Component migration is relevant as it has been shown to predict aseptic loosening. We performed 2-year follow-up of 92 patients who underwent total knee arthroplasty surgery with an uncemented tibia component. Bone mineral density (BMD; g/cm 2 ) of the tibia host bone was measured preoperatively using dual energy X-ray absorptiometry. The proximal tibia was divided into 2 regions of interest (ROI) in the part of the tibia bone where the components were implanted. Radiostereometric analysis was performed postoperatively and after 3, 6, 12, and 24 months. The primary outcome was maximum total point motion (MTPM; mm). Regression analysis was performed to evaluate the relation between preoperative BMD and MTPM. We found low preoperative BMD in ROI1 to be significantly related to high MTPM at all follow-ups: after 3 months (R 2  = 20%, P BMD  = 0.017), 6 months (R 2  = 29%, P BMD  = 0.003), 12 months (R 2  = 33%, P BMD  = 0.001), and 24 months (R 2  = 27%, P BMD  = 0.001). We also found a significant relation for low BMD in ROI2 and high MTPM: 3 months (R 2  = 19%, P BMD  = 0.042), 6 months (R 2  = 28%, P BMD  = 0.04), 12 months (R 2  = 32%, P BMD  = 0.004), and 24 months (R 2  = 24%, P BMD  = 0.005). Low preoperative BMD in the tibia is related to high MTPM. Thus, high migration of uncemented tibia components is to be expected in patients with poor bone quality. Copyright © 2017 Elsevier Inc. All rights reserved.

Epistatic Effects Contribute to Variation in BMD in Fischer 344 × Lewis F2 Rats

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Koller, Daniel L; Liu, Lixiang; Alam, Imranul; Sun, Qiwei; Econs, Michael J; Foroud, Tatiana; Turner, Charles H

2008-01-01

To further delineate the factors underlying the complex genetic architecture of BMD in the rat model, a genome screen for epistatic interactions was conducted. Several significant interactions were identified, involving both previously identified and novel QTLs. Introduction The variation in several of the risk factors for osteoporotic fracture, including BMD, has been shown to be caused largely by genetic differences. However, the genetic architecture of BMD is complex in both humans and in model organisms. We have previously reported quantitative trait locus (QTL) results for BMD from a genome screen of 595 female F2 progeny of Fischer 344 and Lewis rats. These progeny also provide an excellent opportunity to search for epistatic effects, or interaction between genetic loci, that contribute to fracture risk. Materials and Methods Microsatellite marker data from a 20-cM genome screen was analyzed along with weight-adjusted BMD (DXA and pQCT) phenotypic data using the R/qtl software package. Genotype and phenotype data were permuted to determine a genome-wide significance threshold for the epistasis or interaction LOD score corresponding to an α level of 0.01. Results and Conclusions Novel loci on chromosomes 12 and 15 showed a strong epistatic effect on total BMD at the femoral midshaft by pQCT (LOD = 5.4). A previously reported QTL on chromosome 7 was found to interact with a novel locus on chromosome 20 to affect whole lumbar BMD by pQCT (LOD = 6.2). These results provide new information regarding the mode of action of previously identified rat QTLs, as well as identifying novel loci that act in combination with known QTLs or with other novel loci to contribute to the risk factors for osteoporotic fracture. PMID:17907919

Proximal Femur Volumetric Bone Mineral Density and Mortality: 13 Years of Follow-Up of the AGES-Reykjavik Study.

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Marques, Elisa A; Elbejjani, Martine; Gudnason, Vilmundur; Sigurdsson, Gunnar; Lang, Thomas; Sigurdsson, Sigurdur; Aspelund, Thor; Meirelles, Osorio; Siggeirsdottir, Kristin; Launer, Lenore; Eiriksdottir, Gudny; Harris, Tamara B

2017-06-01

Bone mineral density (BMD) has been linked to mortality, but little is known about the independent contribution of each endosteal bone compartment and also the rate of bone loss to risk of mortality. We examined the relationships between (1) baseline trabecular and cortical volumetric BMD (vBMD) at the proximal femur, and (2) the rate of trabecular and cortical bone loss and all-cause mortality in older adults from the AGES-Reykjavik study. The analysis of trabecular and cortical vBMD and mortality was based on the baseline cohort of 4654 participants (aged ≥66 years) with a median follow-up of 9.4 years; the association between rate of bone loss and mortality was based on 2653 participants with bone loss data (median follow-up of 5.6 years). Analyses employed multivariable Cox-proportional models to estimate hazard ratios (HRs) with time-varying fracture status; trabecular and cortical variables were included together in all models. Adjusted for important confounders, Cox models showed that participants in the lowest quartile of trabecular vBMD had an increased risk of mortality compared to participants in other quartiles (HR = 1.12; 95% confidence interval (CI), 1.01 to 1.25); baseline cortical vBMD was not related to mortality (HR = 1.08; 95% CI, 0.97 to 1.20). After adjustment for time-dependent fracture status, results were attenuated and not statistically significant. A faster loss (quartile 1 versus quartiles 2-4) in both trabecular and cortical bone was associated with higher mortality risk (HR = 1.37 and 1.33, respectively); these associations were independent of major potential confounders including time-dependent incident fractures (HR = 1.32 and 1.34, respectively). Overall, data suggest that faster bone losses over time in both the trabecular and cortical bone compartments are associated with mortality risk and that measurements of change in bone health may be more informative than single-point measurements in explaining mortality

Rural versus nonrural differences in BMC, volumetric BMD, and bone size: a population-based cross-sectional study.

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Specker, Bonny; Binkley, Teresa; Fahrenwald, Nancy

2004-12-01

Despite reports of lower fracture risk among rural versus urban populations, few studies have investigated rural versus urban differences in bone mineral content (BMC) and bone mineral density (BMD). Population differences in cross-sectional bone geometry and understanding lifestyle factors responsible for these differences may reveal insights into the reason for differences in fracture risk. We hypothesized that if lifestyle differences in bone mass, size, and geometry are a result of muscle strength, activity, or dietary differences, Hutterite and rural populations should have greater bone mass compared to nonrural populations. The study population consisted of 1189 individuals: 504 rural Hutterites (188 men), 349 rural individuals (>75% life farming, 184 men), and 336 nonrural individuals (never lived on farm, 134 men) aged 20 to 66 years. BMC, bone area, and areal BMD (aBMD) of the total body (TB), hip, femoral neck (FN), and spine by DXA; volumetric BMD (vBMD) and bone geometry at the 4% and 20% radius; polar stress strain index (pSSI), a measure of bone strength, at the 20% pQCT site; and strength, 7-day activity recall, and 24-h diet recall were collected and compared among groups. Hutterite women and men had greater grip strength compared to rural and nonrural populations (both, P BMC and areal size than the nonrural population, while Hutterites had greater BMC and areal size than rural population at some (TB, FN for females only), but not all (proximal hip), sites. Cortical vBMD was inversely associated with periosteal circumference at the 20% radius in women (r=-0.25, P BMC, aBMD, vBMD, or bone size.

Microarchitecture Parameters Describe Bone Structure and Its Strength Better Than BMD

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Tomasz Topoliński

2012-01-01

Full Text Available Introduction and Hypothesis. Some papers have shown that bone mineral density (BMD may not be accurate in predicting fracture risk. Recently microarchitecture parameters have been reported to give information on bone characteristics. The aim of this study was to find out if the values of volume, fractal dimension, and bone mineral density are correlated with bone strength. Methods. Forty-two human bone samples harvested during total hip replacement surgery were cut to cylindrical samples. The geometrical mesh of layers of bone mass obtained from microCT investigation and the volumes of each layer and fractal dimension were calculated. The finite element method was applied to calculate the compression force F causing ε=0.8% strain. Results. There were stronger correlations for microarchitecture parameters with strength than those for bone mineral density. The values of determination coefficient R2 for mean volume and force were 0.88 and 0.90 for mean fractal dimension and force, while for BMD and force the value was 0.53. The samples with bigger mean bone volume of layers and bigger mean fractal dimension of layers (more complex structure presented higher strength. Conclusion. The volumetric and fractal dimension parameters better describe bone structure and strength than BMD.

Development and testing of texture discriminators for the analysis of trabecular bone in proximal femur radiographs

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Huber, M. B.; Carballido-Gamio, J.; Fritscher, K.; Schubert, R.; Haenni, M.; Hengg, C.; Majumdar, S.; Link, T. M. [Department of Radiology and Biomedical Imaging, University of California, 400 Parnassus Avenue, San Francisco, California 94143 (United States); University of Health Sciences, Medical Informatics and Technology, 6060 Hall (Austria); AO Development Institute, 7270 Davos Platz (Switzerland); Medical University Innsbruck, 6020 Innsbruck (Austria); Department of Radiology and Biomedical Imaging, University of California, 400 Parnassus Avenue, San Francisco, California 94143 (United States)

2009-11-15

Purpose: Texture analysis of femur radiographs may serve as a potential low cost technique to predict osteoporotic fracture risk and has received considerable attention in the past years. A further application of this technique may be the measurement of the quality of specific bone compartments to provide useful information for treatment of bone fractures. Two challenges of texture analysis are the selection of the best suitable texture measure and reproducible placement of regions of interest (ROIs). The goal of this in vitro study was to automatically place ROIs in radiographs of proximal femur specimens and to calculate correlations between various different texture analysis methods and the femurs' anchorage strength. Methods: Radiographs were obtained from 14 femoral specimens and bone mineral density (BMD) was measured in the femoral neck. Biomechanical testing was performed to assess the anchorage strength in terms of failure load, breakaway torque, and number of cycles. Images were segmented using a framework that is based on the usage of level sets and statistical in-shape models. Five ROIs were automatically placed in the head, upper and lower neck, trochanteric, and shaft compartment in an atlas subject. All other subjects were registered rigidly, affinely, and nonlinearly, and the resulting transformation was used to map the five ROIs onto the individual femora. Results: In each ROI, texture features were extracted using gray level co-occurence matrices (GLCM), third-order GLCM, morphological gradients (MGs), Minkowski dimensions (MDs), Minkowski functionals (MFs), Gaussian Markov random fields, and scaling index method (SIM). Coefficients of determination for each texture feature with parameters of anchorage strength were computed. In a stepwise multiregression analysis, the most predictive parameters were identified in different models. Texture features were highly correlated with anchorage strength estimated by the failure load of up to R{sup 2

Usefullness of three-dimensional templating software to quantify the contact state between implant and femur in total hip arthroplasty.

Science.gov (United States)

Inoue, Daisuke; Kabata, Tamon; Maeda, Toru; Kajino, Yoshitomo; Fujita, Kenji; Hasegawa, Kazuhiro; Yamamoto, Takashi; Takagi, Tomoharu; Ohmori, Takaaki; Tsuchiya, Hiroyuki

2015-12-01

It would be ideal if surgeons could precisely confirm whether the planned femoral component achieves the best fit and fill of implant and femur. However, the cortico-cancellous interfaces can be difficult to standardize using plain radiography, and therefore, determining the contact state is a subjective decision by the examiner. Few reports have described the use of CT-based three-dimensional templating software to quantify the contact state of stem and femur in detail. The purpose of this study was to use three-dimensional templating software to quantify the implant-femur contact state and develop a technique to analyze the initial fixation pattern of a cementless femoral stem. We conducted a retrospective review of 55 hips in 53 patients using a short proximal fit-and-fill anatomical stem (APS Natural-Hip™ System). All femurs were examined by density mapping which can visualize and digitize the contact state. We evaluated the contact state of implant and femur by using density mapping. The varus group (cases that had changed varus 2° by 3 months after surgery) consisted of 11 hips. The varus group showed no significant difference with regard to cortical contact in the proximal medial portion (Gruen 7), but the contact area in the distal portion (Gruen 3 and Gruen 5) was significantly lower than that of non-varus group. Density mapping showed that the stem only has to be press-fit to the medial calcar, but also must fill the distal portion of the implant in order to achieve the ideal contact state. Our results indicated that quantifying the contact state of implant and femur by using density mapping is a useful technique to accurately analyze the fixation pattern of a cementless femoral stem.

Concept and development of an orthotropic FE model of the proximal femur.

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Wirtz, Dieter Christian; Pandorf, Thomas; Portheine, Frank; Radermacher, Klaus; Schiffers, Norbert; Prescher, Andreas; Weichert, Dieter; Niethard, Fritz Uwe

2003-02-01

In contrast to many isotropic finite-element (FE) models of the femur in literature, it was the object of our study to develop an orthotropic FE "model femur" to realistically simulate three-dimensional bone remodelling. The three-dimensional geometry of the proximal femur was reconstructed by CT scans of a pair of cadaveric femurs at equal distances of 2mm. These three-dimensional CT models were implemented into an FE simulation tool. Well-known "density-determined" bony material properties (Young's modulus; Poisson's ratio; ultimate strength in pressure, tension and torsion; shear modulus) were assigned to each FE of the same "CT-density-characterized" volumetric group. In order to fix the principal directions of stiffness in FE areas with the same "density characterization", the cadaveric femurs were cut in 2mm slices in frontal (left femur) and sagittal plane (right femur). Each femoral slice was scanned into a computer-based image processing system. On these images, the principal directions of stiffness of cancellous and cortical bone were determined manually using the orientation of the trabecular structures and the Haversian system. Finally, these geometric data were matched with the "CT-density characterized" three-dimensional femur model. In addition, the time and density-dependent adaptive behaviour of bone remodelling was taken into account by implementation of Carter's criterion. In the constructed "model femur", each FE is characterized by the principal directions of the stiffness and the "CT-density-determined" material properties of cortical and cancellous bone. Thus, on the basis of anatomic data a three-dimensional FE simulation reference model of the proximal femur was realized considering orthotropic conditions of bone behaviour. With the orthotropic "model femur", the fundamental basis has been formed to realize realistic simulations of the dynamical processes of bone remodelling under different loading conditions or operative procedures

Associations of Polyunsaturated Fatty Acid Intake with Bone Mineral Density in Postmenopausal Women

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Margaret Harris

2015-01-01

Full Text Available A secondary analysis of cross-sectional data was analyzed from 6 cohorts (Fall 1995–Fall 1997 of postmenopausal women (n=266; 56.6±4.7 years participating in the Bone Estrogen Strength Training (BEST study (a 12-month, block-randomized, clinical trial. Bone mineral density (BMD was measured at femur neck and trochanter, lumbar spine (L2–L4, and total body BMD using dual-energy X-ray absorptiometry (DXA. Mean dietary polyunsaturated fatty acids (PUFAs intakes were assessed using 8 days of diet records. Multiple linear regression was used to examine associations between dietary PUFAs and BMD. Covariates included in the models were total energy intake, body weight at year 1, years after menopause, exercise, use of hormone therapy (HT, total calcium, and total iron intakes. In the total sample, lumbar spine and total body BMD had significant negative associations with dietary PUFA intake at P<0.05. In the non-HT group, no significant associations between dietary PUFA intake and BMD were seen. In the HT group, significant inverse associations with dietary PUFA intake were seen in the spine, total body, and Ward’s triangle BMD, suggesting that HT may influence PUFA associations with BMD. This study is registered with clinicaltrials.gov, identifier: NCT00000399.

Evaluation of Bone Mineral Density in Rural Women of Kawar-Fars

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Masoumeh Tohidi

2010-12-01

Full Text Available Background: Osteoporosis is a major public health problem. This study designed to assess peak bone mineral density (BMD, its onset in rural women in Kawar-Fars as well as prevalence of osteopenia and osteoporosis according to WHO and local reference values. Methods: In this cross sectional study , 266 healthy women aged 20-85 years from Kawar-Fars participated and they underwent Dual-energy X-ray absorptiometry (DXA scanning including two lumbar and femur regions. Results: Peak bone mass of lumbar spine occurred during 29±2 years. Also peak bone mass of total femur occurred around the age of 34±2 years. Prevalence of osteoporosis in lumbar spine according to WHO reference data was 29.7% but using Iranian normative data was 10.5%. Also using WHO reference data, prevalence of osteoporosis in total femur in rural women was 15.4% whereas according to the Iranian normative data was 16.2%. Conclusion: This study provided a baseline normative data of BMD for rural Iranian women. Also it showed prevalence of osteoporosis in rural women is more than urban women.

Experimental study of pedicle screw stability on low BMD vertebrae

International Nuclear Information System (INIS)

Li Qi; Yang Huilin; Tang Tiansi; Wu Yiwei; Wang Yijin

2005-01-01

Objective: To conduct biomechanical study of different pedicle screws stability on spinal specimen, discuss the relationship between design parameter of screw, insertion torgue and BMD, establish the theoretical foundation for application of pedicle screw on osteoporotic patients. Methods: Six fixed lumbar cadavers were collected, the effects of design parameter, insertion torque and etc on fixation stability were determined under various BMD by using biomechanical ways. Results: According to in vitro study: (1) There was a significant difference among pullout strength of all screws (P 2 >U 1 >SF 1 >SF 2 >RF. Conclusions: There is a close correlated between type of screw, BMD and stability. The U-type screw displays the best fixation effect on specimen of low BMD. (authors)

Is BMD testing appropriate for all menopausal women?

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Kleerekoper, Michael; Nelson, Dorothy A

2005-01-01

The United States Preventive Services Task Force has provided an evidence-based guideline indicating that bone mineral density (BMD) testing is appropriate for all women aged 65 or older. This does not preclude BMD testing in younger postmenopausal women but places the onus on the treating physician to justify the procedure to the patient and often the patient's insurance carrier. There are very few circumstances in which BMD testing is appropriate for healthy premenopausal women, but BMD testing in younger postmenopausal women is often appropriate: when there is a family history of osteoporosis with fracture, a personal history of fracture as an adult, and a medical, surgical or therapeutic history that might be associated with accelerated bone loss or increased risk of fracture. Medical conditions include intestinal diseases associated with malabsorption, such as non-tropical sprue, or primary hyperparathyroidism. Women who have neurologic conditions that increase the risk of falling should also be tested. There are data to suggest that patients with hemoglobinopathy are at increased risk for osteoporosis. Surgical conditions include the increasingly performed surgery for obesity and other surgery resulting in bowel resection (e.g., for inflammatory bowel disease). The major medication-related concern is corticosteroid therapy, but chronic or over-treatment with thyroxine, and chronic heparin therapy, should also be considered risk factors for osteoporosis. When performing a BMD test for the first time, it is essential to remember that 50% of women at menopause will have a negative T-score, but this does not imply that the patient has indeed lost any bone from her peak bone mass.

Total body and regional bone mineral content in hemodialysis patients

International Nuclear Information System (INIS)

Hagiwara, Satoshi; Aratani, Hideyui; Miki, Takami; Nishizawa, Yoshiki; Okamura, Terue; Koizumi, Yoshiko; Ochi, Hironobu; Morii, Hirotoshi

1994-01-01

Bone mineral content (BMC) in the total body and lumbar spine was evaluated in 126 hemodialysis patients (60 males, 66 females) by dual photon absorptiometry with the Norland DBD 2600. Measurements of: 1) total body BMC divided by lean body mass (BMC TB /LBM), 2) bone mineral density (BMD) of total body, 3) BMD of four regional sections (head, trunk, pelvis, and legs), and 4) BMD of lumbar spine, generally showed a significant decrease in the hemodialysis patients compared to the reference population. However, arm BMD did not show a significant difference between patients and control populations. The z-score of BMC TB /LBM declined significantly throughout the duration of hemodialysis, although that of the lumbar spine BMD did not. It should be noted that the degree of decrease in BMC was more prominent in the total body measurement than in the lumbar spine measurement. There was preferential osteopenia of the total body in the hemodialysis patients. Although the lumbar spine BMD showed a lower value than the control population, the lumbar spine is not the recommended region to monitor the BMD change in hemodialysis patients. (author)

Derivation of standardised BMD using the European Spine Phantom

International Nuclear Information System (INIS)

McCloskey, E.V.

2000-01-01

The primary aim of this study is to compare peak bone mass in a range of populations and to examine the determinants of any differences which may be observed. Bone mineral density (areal BMD) has been measured by densitometers manufactured by two companies, Hologic (Waltham, USA) and Lunar (Madison, USA). Systematic differences exist between tile manufacturers in several stages of the scanning procedure (e.g. edge-detection, calibration) so that the normal ranges produced are specific to each brand. To allow comparison of BMD between manufacturers (and thus between centres) we have therefore undertaken a cross-calibration of the scanners in order to derive a standardised BMD

Role of peripheral quantitative computed tomography in identifying disuse osteoporosis in paraplegia

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Coupaud, Sylvie [University of Glasgow, Centre for Rehabilitation Engineering, Department of Mechanical Engineering, Glasgow (United Kingdom); Southern General Hospital, Queen Elizabeth National Spinal Injuries Unit, Glasgow (United Kingdom); McLean, Alan N.; Allan, David B. [Southern General Hospital, Queen Elizabeth National Spinal Injuries Unit, Glasgow (United Kingdom)

2009-10-15

Disuse osteoporosis is a major long-term health consequence of spinal cord injury (SCI) that still needs to be addressed. Its management in SCI should begin with accurate diagnosis, followed by targeted treatments in the most vulnerable subgroups. We present data quantifying disuse osteoporosis in a cross-section of the Scottish paraplegic population to identify subgroups with lowest bone mineral density (BMD). Forty-seven people with chronic SCI at levels T2-L2 were scanned using peripheral quantitative computed tomography at four tibial sites and two femoral sites, at the Queen Elizabeth National Spinal Injuries Unit, Glasgow (UK). At the distal epiphyses, trabecular BMD (BMDtrab), total BMD, total bone cross-sectional area (CSA) and bone mineral content (BMC) were determined. In the diaphyses, cortical BMD, total bone CSA, cortical CSA and BMC were calculated. Bone, muscle and fat CSAs were estimated in the lower leg and thigh. BMDtrab decreased exponentially with time since injury at different rates in the tibia and femur. At most sites, female paraplegics had significantly lower BMC, total bone CSA and muscle CSA than male paraplegics. Subjects with lumbar SCI tended to have lower bone values and smaller muscle CSAs than in thoracic SCI. At the distal epiphyses of the tibia and femur, there is generally a rapid and extensive reduction in BMDtrab after SCI. Female subjects, and those with lumbar SCI, tend to have lower bone values than males or those with thoracic SCI, respectively. (orig.)

Role of peripheral quantitative computed tomography in identifying disuse osteoporosis in paraplegia

International Nuclear Information System (INIS)

Coupaud, Sylvie; McLean, Alan N.; Allan, David B.

2009-01-01

Disuse osteoporosis is a major long-term health consequence of spinal cord injury (SCI) that still needs to be addressed. Its management in SCI should begin with accurate diagnosis, followed by targeted treatments in the most vulnerable subgroups. We present data quantifying disuse osteoporosis in a cross-section of the Scottish paraplegic population to identify subgroups with lowest bone mineral density (BMD). Forty-seven people with chronic SCI at levels T2-L2 were scanned using peripheral quantitative computed tomography at four tibial sites and two femoral sites, at the Queen Elizabeth National Spinal Injuries Unit, Glasgow (UK). At the distal epiphyses, trabecular BMD (BMDtrab), total BMD, total bone cross-sectional area (CSA) and bone mineral content (BMC) were determined. In the diaphyses, cortical BMD, total bone CSA, cortical CSA and BMC were calculated. Bone, muscle and fat CSAs were estimated in the lower leg and thigh. BMDtrab decreased exponentially with time since injury at different rates in the tibia and femur. At most sites, female paraplegics had significantly lower BMC, total bone CSA and muscle CSA than male paraplegics. Subjects with lumbar SCI tended to have lower bone values and smaller muscle CSAs than in thoracic SCI. At the distal epiphyses of the tibia and femur, there is generally a rapid and extensive reduction in BMDtrab after SCI. Female subjects, and those with lumbar SCI, tend to have lower bone values than males or those with thoracic SCI, respectively. (orig.)

Bone remodelling of the proximal femur after total hip arthroplasty with 2 different hip implant designs

DEFF Research Database (Denmark)

Christiansen, Janus D.; Laursen, Mogens B; Ejaz, Ashir

2018-01-01

INTRODUCTION: The thrust plate prosthesis (TPP) was introduced to preserve bone in patients undergoing total hip arthroplasty. We assessed the long-term results of hip arthroplasty in patients who received the TPP compared to a traditional intramedullary stem (Bi-Metric). METHODS......: In this prospective observational cohort study, we evaluated bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), radiological imaging and clinical outcome using Harris Hip Score (HHS). Twenty patients received the TPP (group A) and 18 patients received the Bi-Metric stem (group B). Baseline......% (95% confidence interval [CI], 4-16; p = 0.003) and 8% (95% CI, 1-15; p = 0.03) at 8 years. Regarding ROI4, group A had a lesser decrease in general compared to group B. The radiological findings did not reveal any subsidence or detectable implant migration. HHS improved from 53 (23-69) to 93 (55...

Correlation of fracture index with BMD T score in postmenopausal females

International Nuclear Information System (INIS)

Chaudhary, U.J.; Osman, S.S.; Moazam, S.; Shah, S.I.A.

2004-01-01

Objective: To find the correlation between fracture index and BMD T-score so that fracture index can be used as a predictive tool for fracture risk estimation in post menopausal females. Design: A cross-sectional study was conducted on a sample of 396 women age 50 years and above. BMD T-score measurements using ultrasound and fracture index calculation based on the risk factor assessment were performed. Results: The study results showed that when fracture index increases BMD T-score decreased to osteoporotic range and correlation coefficient is -0.162. Conclusion: When fracture index increases, BMD T-score decreases therefore we can use fracture index as an assessment tool for predicting fracture risk in postmenopausal females. (author)

A biomechanical comparison of composite femurs and cadaver femurs used in experiments on operated hip fractures.

Science.gov (United States)

Basso, Trude; Klaksvik, Jomar; Syversen, Unni; Foss, Olav A

2014-12-18

Fourth generation composite femurs (4GCFs, models #3406 and #3403) simulate femurs of males cadaver femurs (HCFs) selected to represent patients with hip fractures. Ten 4GCFs (Sawbones, Pacific Research Laboratories, Inc., Vashon, WA, USA) were compared to 24 HCFs from seven females and five males >60 years. Proximal femur anthropometric measurements were noted. Strain gauge rosettes were attached and femurs were mounted in a hip simulator applying a combined subject-specific axial load and torque. Baseline measurements of resistance to deformation were recorded. Standardized femoral neck fractures were surgically stabilized before the constructs were subjected to 20,000 load-cycles. An optical motion tracking system measured relative movements. Median (95% CI) head fragment migration was 0.8mm (0.4 to 1.1) in the 4GCF group versus 2.2mm (1.5 to 4.6) in the cadaver group (p=0.001). This difference in fracture stability could not be explained by observed differences in femoral anthropometry or potential overloading of 4GCFs. 4GCFs failed with fracture-patterns different from those observed in cadavers. To conclude, standard 4GCFs provide unrealistically stable bone-implant constructs and fail with fractures not observed in cadavers. Until a validated osteopenic or osteoporotic composite femur model is provided, standard 4GCFs should only be used when representing the biomechanical properties of young healthy femurs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comparison of Bone Mineral Density in Thalassemia Major Patients with Healthy Controls

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Mahesh Chand Meena

2015-01-01

Full Text Available Chronic hemoglobinopathies like thalassemia are associated with many osteopathies like osteoporosis. Methods. This observational study was carried out to compare the bone mineral density (BMD in transfusion dependent thalassemics with that of healthy controls. Thirty-two thalassemia patients, aged 2–18 years, and 32 age and sex matched controls were studied. The bone mineral concentration (BMC and BMD were assessed at lumbar spine, distal radius, and neck of femur. Biochemical parameters like serum calcium and vitamin D levels were also assessed. Results. The BMC of neck of femur was significantly low in cases in comparison to controls. We also observed significantly lower BMD at the lumbar spine in cases in comparison to controls. A significantly positive correlation was observed between serum calcium levels and BMD at neck of femur. Conclusion. Hence, low serum calcium may be used as a predictor of low BMD especially in populations where incidence of hypovitaminosis D is very high.

Comparison of osteoporosis in US adults with type 1 and type 2 diabetes mellitus.

Science.gov (United States)

DeShields, S C; Cunningham, T D

2018-01-20

We examined bone mineral density (BMD) and osteoporosis prevalence in those with type 1 compared to type 2 diabetes derived from a nationally representative sample from the civilian community in the United States. Data from the National Health and Nutrition Examination Survey (NHANES) for 2005-2006, 2007-2008, 2009-2010, and 2013-2014 were merged to obtain a large sample of diabetics at least 20 years of age with participation in the interview and medical examination. Osteoporosis status was defined by BMD at the total femur, femoral neck, or total lumbar spine. Self-reported diabetics that were prescribed insulin within the first year of diagnosis, are currently taking insulin, and reported no prescriptions for any diabetic pills were classified as type 1. Remaining self-reported diabetics were deemed as having type 2. A total of 2050 diabetics were included in which 87 (4%) were classified as type 1. Type 1 diabetics were found to have a significantly lower BMD at the total femur and femoral neck, but not at the lumbar spine in the adjusted models. Diabetics with type 1 were 4.7 times more likely to have osteoporosis than those with type 2. There was no significant relationship between diabetes type and BMD or osteoporosis prior to adjustment for confounders. Although our results show an increased likelihood of osteoporosis among those with type 1 diabetes, future studies including a larger sample from a community population are needed. It may benefit diabetics, especially those with type 1, to initiate osteoporosis screening methods including evaluation of fracture risk, bone quality, and BMD measurements at multiple sites earlier than recommended.

Anthropometric adjustments are helpful in the interpretation of BMD and BMC Z-scores of pediatric patients with Prader-Willi syndrome.

Science.gov (United States)

Hangartner, T N; Short, D F; Eldar-Geva, T; Hirsch, H J; Tiomkin, M; Zimran, A; Gross-Tsur, V

2016-12-01

Anthropometric adjustments of bone measurements are necessary in Prader-Willi syndrome patients to correctly assess the bone status of these patients. This enables physicians to get a more accurate diagnosis of normal versus abnormal bone, allow for early and effective intervention, and achieve better therapeutic results. Bone mineral density (BMD) is decreased in patients with Prader-Willi syndrome (PWS). Because of largely abnormal body height and weight, traditional BMD Z-scores may not provide accurate information in this patient group. The goal of the study was to assess a cohort of individuals with PWS and characterize the development of low bone density based on two adjustment models applied to a dataset of BMD and bone mineral content (BMC) from dual-energy X-ray absorptiometry (DXA) measurements. Fifty-four individuals, aged 5-20 years with genetically confirmed PWS, underwent DXA scans of spine and hip. Thirty-one of them also underwent total body scans. Standard Z-scores were calculated for BMD and BMC of spine and total hip based on race, sex, and age for all patients, as well as of whole body and whole-body less head for those patients with total-body scans. Additional Z-scores were generated based on anthropometric adjustments using weight, height, and percentage body fat and a second model using only weight and height in addition to race, sex, and age. As many PWS patients have abnormal anthropometrics, addition of explanatory variables weight, height, and fat resulted in different bone classifications for many patients. Thus, 25-70 % of overweight patients, previously diagnosed as normal, were subsequently diagnosed as below normal, and 40-60 % of patients with below-normal body height changed from below normal to normal depending on bone parameter. This is the first study to include anthropometric adjustments into the interpretation of BMD and BMC in children and adolescents with PWS. This enables physicians to get a more accurate diagnosis of

Secondary Hyperparathyroidism and Bone Turnover in Elderly with Bone Loss - Original Investigation

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Nurdan Peker

2006-12-01

Full Text Available Bone loss is common in the elderly. Parathyroid hormone (PTH, which regulates serum calcium levels,calcitonin and vitamin D metabolites have various effects on skeletal system. The aim of this study was to assess secondary hyperparathyroidism (HPTH and bone turnover in elderly with bone loss. Fifty-five patients (9 men,46 women older than 65 years with bone loss were included in the study. Bone mineral density was measured by dual energy x-ray absorptiomety (DXA at L1-4 vertebrae and proximal femur regions. Patients with T scores <-1.5 at one of the measurement sites were included in the study. Study subjects were assessed in terms of fracture history, sunbathing and walking activity. Routine biochemical tests, serum osteocalcin (OC and C-telopeptide type 1 collagen (CTX and lateral thoracal and lumbar vertebrae radyographic evaluation was performed. Our results showed that 70.9% of the patients had HPTH. Total femur BMD values and femur neck T scores were significantly lower in HPTH group than PTH normal one (p=0.05, p=0.03. Serum OC and CTX levels were higher in both groups. There was a negative correlation with femur neck BMD and CTX (r=0,321. There was no correlation between serum PTH levels and lumbar vertebrae and proximal femur BMD values. Serum PTH and alkaline phosphatase levels showed a significant positive correlation. In conclusion secondary HPTH and increased bone turnover is common elderly with bone loss. Adequate calcium and vitamin D intake is important the older people. (Osteoporoz Dünyasından 2006; 12: 70-3

A 1-year randomized, double-blind, placebo-controlled study of intravenous ibandronate on bone loss following renal transplantation.

Science.gov (United States)

Smerud, K T; Dolgos, S; Olsen, I C; Åsberg, A; Sagedal, S; Reisæter, A V; Midtvedt, K; Pfeffer, P; Ueland, T; Godang, K; Bollerslev, J; Hartmann, A

2012-12-01

The clinical profile of ibandronate as add-on to calcitriol and calcium was studied in this double-blind, placebo-controlled trial of 129 renal transplant recipients with early stable renal function (≤ 28 days posttransplantation, GFR ≥ 30 mL/min). Patients were randomized to receive i.v. ibandronate 3 mg or i.v. placebo every 3 months for 12 months on top of oral calcitriol 0.25 mcg/day and calcium 500 mg b.i.d. At baseline, 10 weeks and 12 months bone mineral density (BMD) and biochemical markers of bone turnover were measured. The primary endpoint, relative change in BMD for the lumbar spine from baseline to 12 months was not different, +1.5% for ibandronate versus +0.5% for placebo (p = 0.28). Ibandronate demonstrated a significant improvement of BMD in total femur, +1.3% versus -0.5% (p = 0.01) and in the ultradistal radius, +0.6% versus -1.9% (p = 0.039). Bone formation markers were reduced by ibandronate, whereas the bone resorption marker, NTX, was reduced in both groups. Calcium and calcitriol supplementation alone showed an excellent efficacy and safety profile, virtually maintaining BMD without any loss over 12 months after renal transplantation, whereas adding ibandronate significantly improved BMD in total femur and ultradistal radius, and also suppressed biomarkers of bone turnover. Ibandronate was also well tolerated. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

Studies of osteoporosis in the northern part of China using isotope-related techniques

International Nuclear Information System (INIS)

Qin Linlin

1998-01-01

Using Lunar DPX-L DXA, the BMD of 518 subjects were measured from June 1995 to July 1996. The 93 excluded cases include minority nationalities, southern chinese or underlying patients. Modifying BMD by body weight, the measurement results of 45 healthy subjects showed: in male the age of formatting peak bone is 20 ∼ 24 at lumbar, proximal femur and total body, however in female is 25 ∼ 29 at the same sites. Before the age of 40, the BMD of all sites in both sexes are basic stable. Further working plan were reported in this paper. (author)

Additive association of vitamin D insufficiency and sarcopenia with low femoral bone mineral density in noninstitutionalized elderly population: the Korea National Health and Nutrition Examination Surveys 2009-2010.

Science.gov (United States)

Lee, S-G; Lee, Y-h; Kim, K J; Lee, W; Kwon, O H; Kim, J-H

2013-11-01

Vitamin D insufficiency and sarcopenia are crucial risk factors for osteoporosis. In a study of noninstitutionalized elderly subjects, we investigated the simultaneous effect of vitamin D and sarcopenia on bone mineral density (BMD) and found that sarcopenia was associated with low BMD in the femur, especially in those with suboptimal vitamin D levels. Although vitamin D insufficiency and sarcopenia are prevalent in the elderly population worldwide, their possible influence on BMD has not been determined. We aimed to investigate the different effect of vitamin D insufficiency and sarcopenia on BMD in the elderly Korean population. Individuals aged 60 or older were selected from those who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys conducted in 2009 and 2010; 1,596 males and 1,886 females were analyzed. Appendicular skeletal muscle mass (ASM) and BMD were assessed by dual-energy X-ray absorptiometry; serum 25-hydroxyvitamin D [25(OH)D] and a panel of clinical and laboratory parameters were also measured. The study population was divided into four groups according to their vitamin D and sarcopenic status. BMD in total femur and in the femoral neck but not the lumbar spine was markedly decreased in sarcopenic subjects with vitamin D insufficiency [25(OH)D sarcopenia, low daily calcium intake, low 25(OH)D levels, age, and BMI. These data showed that an association between vitamin D insufficiency and low BMD was more prominent in elderly subjects with sarcopenia.

Effects of intravenously injected lanthanum chloride on the femur of rats

International Nuclear Information System (INIS)

Miyagawa, Makoto; Daimon, Tateo

2010-01-01

Lanthanum (La) is widely used in industry and medicine. Because of lanthanum's physicochemical resemblance to calcium, the possible effects of it on bone have to be considered. The aim of this study was to examine the effects of La on bone toxicity. Rats were intravenously administrated with lanthanum chloride at 5 mg La/kg per week for five weeks. Histomorphometric analysis of femurs were performed using micro-CT scan. Compared with normal controls, the total bone area of the femur did not show any change in La-administrated rats, whereas the trabecular area slightly decreased. The trabecular bone mineral density in the experimented rats was higher than that in the normal controls, although the mineral density of the cortical bone and cancerou one was unchanged after the administration of La. La did not alter mechanical barometers of the femur such as mean cross-sectional moment of inertia, minimum cross-sectional moment of inertia and polar moment of inertia. Additionally, light microscopic analysis of the femurs revealed that histological features of osteoid, calcification front and bone matrix were normal after the administration of La. La was detected in the macrophages in the bone marrow, but not in the bone matrix by histological stain for La and X-ray fluorescence microanalysis. Thus, these micro-CT imaging and microscopy of the femurs did not reveal toxic changes due to La. (author)

Genome-Wide Association Study of Bone Mineral Density in Korean Men

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Ye Seul Bae

2016-06-01

Full Text Available Osteoporosis is a medical condition of global concern, with increasing incidence in both sexes. Bone mineral density (BMD, a highly heritable trait, has been proven a useful diagnostic factor in predicting fracture. Because medical information is lacking about male osteoporotic genetics, we conducted a genome-wide association study of BMD in Korean men. With 1,176 participants, we analyzed 4,414,664 single nucleotide polymorphisms (SNPs after genomic imputation, and identified five SNPs and three loci correlated with bone density and strength. Multivariate linear regression models were applied to adjust for age and body mass index interference. Rs17124500 (p = 6.42 × 10-7, rs34594869 (p = 6.53 × 10-7 and rs17124504 (p = 6.53 × 10-7 in 14q31.3 and rs140155614 (p = 8.64 × 10-7 in 15q25.1 were significantly associated with lumbar spine BMD (LS-BMD, while rs111822233 (p = 6.35 × 10-7 was linked with the femur total BMD (FT-BMD. Additionally, we analyzed the relationship between BMD and five genes previously identified in Korean men. Rs61382873 (p = 0.0009 in LRP5, rs9567003 (p = 0.0033 in TNFSF11 and rs9935828 (p = 0.0248 in FOXL1 were observed for LS-BMD. Furthermore, rs33997547 (p = 0.0057 in ZBTB and rs1664496 (p = 0.0012 in MEF2C were found to influence FT-BMD and rs61769193 (p = 0.0114 in ZBTB to influence femur neck BMD. We identified five SNPs and three genomic regions, associated with BMD. The significance of our results lies in the discovery of new loci, while also affirming a previously significant locus, as potential osteoporotic factors in the Korean male population.

Minimally invasive computer-navigated total hip arthroplasty, following the concept of femur first and combined anteversion: design of a blinded randomized controlled trial

Directory of Open Access Journals (Sweden)

Woerner Michael

2011-08-01

Full Text Available Abstract Background Impingement can be a serious complication after total hip arthroplasty (THA, and is one of the major causes of postoperative pain, dislocation, aseptic loosening, and implant breakage. Minimally invasive THA and computer-navigated surgery were introduced several years ago. We have developed a novel, computer-assisted operation method for THA following the concept of "femur first"/"combined anteversion", which incorporates various aspects of performing a functional optimization of the cup position, and comprehensively addresses range of motion (ROM as well as cup containment and alignment parameters. Hence, the purpose of this study is to assess whether the artificial joint's ROM can be improved by this computer-assisted operation method. Second, the clinical and radiological outcome will be evaluated. Methods/Design A registered patient- and observer-blinded randomized controlled trial will be conducted. Patients between the ages of 50 and 75 admitted for primary unilateral THA will be included. Patients will be randomly allocated to either receive minimally invasive computer-navigated "femur first" THA or the conventional minimally invasive THA procedure. Self-reported functional status and health-related quality of life (questionnaires will be assessed both preoperatively and postoperatively. Perioperative complications will be registered. Radiographic evaluation will take place up to 6 weeks postoperatively with a computed tomography (CT scan. Component position will be evaluated by an independent external institute on a 3D reconstruction of the femur/pelvis using image-processing software. Postoperative ROM will be calculated by an algorithm which automatically determines bony and prosthetic impingements. Discussion In the past, computer navigation has improved the accuracy of component positioning. So far, there are only few objective data quantifying the risks and benefits of computer navigated THA. Therefore, this

BMD measurements of the spine derived from sagittal reformations of contrast-enhanced MDCT without dedicated software

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Baum, Thomas, E-mail: thbaum@gmx.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany); Mueller, Dirk, E-mail: dirk.mueller@roe.med.tum.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany); Dobritz, Martin, E-mail: dobritz@roe.med.tum.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany); Rummeny, Ernst J., E-mail: institut@roe.med.tum.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany); Link, Thomas M., E-mail: thomas.link@radiology.ucsf.edu [Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107 (United States); Bauer, Jan S., E-mail: jsb@roe.med.tum.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany)

2011-11-15

Purpose: To assess QCT equivalent BMD of the lumbar spine in sagittal reformations of routine abdominal contrast-enhanced MDCT with simple PACS measurement tools and to apply this method to MDCT datasets for differentiating patients with and without osteoporotic vertebral fractures. Materials and methods: Eight postmenopausal women (65 {+-} 5years) underwent standard QCT to assess BMD of L1-L3. Afterwards routine abdominal contrast-enhanced MDCT images of these women were obtained and apparent BMD of L1-L3 was measured using the sagittal reformations. The MDCT-to-QCT conversion equation for BMD was calculated with linear regression analysis. The conversion equation was applied to vertebral BMD datasets (L1-L3) of 75 postmenopausal women (66 {+-} 4years). Seventeen of the 75 patients had osteoporotic vertebral fractures. Results: BMD values of contrast-enhanced MDCT were on average 56 mg/ml higher than those of standard QCT. A correlation coefficient of r = 0.94 (p < 0.05) was calculated for the BMD values of MDCT and standard QCT with the conversion equation BMD{sub QCT} = 0.69 x BMD{sub MDCT} - 11 mg/ml. Accordingly converted BMD values of patients with vertebral fractures were significantly lower than those of patients without vertebral fractures (69 mg/ml vs. 85 mg/ml; p < 0.05). Using ROC analysis to differentiate patients with and without vertebral fractures, AUC = 0.72 was obtained for converted BMD values (p < 0.05). Short- and long-term reproducibility errors for BMD measurements in the sagittal reformations amounted 2.09% and 7.70%, respectively. Conclusion: BMD measurements of the spine could be computed in sagittal reformations of routine abdominal contrast-enhanced MDCT with minimal technical and time effort. Using the conversion equation, the acquired BMD data could differentiate patients with and without osteoporotic vertebral fractures.

Loss of Hip BMD in Older Men: The Osteoporotic Fractures in Men (MrOS) Study

OpenAIRE

Cawthon, Peggy M.; Ewing, Susan K.; McCulloch, Charles E.; Ensrud, Kristine E.; Cauley, Jane A.; Cummings, Steven R.; Orwoll, Eric S.

2009-01-01

Previous studies in older men have not evaluated whether loss of BMD or BMC accelerates nonlinearly with age. This study aimed to describe hip bone loss (both in BMC and BMD) in older men and to test whether BMD loss accelerates with age in an exponential manner in a cohort of 4720 community-dwelling men ≥65 yr of age. Men had two to three measures of femoral neck (FN) BMD (by DXA) over an average follow-up of 4.6 yr. Change in BMD during follow-up was estimated from mixed effects regression ...

Reassuring Russia On BMD

Science.gov (United States)

2016-02-16

paranoid about this, but George Bush was right. This was not a threat 6 to them. And this program will not be a threat to them.”16 Rhetoric aside...measures to “ overcome any BMD system and protect Russia’s retaliation potential.” Putin also added, “Whatever you call it, this has some elements of an...transferring part of its responsibility for protecting elements of NATO territory to a state that is not within NATO.”39 To overcome these differences

A study on the change of bone mineral density (BMD) by life habit and physical condition

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Geun [Woosuk University Oriental Medical Hospital, Wanju (Korea, Republic of)

2006-09-15

To evaluate the correlation between BMD and life habit such as drinking exercise smoking or physical condition such as age, sex, height, weight, body mass index (BMI). I evaluated the BMD of the femoral neck and L2-L4 spines of 321 persons who took a regular health screening in Woosuk university oriental medical hospital from February to April in 2006 by dual energy bone mineral densitometry. The age of persons ranged from 20 years to 75 years (mean 45.10 {+-} 11.54) and there were 160 males and 161 females. In males, BMD of the femoral head was highest at 2nd decade, BMD of the spine was highest at 4th decade, and BMD of both femoral head and lumbar spine was lowest at 6th decade. In fenales, BMD of both femoral head and lumbar spine was highest at 4th decade and lowest at 6th decade. Among the various physical conditions, only height of persons showed significant correlation with BMD in both males and females, BMD was increased according to increasing height. In males, BMD of persons who had habit such as drinking, exercise or smoking did not show significant change statistically. But in females, drinking group showed high BMD relative to non-drinking group in both femoral head and lumbar spine. BMD was different according to age, sex, height and life habit. Especially aged people showed osteoporotic change progressively. More persistent effort is needed to find out the factors decreasing BMD for prevention of problems by osteoporosis.

A study on the change of bone mineral density (BMD) by life habit and physical condition

International Nuclear Information System (INIS)

Kim, Sun Geun

2006-01-01

To evaluate the correlation between BMD and life habit such as drinking exercise smoking or physical condition such as age, sex, height, weight, body mass index (BMI). I evaluated the BMD of the femoral neck and L2-L4 spines of 321 persons who took a regular health screening in Woosuk university oriental medical hospital from February to April in 2006 by dual energy bone mineral densitometry. The age of persons ranged from 20 years to 75 years (mean 45.10 ± 11.54) and there were 160 males and 161 females. In males, BMD of the femoral head was highest at 2nd decade, BMD of the spine was highest at 4th decade, and BMD of both femoral head and lumbar spine was lowest at 6th decade. In fenales, BMD of both femoral head and lumbar spine was highest at 4th decade and lowest at 6th decade. Among the various physical conditions, only height of persons showed significant correlation with BMD in both males and females, BMD was increased according to increasing height. In males, BMD of persons who had habit such as drinking, exercise or smoking did not show significant change statistically. But in females, drinking group showed high BMD relative to non-drinking group in both femoral head and lumbar spine. BMD was different according to age, sex, height and life habit. Especially aged people showed osteoporotic change progressively. More persistent effort is needed to find out the factors decreasing BMD for prevention of problems by osteoporosis

Effects of swimming training and free mobilization on bone mineral densities of rats with the immobilization-induced osteopenia

International Nuclear Information System (INIS)

Karatosun, H.; Erdogan, A.; Akgun, C.; Cetin, C.; Yeldiz, M.

2006-01-01

To investigate the possible effects of regular swimming exercise on bone mineral density (BMD) compared with free activity after cast immobilization of rats. We carried out the study from April 2005 to June 2005 at the Department of Sports Medicine, Medical School of Suleyman Demirel University, Isparta, Turkey. The study included a total of 24 female Wistar rats. The rats were randomized to control (n = 6), swimming training (ST) n = 9, and free mobilization (FM) n = 9 groups. We measured Bone mineral densities of femur and vertebra of all rats with a total body scanner using software specifically designed for small animals, before study started and at weeks 3 and 7. Timepoints corresponded to basal, after cast removal (ACIM), and after 3 weeks of free mobilization (AFM) or swimming training (AST). We immobilized the right hindlimb of each ST and FM animal with a cast while the left hindlimbs were kept free. After 3 weeks, the casts were removed. Then we allowed the rats to move freely in their cage for one week, after which the animals in ST group started to swim for 5 days a week for 3 weeks for 30 minutes per day. The group FM rats moved freely in the cage. Bone mineral density of the femur and vertebra after cast immobilization was significantly decreased compared with both their basal and age-matched control group. After mobilization, significant increases occurred in both groups according to ACIM. Similar but milder changes were observed in free limbs femur BMD of rats. Interestingly, vertebra BMD of swimming group was also higher than its age-matched control group (p<0.05). Our study showed that swimming exercise had a significant rehabilitative effect on BMD loss associated with immobilization. Further studies are needed to investigate the effects of swimming on other bone properties. (author)

Failure analysis of stainless steel femur fixation plate.

Science.gov (United States)

Hussain, P B; Mohammad, M

2004-05-01

Failure analysis was performed to investigate the failure of the femur fixation plate which was previously fixed on the femur of a girl. Radiography, metallography, fractography and mechanical testing were conducted in this study. The results show that the failure was due to the formation of notches on the femur plate. These notches act as stress raisers from where the cracks start to propagate. Finally fracture occurred on the femur plate and subsequently, the plate failed.

Influence of lean and fat mass on bone mineral density (BMD) in postmenopausal women with osteoporosis.

Science.gov (United States)

Dytfeld, Joanna; Ignaszak-Szczepaniak, Magdalena; Gowin, Ewelina; Michalak, Michał; Horst-Sikorska, Wanda

2011-01-01

Despite known positive association between body mass and bone mineral density (BMD), relative contribution of fat and lean tissue to BMD remains under debate. We aimed at investigating the effect of selected anthropometric parameters, including fat content and lean body mass (LBM) on BMD in postmenopausal, osteoporotic women with body mass index (BMI) > 20 kg/m(2). The study involved 92 never-treated women (mean age 69.5 ± 7.3). L1-L4 and femoral neck (FN) BMD were measured by dual energy X-ray absorptiometry (DEXA). Absolute (kg) and relative (%) fat and LBM were assessed by means of electric bioimpedance method. We showed both FN and L1-L4 BMD were positively correlated with body mass, waist circumference (WC), hip circumference (HC) and LBM (kg). Fat content correlated with FN BMD (r = 0.36, p obese. Obese women displayed the highest BMD. Both L1-L4 and FN BMD were higher in women with WC > 80 cm. In postmenopausal osteoporotic women with BMI > 20 kg/m(2) both fat and lean tissue might contribute to BMD. Positive association between body mass and BMD does not make obesity and osteoporosis mutually exclusive. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Epistasis between QTLs for bone density variation in Copenhagen × dark agouti F2 rats

Science.gov (United States)

Liu, Lixiang; Alam, Imranul; Sun, Qiwei; Econs, Michael J.; Foroud, Tatiana; Turner, Charles H.

2010-01-01

The variation in several of the risk factors for osteoporotic fracture, including bone mineral density (BMD), has been shown to be strongly influenced by genetic differences. However, the genetic architecture of BMD is complex in both humans and in model organisms. We previously reported quantitative trait locus (QTL) results for BMD from a genome screen of 828 F2 progeny of Copenhagen and dark agouti rats. These progeny also provide an excellent opportunity to search for epistatic effects, or interaction between genetic loci, that contribute to fracture risk. Microsatellite marker data from a 20-cM genome screen was analyzed along with weight-adjusted bone density (DXA and pQCT) phenotypic data using the R/qtl software package. Genotype and phenotype data were permuted to determine genome-wide significance thresholds for the full model and epistasis (interaction) LOD scores corresponding to an alpha level of 0.01. A novel locus on chromosome 15 and a previously reported chromosome 14 QTL demonstrated a strong epistatic effect on BMD at the femur by DXA (LOD = 5.4). Two novel QTLs on chromosomes 2 and 12 were found to interact to affect total BMD at the femur midshaft by pQCT (LOD = 5.0). These results provide new information regarding the mode of action of previously identified QTL in the rat, as well as identifying novel loci that act in combination with known QTL or with other novel loci to contribute to BMD variation. PMID:19153792

Epistasis between QTLs for bone density variation in Copenhagen x dark agouti F2 rats.

Science.gov (United States)

Koller, Daniel L; Liu, Lixiang; Alam, Imranul; Sun, Qiwei; Econs, Michael J; Foroud, Tatiana; Turner, Charles H

2009-03-01

The variation in several of the risk factors for osteoporotic fracture, including bone mineral density (BMD), has been shown to be strongly influenced by genetic differences. However, the genetic architecture of BMD is complex in both humans and in model organisms. We previously reported quantitative trait locus (QTL) results for BMD from a genome screen of 828 F2 progeny of Copenhagen and dark agouti rats. These progeny also provide an excellent opportunity to search for epistatic effects, or interaction between genetic loci, that contribute to fracture risk. Microsatellite marker data from a 20-cM genome screen was analyzed along with weight-adjusted bone density (DXA and pQCT) phenotypic data using the R/qtl software package. Genotype and phenotype data were permuted to determine genome-wide significance thresholds for the full model and epistasis (interaction) LOD scores corresponding to an alpha level of 0.01. A novel locus on chromosome 15 and a previously reported chromosome 14 QTL demonstrated a strong epistatic effect on BMD at the femur by DXA (LOD = 5.4). Two novel QTLs on chromosomes 2 and 12 were found to interact to affect total BMD at the femur midshaft by pQCT (LOD = 5.0). These results provide new information regarding the mode of action of previously identified QTL in the rat, as well as identifying novel loci that act in combination with known QTL or with other novel loci to contribute to BMD variation.

Identification of Hip BMD Loss and Fracture Risk Markers Through Population-Based Serum Proteomics: HIP BMD LOSS & FRACTURE RISK MARKERS BY POPULATION-BASED SERUM PROTEOMICS

Energy Technology Data Exchange (ETDEWEB)

Nielson, Carrie; Wiedrick, Jack; Shen, Jian; Jacobs, Jon M.; Baker, Erin M.; Baraff, Aaron; Piehowski, Paul D.; Lee, Christine; Baratt, Arie; Petyuk, Vladislav A.; Mcweeney, Shannon K.; Lim, Jeong Youn; Bauer, Douglas C.; Lane, Nancy E.; Cawthon, Peggy M.; Smith, Richard D.; Lapidus, Jodi; Orwoll, Eric S.

2017-04-06

Accelerated bone loss significantly increases the risk of osteoporosis and fracture. The mechanisms underlying bone loss remain incompletely understood, and there are few available biomarkers. We utilized a novel proteomics approach to identify serum peptides and proteins associated with bone loss in 1967 older men who were randomly chosen from the Osteoporotic Fracture in Men Study (MrOS study) (age ≥ 65 yrs). Men had 2-3 measures of femoral neck BMD over an average follow-up of 4.6 years. Change in BMD was estimated and then categorized into three groups: maintained BMD (n=453), expected loss (n=1185) and accelerated loss (n=237). A liquid chromatography–ion mobility separation-mass spectrometry (LC-IMS-MS) proteomics platform was used to identify and quantify peptides from serum proteins. The whole cohort was randomly divided into discovery (N= 960) and validation (N= 915) sub-cohorts. Linear regression models and a random forest approach were used to discover differentially abundant individual peptides and a proteomic signature that distinguished individuals with accelerated bone loss from those who maintained BMD. Network analyses were performed using the MetaCore knowledgebase. We identified 12 peptides that were associated with BMD loss in both discovery (P< 0.1 FDR) and replication sub-cohorts (P<0.05). Those 12 peptides mapped to the following proteins: ALS, LYVE1, RNAS1, C2, ICOSL, C163A, C7, HEMO, CD14, CERU, CRAC1 and CD59. Meta-analysis of peptidesassociated with bone loss identified 6 additional proteins including GRP78, IGF-2, SHBG, ENPP2, IBP2 and IBP6. We also identified a proteomic signature that was predictive of BMD loss with a discriminative value similar to serum bone marker carboxy-terminal collagen crosslink peptide (CTX). Interestingly, combining the proteomic signature with CTX significantly improved the ability to discriminate men with accelerated loss. In summary, we have identified potential new biomarkers for bone loss that provide

[A therapeutic effect analysis of femur first principle and combined anteversion technique during total hip arthroplasty].

Science.gov (United States)

Wang, X Q; Wu, C S; Sun, S; Wang, J; Li, W; Zhang, W

2018-04-01

Objective: To investigate the situation of hip dislocation with the application of "femur first" principle and "combined anteversion technique" during total hip arthroplasty. Methods: A retrospective analysis has been done on the clinical data about 104 patients(133 hips)who were diagnosed as hip disease and were treated with total hip arthroplasty by the doctors from the Department of Joint Orthorpaedics of Shandong Provincial Hospital Affiliated to Shandong University from June 2014 to June 2016, and all the prostheses applied in the operation were cementless ones.Among them, 65 patients were males, 39 females and their age was 46.6 years (ranging from 23 to 76 years) .And 29 of them underwent bilateral hip operations and 75 unilateral ones.Seventy-six cases of aseptic necrosis of the femoral head in the terminal stage, 28 cases of hip dysplasia and osteoarthritis.Surgical approach: of all the operations, 103 hips were operated on with hardinge approach, 30 with posterolateral approach.During the operation, first of all, the femoral medullary cavity was broached and then the anteversion of intramedullary broacher was measured.After that, the anteversion of the acetabular cup was calculated as 37° minus the anteversion of the broacher, and the acetabular cup was implanted at that angle.The patients' prosthesis combined anteversion, range of motion of the hip joint, operation time, hemorrhage amount, and complications had been kept record.One, three, and six months respectively after the operation, all the patients received outpatient review, and took anteroposterior and lateral position X-ray examination.Harris hip score had been applied to evaluate their hip function before the operation and six months after the operation. Results: All the patients had been operated on smoothly, with the operation time of(57.6±14.5)minutes(36-115 minutes)and hemorrhage amount of (336.5±50.8)ml(180-620 ml). The operation finding showed that the combined anteversion by employing"femur

Self-reported dietary intake of omega-3 fatty acids and association with bone and lower extremity function.

Science.gov (United States)

Rousseau, James H; Kleppinger, Alison; Kenny, Anne M

2009-10-01

To assess the relationship between self-reported omega-3 fatty acid (O3FA) intake and bone mineral density (BMD) and lower extremity function in older adults. Cross-sectional analysis of baseline information from three separate ongoing studies of older adults, pooled for this analysis. Academic health center. Two hundred forty-seven men (n=118) and women (n=129) residing in the community or an assisted living facility. Self-reported dietary intake (O3FA, omega-6 fatty acids (O6FA), protein, and total calorie); BMD of the hip or heel; and lower extremity function including leg strength, chair rise time, walking speed, Timed Up and Go, and frailty. The mean reported intake of O3FA was 1.27 g/day. Correlation coefficients (r) between O3FA and T-scores from total femur (n=167) were 0.210 and 0.147 for combined femur and heel T scores. Similar correlations were found for leg strength (r=0.205) and chair rise time (r=-0.178), but the significance was lost when corrected for protein intake. Subjects with lower reported O3FA intake (<1.27 g/day) had lower BMD than those with higher reported O3FA intake. In a multiple regression analysis with femoral neck BMD as the dependent variable and reported intake of O3FA, O6FA, protein, and vitamin D as independent variables, reported O3FA intake was the only significant variable, accounting for 6% of the variance in BMD. Older adults had low reported intakes of O3FA. There was an association between greater reported O3FA intake and higher BMD. There was no independent association between reported O3FA intake and lower extremity function. Results from this preliminary report are promising and suggest further investigation.

Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women.

Science.gov (United States)

Kim, Kyong-Chol; Shin, Dong-Hyuk; Lee, Sei-Young; Im, Jee-Aee; Lee, Duk-Chul

2010-11-01

The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture. A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured. After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p related to BMD of all sites (p related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011). In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fracture.

Novel anthropomorphic hip phantom corrects systemic interscanner differences in proximal femoral vBMD

International Nuclear Information System (INIS)

Bonaretti, S; Saeed, I; Burghardt, A J; Lang, T; Carpenter, R D; Yu, L; Bruesewitz, M; Khosla, S

2014-01-01

Quantitative computed tomography (QCT) is increasingly used in osteoporosis studies to assess volumetric bone mineral density (vBMD), bone quality and strength. However, QCT is confronted by technical issues in the clinical research setting, such as potentially confounding effects of body size on vBMD measurements and lack of standard approaches to scanner cross-calibration, which affects measurements of vBMD in multicenter settings. In this study, we addressed systematic inter-scanner differences and subject-dependent body size errors using a novel anthropomorphic hip phantom, containing a calibration hip to estimate correction equations, and a contralateral test hip to assess the quality of the correction. We scanned this phantom on four different scanners and we applied phantom-derived corrections to in vivo images of 16 postmenopausal women scanned on two scanners. From the phantom study, we found that vBMD decreased with increasing phantom size in three of four scanners and that inter-scanner variations increased with increasing phantom size. In the in vivo study, we observed that inter-scanner corrections reduced systematic inter-scanner mean vBMD differences but that the inter-scanner precision error was still larger than expected from known intra-scanner precision measurements. In conclusion, inter-scanner corrections and body size influence should be considered when measuring vBMD from QCT images. (paper)

Late radiation damage to the rat femur and the NSD formula

International Nuclear Information System (INIS)

Pitkaenen, M.A.; Hietanen, T.

1984-01-01

The extraction of 86 Rb chloride, the red blood cell volume and the mineral content in the rat femur have been studied 7 months after local X-irradiation. Doses were given as 3, 6 and 9 fractions over three weeks. The total doses used were based on NSD value of 1450 and 1900 on the basis of the results from our previous single dose irradiation studies. The reduction in the extraction of 86 Rb chloride was statistically significant for all fractionation schemes and at both NSD levels. In the whole femur, with bone marrow, the extraction was reduced by 33% to 46%. In the hard bone the reduction was less only 18% to 38%. There was no significant difference between the fractionation schemes used at each NSD level. The red blood cell volume was significantly reduced in the whole femur, with bone marrow, with no difference between the fractionation schemes. However, there was no change in the hard bone. The dry bone weight was reduced by 3 to 6% with no significant difference between the different fractionation schemes. The dose levels predicted by the NSD formula produced approximately the same damage to the rat femur 7 months after the irradiation when the dry weight and the extraction of 86 Rb chloride were used as end points for the evaluation of the severity of late radiation damage. (orig.) [de

A comparative study of influencing BMD factors in postpartum and general women in their twenties and thirties

International Nuclear Information System (INIS)

Kim, Sun Geun; Oh, Chan Ho; Kweon, Dae Cheol

2007-01-01

The study is to evaluate the factors that affect to the bone mineral density (BMD) of postpartum women by comparing BMD between postpartum and general women who are ages from 20 to 39, and to identify correlation between various factors weight, height, body mass index (BMI), hemoglobin (Hb) and BMD. Study subjects were postpartum (n = 159) and general (n = 180) women. We checked the BMD of femoral neck and lumbar spine by using dual energy X-ray bone densitometry. The mean age was 30.69 ± 3.32 in postpartum care group and 31.22 ± 5.66 in general women group. In postpartum care group, the mean BMD of femoral neck and lumbar spine were -0.187 and -0.076. In general women group, the mean BMD of femoral neck and lumbar spine were -0.029, and -0.169. According to BMI level, each group was divided into two subgroups. One was 23 or more BMI subgroup, and the other was under 23 BMI subgroup. There was a significant difference in BMD of femoral neck and lumbar spine between two subgroups in general women group, but only a significant difference in BMD of lumbar spine is noted between two subgroups of postpartum group. According to Hb level, each group was divided into two subgroups. One was 11 g/dl or more subgroup, and the other was under 11 g/dl subgroup. There was not a statistically significant difference of BMD in all subgroups. BMD of femoral neck and lumbar spine showed a significant correlation with weight, height, BMI in both groups. There was a significant correlation between BMD and Hb level in postpartum care group, but a significant correlation was not noted in general women group. The postpartum women showed a significant correlation between BMD and various factors such as weight, height, BMI just like in general women. There was a significant correlation between BMD and Hb in postpartum women, but not in general women

A comparative study of influencing BMD factors in postpartum and general women in their twenties and thirties

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Geun; Oh, Chan Ho [Woosuk University, Wanju (Korea, Republic of); Kweon, Dae Cheol [Seoul National University Hospital, Seoul (Korea, Republic of)

2007-03-15

The study is to evaluate the factors that affect to the bone mineral density (BMD) of postpartum women by comparing BMD between postpartum and general women who are ages from 20 to 39, and to identify correlation between various factors weight, height, body mass index (BMI), hemoglobin (Hb) and BMD. Study subjects were postpartum (n = 159) and general (n = 180) women. We checked the BMD of femoral neck and lumbar spine by using dual energy X-ray bone densitometry. The mean age was 30.69 {+-} 3.32 in postpartum care group and 31.22 {+-} 5.66 in general women group. In postpartum care group, the mean BMD of femoral neck and lumbar spine were -0.187 and -0.076. In general women group, the mean BMD of femoral neck and lumbar spine were -0.029, and -0.169. According to BMI level, each group was divided into two subgroups. One was 23 or more BMI subgroup, and the other was under 23 BMI subgroup. There was a significant difference in BMD of femoral neck and lumbar spine between two subgroups in general women group, but only a significant difference in BMD of lumbar spine is noted between two subgroups of postpartum group. According to Hb level, each group was divided into two subgroups. One was 11 g/dl or more subgroup, and the other was under 11 g/dl subgroup. There was not a statistically significant difference of BMD in all subgroups. BMD of femoral neck and lumbar spine showed a significant correlation with weight, height, BMI in both groups. There was a significant correlation between BMD and Hb level in postpartum care group, but a significant correlation was not noted in general women group. The postpartum women showed a significant correlation between BMD and various factors such as weight, height, BMI just like in general women. There was a significant correlation between BMD and Hb in postpartum women, but not in general women.

Calcium and vitamin D supplementation increases spinal BMD in healthy, postmenopausal women

DEFF Research Database (Denmark)

Baeksgaard, L; Andersen, K P; Hyldstrup, Lars

1998-01-01

of treatment was 2 years. Bone mineral density (BMD) was measured at the lumbar spine, hip and forearm. A dietary questionnaire was administered twice during the study and revealed a fairly good calcium and vitamin D intake (919 mg calcium/day; 3.8 micrograms vitamin D/day). An increase in lumbar spine BMD...

Computer-navigated minimally invasive total knee arthroplasty for patients with retained implants in the femur

Directory of Open Access Journals (Sweden)

Sung-Yen Lin

2014-08-01

Full Text Available Total knee arthroplasty (TKA in patients with knee arthritis and retained implants in the ipsilateral femur is a challenge for knee surgeons. Use of a conventional intramedullary femoral cutting guide is not practical because of the obstruction of the medullary canal by implants. Previous studies have shown that computer-assisted surgery (CAS can help restore alignment in conventional TKA for patients with knee arthritis with retained femoral implants or extra-articular deformity, without the need for implant removal or osteotomy. However, little has been published regarding outcomes with the use of navigation in minimally invasive surgery (MIS-TKA for patients with this complex knee arthritis. MIS has been proven to provide less postoperative pain and faster recovery than conventional TKA, but MIS-TKA in patients with retained femoral implants poses a greater risk in limb malalignment. The purpose of this study is to report the outcome of CAS-MIS-TKA in patients with knee arthritis and retained femoral implants. Between April 2006 and March 2008, eight patients with knee arthritis and retained femoral implants who underwent the CAS-MIS-TKA were retrospectively reviewed. Three of the eight patients had extra-articular deformity, including two femur bones and one tibia bone, in the preoperative examination. The anteroposterior, lateral, and long-leg weight-bearing radiographs carried out at 3-month follow-up was used to determine the mechanical axis of lower limb and the position of components. The mean preoperative femorotibial angle in patients without extra-articular deformity was 3.8° of varus and was corrected to 4.6° of valgus. With the use of navigation in MIS-TKA, the two patients in this study with extra-articular femoral deformity also obtained an ideal postoperative mechanical axis within 2° of normal alignment. Overall, there was a good restoration of postoperative mechanical alignment in all cases, with a mean angle of 0.4° of

Accuracy of DXA scanning of the thoracic spine: cadaveric studies comparing BMC, areal BMD and geometric estimates of volumetric BMD against ash weight and CT measures of bone volume.

Science.gov (United States)

Sran, Meena M; Khan, Karim M; Keiver, Kathy; Chew, Jason B; McKay, Heather A; Oxland, Thomas R

2005-12-01

Biomechanical studies of the thoracic spine often scan cadaveric segments by dual energy X-ray absorptiometry (DXA) to obtain measures of bone mass. Only one study has reported the accuracy of lateral scans of thoracic vertebral bodies. The accuracy of DXA scans of thoracic spine segments and of anterior-posterior (AP) thoracic scans has not been investigated. We have examined the accuracy of AP and lateral thoracic DXA scans by comparison with ash weight, the gold-standard for measuring bone mineral content (BMC). We have also compared three methods of estimating volumetric bone mineral density (vBMD) with a novel standard-ash weight (g)/bone volume (cm3) as measured by computed tomography (CT). Twelve T5-T8 spine segments were scanned with DXA (AP and lateral) and CT. The T6 vertebrae were excised, the posterior elements removed and then the vertebral bodies were ashed in a muffle furnace. We proposed a new method of estimating vBMD and compared it with two previously published methods. BMC values from lateral DXA scans displayed the strongest correlation with ash weight (r=0.99) and were on average 12.8% higher (pBMC (AP or lateral) was more strongly correlated with ash weight than areal bone mineral density (aBMD; AP: r=0.54, or lateral: r=0.71) or estimated vBMD. Estimates of vBMD with either of the three methods were strongly and similarly correlated with volumetric BMD calculated by dividing ash weight by CT-derived volume. These data suggest that readily available DXA scanning is an appropriate surrogate measure for thoracic spine bone mineral and that the lateral scan might be the scan method of choice.

Herniation pits of the femur neck: incidence and radiologic findings

International Nuclear Information System (INIS)

Cho, Jae Hyun; Suh, Jin Suk; Lee, Hye Yeon

1994-01-01

In order to assess the incidence and radiologic findings of herniation pit of the femur neck in Korean. In 152 macerated femurs of 88 cadavers, and randomly selected 115 hips of 70 patients, the presence of herniation pit was determined by using fluoroscopy and radiography. It was then examined by CT for inspection of overlying surface and its opening was confirmed by inserting thin steal wire under the fluoroscopic guidance. Seventeen herniation pits in 15 macerated femurs of 13 cadavers were noted. (14.8%, 13/88). Two of 13 individuals showed bilaterality. All lesions were found only in males. Six herniation pit in 6 femurs of 6 patients (8.6%, 6/70) were also noted. All lesions were on anterosuperior aspect of femur neck. Plain radiographs of macerated femurs revealed well marginated and thin sclerosis in 15 lesions. Of all 23 lesions, CT showed cortical breakdown in 3, and overlying cortical thickening in 8. In 15 macerated femurs, roughed area of cortex was found in anterosuperior aspect of femur in all cases, and tiny openings(diameter less than 1 mm) related to cystic lesions were confirmed in 9 lesions. The incidence of herniation pits was 14.8% in 88 cadaver, and 8.6% in 70 patients. All were males

Baseline Vitamin D Status is Predictive of Longitudinal Change in Tibial BMD in Knee Osteoarthritis (OA)

Science.gov (United States)

With its lack of effective treatment and high prevalence, the public health impact of OA is substantial. Peri-articular bone in OA can be evaluated with the medial:lateral tibial BMD ratio (M:L BMD) obtained from dual x-ray absorptiometry (DXA). Higher M:L BMD is associated with medial OA features...

The influences of bowel condition with lumbar spine BMD measurement

Energy Technology Data Exchange (ETDEWEB)

Yoon, Joon; Lee, Hoo Min; Lee, Jung Min; Kwon, Soon Mu; Cho, Hyung Wook [Dept. of Radiologic Technology, Dongnam Health College, Suwon (Korea, Republic of); Kim, Yun Min; Kang, Yeong Han; Kim, Boo Soon; Kim, Jung Soo [Dept. of Diagonostic Radiology, Samsung Medical Center, Seoul (Korea, Republic of)

2014-12-15

Bone density measurement use of diagnosis of osteoporosis and it is an important indicator for treatment as well as prevention. But errors in degree of precision of BMD can be occurred by status of patient, bone densitometer and radiological technologist. Therefore the author evaluated that how BMD changes according to the condition of the patient. As Lumbar region, which could lead to substantial effects on bone density by diverse factors such as the water, food, intentional bowels. We recognized a change of bone mineral density in accordance with the height of the water tank and in the presence or absence of the gas using the Aluminum Spine Phantom. We also figured out the influence of bone mineral density by increasing the water and food into a target on the volunteers. Measured bone mineral density through Aluminum Spine Phantom had statistically significant difference accordance with increasing the height of water tank(p=0.026). There was no significant difference in BMD according to the existence of the bowl gas(p=0.587). There was no significant difference in a study of six people targeted volunteers in the presence or absence of the food(p=0.812). And also there was no significant difference according to the existence of water(p=0.618). If it is not difficult to recognize the surround of bone in measuring BMD of lumbar bone, it is not the factor which has the great effect on bone mineral density whether the test is after endoscopic examination of large intestine and patient’s fast or not.

The influences of bowel condition with lumbar spine BMD measurement

International Nuclear Information System (INIS)

Yoon, Joon; Lee, Hoo Min; Lee, Jung Min; Kwon, Soon Mu; Cho, Hyung Wook; Kim, Yun Min; Kang, Yeong Han; Kim, Boo Soon; Kim, Jung Soo

2014-01-01

Bone density measurement use of diagnosis of osteoporosis and it is an important indicator for treatment as well as prevention. But errors in degree of precision of BMD can be occurred by status of patient, bone densitometer and radiological technologist. Therefore the author evaluated that how BMD changes according to the condition of the patient. As Lumbar region, which could lead to substantial effects on bone density by diverse factors such as the water, food, intentional bowels. We recognized a change of bone mineral density in accordance with the height of the water tank and in the presence or absence of the gas using the Aluminum Spine Phantom. We also figured out the influence of bone mineral density by increasing the water and food into a target on the volunteers. Measured bone mineral density through Aluminum Spine Phantom had statistically significant difference accordance with increasing the height of water tank(p=0.026). There was no significant difference in BMD according to the existence of the bowl gas(p=0.587). There was no significant difference in a study of six people targeted volunteers in the presence or absence of the food(p=0.812). And also there was no significant difference according to the existence of water(p=0.618). If it is not difficult to recognize the surround of bone in measuring BMD of lumbar bone, it is not the factor which has the great effect on bone mineral density whether the test is after endoscopic examination of large intestine and patient’s fast or not

Nutritional Programming of Bone Structure in Male Offspring by Maternal Consumption of Citrus Flavanones.

Science.gov (United States)

Sacco, Sandra M; Saint, Caitlin; LeBlanc, Paul J; Ward, Wendy E

2018-06-01

Maternal exposure to hesperidin (HSP) and naringin (NAR) during pregnancy and lactation transiently compromised bone mineral density (BMD) and bone structure at the proximal tibia in female CD-1 offspring. We examined whether maternal consumption of HSP + NAR during pregnancy and lactation compromises BMD, bone structure, and bone strength in male CD-1 offspring. Male CD-1 offspring, from mothers fed a control diet (CON, n = 10) or a 0.5% HSP + 0.25% NAR diet (HSP + NAR, n = 8) for 5 weeks before mating and throughout pregnancy and lactation, were weaned and fed CON until 6 months of age. In vivo micro-computed tomography (µCT) measured tibia BMD and structure at 2, 4, and 6 months of age. Ex vivo µCT measured femur and lumbar vertebrae (LV) structure at age 6 months. Ex vivo BMD (femur, LV) and biomechanical strength (femur and tibia midpoint, femur neck) were assessed at age 6 months by dual energy x-ray absorptiometry and strength testing, respectively. At all ages, HSP + NAR offspring had greater (p structure compared to CON offspring. At age 4 months, proximal tibia trabecular structure was greater (p structure were greater (p structure at the proximal tibia in male CD-1 offspring that persisted to 6 months of age. Thus, maternal programming of offspring BMD and bone structure from consumption of HSP + NAR occurred as a sex-specific response.

Preoperative morphometric differences in the distal femur are based on skeletal size in Japanese patients undergoing total knee arthroplasty.

Science.gov (United States)

Nishikawa, Masataka; Owaki, Hajime; Kaneshiro, Shoichi; Fuji, Takeshi

2014-12-01

The objectives of this study were to measure the morphometric parameters of preoperative distal femurs to determine the differences by diagnosis and gender after accounting for skeletal size. One-hundred and seventy-nine Japanese patients who underwent total knee arthroplasty (TKA) (25 males and 154 females) were assessed. The anteroposterior length (AP), mediolateral width (ML), aspect ratio (AR), surgical epicondylar axis (SEA) to posterior condylar axis (PCA) angle, and Whiteside to SEA angle were measured on preoperative computed tomography scans. The AP/ML, AR/ML, SEA/PCA, and Whiteside/PCA relationships were evaluated and compared by patient diagnosis and gender. The results were also compared with the sizes of 10 currently available TKA implants in Japan. The mean AP, ML, AR, SEA/PCA angle, and Whiteside/PCA angle were 58.8 mm, 64.7 mm, 0.91, external rotation (ER) 3.5°, and ER 1.6°, respectively. AP and AR each were significantly correlated with ML (p different between patients diagnosed with osteoarthritis and rheumatoid arthritis. AP/ML and AR/ML were significantly correlated within each diagnosis (p differences between the diagnoses. AP and ML were significantly longer (p gender. However, the analysis of covariance showed no significant differences between gender in the AP/ML and AR/MR correlations. The AP/ML ratio of our data was similar to the size variations of the 10 TKA implants, but the AR/ML ratio was quite different from almost all the implants. No differences in preoperative femur morphometry were found between patients with different diagnoses, but the gender difference in AR was related to the difference in skeletal size between males and females. Case series with no comparison groups, Level IV.

Association between mental health status and bone mineral density: Analysis of the 2008-2010 Korea national health and nutrition examination survey.

Directory of Open Access Journals (Sweden)

Changtae Hahn

Full Text Available The current study aimed to investigate the association between mental health status and bone mineral density (BMD using data from the Korean National Health and Nutrition Examination Survey (KNHANES 2008-2010. We enrolled 15,876 South Korean participants (4,010 postmenopausal females, 4,836 premenopausal females, and 7,016 males, all aged 20 years or older. BMD was measured using dual-energy radiography absorptiometry at the femoral neck (NK, lumbar spine (LSP, and total femur (TFM. Mental health status data were obtained from a self-report questionnaire that assessed psychological stress, depressed mood, and suicidal ideation. Psychological stress was negatively correlated with BMD in the LSP, NK, and TFM for the male group. Depressed mood was associated with lower BMD in the LSP, NK and TFM for the premenopausal female group, and in the LSP for the male group. Suicidal ideation was associated with lower BMD in the NK and TFM for the male group. Mental health problems were associated with lower BMD, especially in premenopausal females and males. Future investigations should focus on the shared pathophysiology between mental health problems and BMD, and the interrelationship between increased BMD and recovery from mental health problems.

Molt performance and bone density of cortical, medullary, and cancellous bone in laying hens during feed restriction or alfalfa-based feed molt.

Science.gov (United States)

Kim, W K; Donalson, L M; Bloomfield, S A; Hogan, H A; Kubena, L F; Nisbet, D J; Ricke, S C

2007-09-01

A study was conducted to evaluate the effects of alfalfa-based molt diets on molting performance and bone qualities. A total of 36 Single Comb White Leghorn hens were used for the study. There were 6 treatments: pretrial control (PC), fully fed (FF), feed withdrawal (FW), 90% alfalfa:10% layer ration (A90), 80% alfalfa:20% layer ration (A80), and 70% alfalfa:30% layer ration (A70). For the PC treatment, hens were euthanized by CO(2) gas, and bones were collected before molt was initiated. At the end of the 9-d molt period, hens were euthanized, and femurs and tibias were collected to evaluate bone qualities by peripheral quantitative computed tomography, mechanical testing, and conventional ash weights. The hens fed alfalfa-based molt diets and FW stopped laying eggs within 5 d after molt started, and all hens in these groups had reduced ovary weights compared with those of the FF hens. In the FW and A90 groups, total femur volumetric bone mineral densities (vBMD) at the midshaft were significantly lower, but those of the A80 and A70 groups were not significantly different from the values for the PC and FF hens. In cortical bone density, the midshaft tibial vBMD were significantly higher for FF and A70 hens than for PC hens. The medullary bone densities at the midshaft femur or tibia of the FW, A90, A80, and A70 hens were reduced compared with those of the PC hens. Femur cancellous densities at the distal femur for the FW and A90 hens were significantly reduced compared with those of the PC and FF hens. The FW, A80, and A70 hens yielded significantly higher elastic moduli, and the A80 hens had higher ultimate stress compared with the PC hens, suggesting that the mechanical integrity of the midshaft bone was maintained even though the medullary vBMD was reduced. These results suggest that alfalfa-based molt diets exhibit molt performance similar to FW, that medullary and cancellous bones are labile bone compartments during molting, and that alfalfa-based molt diets

Distal femoral bone mineral density decreases following patellofemoral arthroplasty: 1-year follow-up study of 14 patients

Directory of Open Access Journals (Sweden)

Innocenti Bernardo

2010-04-01

Full Text Available Abstract Background The bone mineral density (BMD of the distal femur decreases by 16-36% within one year after total knee arthroplasty (TKA because of the femoral component's stress-shielding effect. The aim of this prospective study was to determine the quantitative change from the baseline BMD in the distal femur 1 year after patellofemoral arthroplasty using dual-energy X-ray absorptiometry (DXA. Methods Between December 2007 and December 2008, 14 patients had patellofemoral arthroplasty for isolated patellofemoral osteoarthritis. Distal femoral BMD was assessed using DXA in 2 regions of interest (ROI on the lateral view 2 weeks before and 12 months after patellofemoral arthroplasty. The contra-lateral knee was used as a control, with BMD measurements performed in identical ROIs. Results The mean change from baseline BMD in the operated knees after 1 year was -0.169 g/cm2 (95% CI: -0.293 to -0.046 g/cm2 behind the anterior flange (-15%, and -0.076 g/cm2 (95% CI: -0.177 to 0.024 g/cm2 in the supracondylar area 1 cm above the prosthesis (-8% (p = 0.01 and p = 0.13, respectively. The mean change from baseline BMD in the non-operated knees after 1 year was 0.016 g/cm2 (95% CI: -0.152 to 0.185 g/cm2 behind the anterior flange (2%, and 0.023 g/cm2 (95% CI: -0.135 to 0.180 g/cm2 in the supracondylar area 1 cm above the prosthesis (2% (p = 0.83, and p = 0.76, respectively. Conclusions Our findings suggest that patellofemoral arthroplasty results in a statistically significant decrease in BMD behind the anterior flange.

Exposure to pastures fertilised with sewage sludge disrupts bone tissue homeostasis in sheep

International Nuclear Information System (INIS)

Lind, P. Monica; Gustafsson, Magnus; Hermsen, Sanne A.B.; Larsson, Sune; Kyle, Carol E.; Orberg, Jan; Rhind, Stewart M.

2009-01-01

The femurs of male and female sheep (Ovis aries), aged 18 months, bred on pastures fertilized twice annually with sewage sludge (2.25 tonnes dry matter/ha; Treated; T)) or on pastures treated with inorganic fertilizer (Control; C) were studied, using peripheral Quantitative Computed Tomography (pQCT) and the three-point bending test. Males were maintained on the respective treatments from conception to weaning and then maintained on control pastures while the females were maintained on the respective treatments until slaughter. T rams exhibited increased total bone mineral density (BMD) at the metaphyseal part of femur (+ 10.5%, p < 0.01) compared with C rams but had a reduced total cross sectional area (CSA, - 11.5%, p < 0.001), trabecular CSA (- 17.1%, p < 0.01) and periosteal circumference (- 5.7%, p < 0.001). In the mid-diaphyseal part, T rams had an increased total BMD (+ 13.8%, p < 0.0001) and stiffness (+ 6.4%, p < 0.01) but reduced total CSA (- 12.1%, p < 0.0001) and marrow cavity (- 25.8%, p < 0.0001), relative to C rams. In ewes although pQCT analysis of neither the metaphyseal nor the mid-diaphyseal part of the female femur bones showed any significant differences with treatment, the biomechanical method revealed a reduction in load at failure (- 17.3%, p < 0.01) and stiffness (- 10.7%, p < 0.05) amongst T ewes. It is concluded that exposure to pollutants present in sewage sludge can perturb bone tissue homeostasis in sheep, but particularly in males

Exposure to pastures fertilised with sewage sludge disrupts bone tissue homeostasis in sheep

Energy Technology Data Exchange (ETDEWEB)

Lind, P. Monica [Institute of Environmental Medicine, Karolinska Institutet, Stockholm (Sweden)], E-mail: Monica.Lind@ki.se; Gustafsson, Magnus [Department of Environmental Toxicology, Uppsala University, Uppsala (Sweden); Hermsen, Sanne A.B. [Institute of Environmental Medicine, Karolinska Institutet, Stockholm (Sweden); Larsson, Sune [Department of Orthopaedics, University of Uppsala, Uppsala (Sweden); Kyle, Carol E. [Macaulay Institute, Craigiebuckler, Aberdeen AB15 8QH (United Kingdom); Orberg, Jan [Department of Environmental Toxicology, Uppsala University, Uppsala (Sweden); Rhind, Stewart M. [Macaulay Institute, Craigiebuckler, Aberdeen AB15 8QH (United Kingdom)

2009-03-15

The femurs of male and female sheep (Ovis aries), aged 18 months, bred on pastures fertilized twice annually with sewage sludge (2.25 tonnes dry matter/ha; Treated; T)) or on pastures treated with inorganic fertilizer (Control; C) were studied, using peripheral Quantitative Computed Tomography (pQCT) and the three-point bending test. Males were maintained on the respective treatments from conception to weaning and then maintained on control pastures while the females were maintained on the respective treatments until slaughter. T rams exhibited increased total bone mineral density (BMD) at the metaphyseal part of femur (+ 10.5%, p < 0.01) compared with C rams but had a reduced total cross sectional area (CSA, - 11.5%, p < 0.001), trabecular CSA (- 17.1%, p < 0.01) and periosteal circumference (- 5.7%, p < 0.001). In the mid-diaphyseal part, T rams had an increased total BMD (+ 13.8%, p < 0.0001) and stiffness (+ 6.4%, p < 0.01) but reduced total CSA (- 12.1%, p < 0.0001) and marrow cavity (- 25.8%, p < 0.0001), relative to C rams. In ewes although pQCT analysis of neither the metaphyseal nor the mid-diaphyseal part of the female femur bones showed any significant differences with treatment, the biomechanical method revealed a reduction in load at failure (- 17.3%, p < 0.01) and stiffness (- 10.7%, p < 0.05) amongst T ewes. It is concluded that exposure to pollutants present in sewage sludge can perturb bone tissue homeostasis in sheep, but particularly in males.

Femur morphometry, densitometry, geometry and mechanical properties in young pigs fed a diet free of inorganic phosphorus and supplemented with phytase.

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Skiba, Grzegorz; Sobol, Monika; Raj, Stanisława

2017-02-01

The study investigated in piglets the effect of replacing dietary inorganic P by addition of microbial phytase and its impact on performance, nutrient digestibility and on the geometrical characteristics and mineralisation of the femur. Sixteen pigs on day 58 of age were divided into two groups and fed either a diet free of additional inorganic phosphorus (P) and supplemented with phytase (Diet LP, 4.23 g total P/kg diet) or a diet with a mineral source of P and not supplemented with phytase (Diet SP, 5.38 g total P/kg diet). Performance data and the apparent total tract digestibility of nutrients were estimated between days 58 and 114, and 72 and 86 of age, respectively. On day 114 of age, the pigs were slaughtered, the femur was dissected and the mineral content and mineral density, maximum strength and maximum elastic strength, cortical wall thickness, cross-sectional area and cortical index were analysed. The growth performance and digestibility of nutrient fractions (with exception of P) did not differ between treatment groups. The P-digestibility was significantly higher in Group LP. The femur of pigs in Group LP had significantly greater cortical wall thickness, cortical index, bone mineral content, bone mineral density, maximum strength and maximum elastic strength than Group SP. Femur maximum strength and maximum elastic strength were correlated with cortical wall thickness and cortical index. Resulting from the different supply of digestible P, the femur geometrical, densitometric and mechanical properties of Group LP were better than those of Group SP. The mechanical properties of the femur of pigs depended more on its geometrical characteristics than on the degree of its mineralisation.

Subcutaneous administration of insulin-like growth factor (IGF)-II/IGF binding protein-2 complex stimulates bone formation and prevents loss of bone mineral density in a rat model of disuse osteoporosis

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Conover, Cheryl A.; Johnstone, Edward W.; Turner, Russell T.; Evans, Glenda L.; John Ballard, F. John; Doran, Patrick M.; Khosla, Sundeep

2002-01-01

Elevated serum levels of insulin-like growth factor binding protein-2 (IGFBP-2) and a precursor form of IGF-II are associated with marked increases in bone formation and skeletal mass in patients with hepatitis C-associated osteosclerosis. In vitro studies indicate that IGF-II in complex with IGFBP-2 has high affinity for bone matrix and is able to stimulate osteoblast proliferation. The purpose of this study was to determine the ability of the IGF-II/IGFBP-2 complex to increase bone mass in vivo. Osteopenia of the femur was induced by unilateral sciatic neurectomy in rats. At the time of surgery, 14-day osmotic minipumps containing vehicle or 2 microg IGF-II+9 microg IGFBP-2/100g body weight/day were implanted subcutaneously in the neck. Bone mineral density (BMD) measurements were taken the day of surgery and 14 days later using a PIXImus small animal densitometer. Neurectomy of the right hindlimb resulted in a 9% decrease in right femur BMD (Ploss in BMD was completely prevented by treatment with IGF-II/IGFBP-2. On the control limb, there was no loss of BMD over the 14 days and IGF-II/IGFBP-2 treatment resulted in a 9% increase in left femur BMD (Ploss of BMD associated with disuse osteoporosis and stimulate bone formation in adult rats. Furthermore, they provide proof of concept for a novel anabolic approach to increasing bone mass in humans with osteoporosis.

Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation

Energy Technology Data Exchange (ETDEWEB)

Mueller, Dirk K., E-mail: dirk.mueller@philips.com [Philips GmbH, Healthcare Division, Luebeckertordamm 5, 20099 Hamburg (Germany); Kutscherenko, Alex; Bartel, Hans [Kaiserswerther Diakonie, Florence-Nightingale Hospital, Kreuzbergstrasse 79, 40489 Duesseldorf (Germany); Vlassenbroek, Alain [Philips Healthcare, Bruxelles, Rue des Deux Gares 80, 1070 Bruxelles (Belgium); Ourednicek, Petr [Philips Czech Republic, Safrankova 1, 15500 Prague 5 (Czech Republic); Erckenbrecht, Joachim [Kaiserswerther Diakonie, Florence-Nightingale Hospital, Kreuzbergstrasse 79, 40489 Duesseldorf (Germany)

2011-09-15

Purpose: Phantom-less bone mineral density (PLBMD) systems are easily integrated into the CT workflow for non-dedicated Quantitative CT (QCT) BMD measurements in thoracic and abdominal scans. This in vivo retrospective study aims to determine accuracy and precision of the PLBMD option located on the Extended Brilliance Workspace (Philips Medical Systems, Cleveland, OH, US) from both cross-sectional and longitudinal image data. Materials and methods: The cross-sectional comparison with phantom-based QCT BMD was performed for 82 patients (61 female, 21 male) with a mean age of (63.0 {+-} 11.8 SD) years on 197 vertebrae. This was followed by an interobserver variability analysis on 71 vertebrae. The longitudinal PLBMD study was carried out on 45 vertebrae from 10 patients (5 female, 5 male) with a mean age of (64.4 {+-} 11.5 SD) years. They were re-scanned with standardized scan and contrast-injection protocols within a mean and median of (33 {+-} 41 SD) and 8 days, respectively. All CT scans were acquired on an Mx8000 Quad (Philips) at Florence-Nightingale Hospital, Kaiserswerth, Germany, in a spiral acquisition mode. Results: A negligible BMD bias of -0.9 mg/cm{sup 3} for the PLBMD option was observed with respect to phantom-based QCT BMD. Applying CT number matching of muscle and fat ROIs, the analysis of cross-sectional interobserver and of longitudinal variability yielded precision values of 3.1 mg/cm{sup 3} (CV% = 4.0) and 4.2 mg/cm{sup 3} (CV% = 5.3), respectively. Conclusion: Although the precision is inferior to phantom-based BMD systems, PLBMD is a robust clinical utility for the detection of lowered BMD in a large patient population. This can be achieved without additional radiation exposure from non-contrasted CT scans, to perform an ancillary diagnosis of osteopenia or osteoporosis.

Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation

International Nuclear Information System (INIS)

Mueller, Dirk K.; Kutscherenko, Alex; Bartel, Hans; Vlassenbroek, Alain; Ourednicek, Petr; Erckenbrecht, Joachim

2011-01-01

Purpose: Phantom-less bone mineral density (PLBMD) systems are easily integrated into the CT workflow for non-dedicated Quantitative CT (QCT) BMD measurements in thoracic and abdominal scans. This in vivo retrospective study aims to determine accuracy and precision of the PLBMD option located on the Extended Brilliance Workspace (Philips Medical Systems, Cleveland, OH, US) from both cross-sectional and longitudinal image data. Materials and methods: The cross-sectional comparison with phantom-based QCT BMD was performed for 82 patients (61 female, 21 male) with a mean age of (63.0 ± 11.8 SD) years on 197 vertebrae. This was followed by an interobserver variability analysis on 71 vertebrae. The longitudinal PLBMD study was carried out on 45 vertebrae from 10 patients (5 female, 5 male) with a mean age of (64.4 ± 11.5 SD) years. They were re-scanned with standardized scan and contrast-injection protocols within a mean and median of (33 ± 41 SD) and 8 days, respectively. All CT scans were acquired on an Mx8000 Quad (Philips) at Florence-Nightingale Hospital, Kaiserswerth, Germany, in a spiral acquisition mode. Results: A negligible BMD bias of -0.9 mg/cm 3 for the PLBMD option was observed with respect to phantom-based QCT BMD. Applying CT number matching of muscle and fat ROIs, the analysis of cross-sectional interobserver and of longitudinal variability yielded precision values of 3.1 mg/cm 3 (CV% = 4.0) and 4.2 mg/cm 3 (CV% = 5.3), respectively. Conclusion: Although the precision is inferior to phantom-based BMD systems, PLBMD is a robust clinical utility for the detection of lowered BMD in a large patient population. This can be achieved without additional radiation exposure from non-contrasted CT scans, to perform an ancillary diagnosis of osteopenia or osteoporosis.

Proximal and distal alignment of normal canine femurs: A morphometric analysis.

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Kara, Mehmet Erkut; Sevil-Kilimci, Figen; Dilek, Ömer Gürkan; Onar, Vedat

2018-05-01

Many researchers are interested in femoral conformation because most orthopaedic problems of the long bones occur in the femur and its joints. The neck-shaft (NSA) and the anteversion (AVA) angles are good predictors for understanding the orientation of the proximal end of the femur. The varus (aLDFA) and procurvatum (CDFA) angles have also been used to understand the orientation of the distal end of the femur. The purposes of this study were to investigate the relationship between the proximal and distal angles of the femur and to compare the distal femoral angles in male and female dogs in order to investigate the sexual dimorphism. The measurements of normal CDFAs, which have not been previously reported, may also provide a database of canine distal femoral morphology. A total of 75 cleaned healthy femora from different breeds or mixed breed of dogs were used. The three-dimensional images were reconstructed from computed tomographic images. The AVA, NSA, aLDFA and CDFA were measured on the 3D images. The correlation coefficients were calculated among the measured angles. The distal femoral angles were also compared between male and female femora. The 95% confidence intervals of the AVA and the NSA were calculated to be 24.22°-29.50° and 144.97°-147.50°, respectively. The 95% confidence intervals of the aLDFA and the CDFA for all studied dogs were 92.62°-94.08° and 89.09°-91.94°, respectively. The NSA showed no correlation with either the aLDFA or CDFA. There was a weak inverse correlation between the AVA and CDFA and a weak positive correlation between the AVA and aLDFA. The differences in the aLDFA and CDFA measurements between male and female dog were not significant. In conclusion, femoral version, regardless of the plane, might have little influence on distal femoral morphology in normal dogs. Besides this, there is no evidence of a sexual dimorphism in the varus and procurvatum angles of the dog distal femur. The data from this study may be used in

Effects of genes, sex, age, and activity on BMC, bone size, and areal and volumetric BMD.

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Havill, Lorena M; Mahaney, Michael C; L Binkley, Teresa; Specker, Bonny L

2007-05-01

Quantitative genetic analyses of bone data for 710 inter-related individuals 8-85 yr of age found high heritability estimates for BMC, bone area, and areal and volumetric BMD that varied across bone sites. Activity levels, especially time in moderate plus vigorous activity, had notable effects on bone. In some cases, these effects were age and sex specific. Genetic and environmental factors play a complex role in determining BMC, bone size, and BMD. This study assessed the heritability of bone measures; characterized the effects of age, sex, and physical activity on bone; and tested for age- and sex-specific bone effects of activity. Measures of bone size and areal and volumetric density (aBMD and vBMD, respectively) were obtained by DXA and pQCT on 710 related individuals (466 women) 8-85 yr of age. Measures of activity included percent time in moderate + vigorous activity (%ModVig), stair flights climbed per day, and miles walked per day. Quantitative genetic analyses were conducted to model the effects of activity and covariates on bone outcomes. Accounting for effects of age, sex, and activity levels, genes explained 40-62% of the residual variation in BMC and BMD and 27-75% in bone size (all pBMC and cross-sectional area (CSA) at the 4% radius, but this was not observed among women (sex-by-activity interaction, both p BMD (Cort-vBMD) than younger men, with minimal difference between low and high activity levels. Influence of activity was greater in older women: older women with low activity had lower Cort-vBMD than older men, but older women with high activity had higher Cort-vBMD than older men (age-by-sex-by-activity interaction, p=0.04). High heritability estimates for DXA and pQCT measures varied across bone sites. Percent time spent in moderate to vigorous activity had the most notable effect on bone, and in some cases, this effect was age or sex specific.

A numerical investigation into the influence of the properties of cobalt chrome cellular structures on the load transfer to the periprosthetic femur following total hip arthroplasty.

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Hazlehurst, Kevin Brian; Wang, Chang Jiang; Stanford, Mark

2014-04-01

Stress shielding of the periprosthetic femur following total hip arthroplasty is a problem that can promote the premature loosening of femoral stems. In order to reduce the need for revision surgery it is thought that more flexible implant designs need to be considered. In this work, the mechanical properties of laser melted square pore cobalt chrome molybdenum cellular structures have been incorporated into the design of a traditional monoblock femoral stem. The influence of incorporating the properties of cellular structures on the load transfer to the periprosthetic femur was investigated using a three dimensional finite element model. Eleven different stiffness configurations were investigated by using fully porous and functionally graded approaches. This investigation confirms that the periprosthetic stress values depend on the stiffness configuration of the stem. The numerical results showed that stress shielding is reduced in the periprosthetic Gruen zones when the mechanical properties of cobalt chrome molybdenum cellular structures are used. This work identifies that monoblock femoral stems manufactured using a laser melting process, which are designed for reduced stiffness, have the potential to contribute towards reducing stress shielding. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

Study of Ender’s Nailing in Shaft Femur Fractures of Older Children

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Ladani HG

2014-12-01

Full Text Available Background: Fractures in shaft femur in children are relatively common. Various methods of treating these fractures starting from non operative to methods like closed intramedullary nailing are at our disposal. Traditionally non operative methods are acceptable and find wide acceptance even today in very young children. However in older children certain problems are encountered like failure to control angulation and shortening, prolonged immobilization which causes very much discomfort & the overgrowth phenomenon. In view of above difficulties, closed intramedullary nailing was attempted in older children and adolescents. I have tried to study 23 cases of shaft femur fractures in older children treated by Ender’s nails. Methodology: 22 pts., out of which one having bilateral # shaft femur (total 23 #s with age ranging from 7 to 16 yrs. were studied. 3 pts. having polio limbs studied separately. Fracture was in upper third shaft femur in 5 pts., middle third in 13 pts., lower third in 3pts. & involving more than one region in 2 pts. Fracture was transverse in 6 pts., spiral in 3 pts., oblique in 12 pts.& comminuted in 2 pts.. Results: Average union time was 10 weeks except in polio pts. where it was delayed. No nonunion, no infection. Excellent hip & knee movements in almost all pts. Out of 20 pts. ( except polio pts. limb length was equal in 17 pts., one pt. was having 1 cm. lengthening & 2 pts. were having shortening ( 1cm. & 2 cm.. Conclusion: Results of this study strongly favor the use of Ender’s nailing in shaft femur fractures in older children. Second surgery of implant removal is mandatory. Closed reduction can usually be achieved if surgery is performed earlier.

Heterogeneous modelling and finite element analysis of the femur

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Zhang Binkai

2017-01-01

Full Text Available As the largest and longest bone in the human body, the femur has important research value and application prospects. This paper introduces a fast reconstruction method with Mimics and ANSYS software to realize the heterogeneous modelling of the femur according to Hu distribution of the CT series, and simulates it in various situations by finite element analysis to study the mechanical characteristics of the femur. The femoral heterogeneous model shows the distribution of bone mineral density and material properties, which can be used to assess the diagnosis and treatment of bone diseases. The stress concentration position of the femur under different conditions can be calculated by the simulation, which can provide reference for the design and material selection of prosthesis.

Age, gender, and race/ethnic differences in total body and subregional bone density.

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Looker, A C; Melton, L J; Harris, T; Borrud, L; Shepherd, J; McGowan, J

2009-07-01

Total body bone density of adults from National Health and Nutrition Examination Survey (NHANES) 1999-2004 differed as expected for some groups (men>women and blacks>whites) but not others (whites>Mexican Americans). Cross-sectional age patterns in bone mineral density (BMD) of older adults differed at skeletal sites that varied by degree of weight-bearing. Total body dual-energy X-ray absorptiometry (DXA) data offer the opportunity to compare bone density of demographic groups across the entire skeleton. The present study uses total body DXA data (Hologic QDR 4500A, Hologic, Bedford MA, USA) from the NHANES 1999-2004 to examine BMD of the total body and selected skeletal subregions in a wide age range of adult men and women from three race/ethnic groups. Total body, lumbar spine, pelvis, right leg, and left arm BMD and lean mass from 13,091 adults aged 20 years and older were used. The subregions were chosen to represent sites with different degrees of weight-bearing. Mean BMD varied in expected ways for some demographic characteristics (men>women and non-Hispanic blacks>non-Hispanic whites) but not others (non-Hispanic whites>Mexican Americans). Differences in age patterns in BMD also emerged for some characteristics (sex) but not others (race/ethnicity). Differences in cross-sectional age patterns in BMD and lean mass by degree of weight-bearing in older adults were observed for the pelvis, leg, and arm. This information may be useful for generating hypotheses about age, race, and sex differences in fracture risk in the population.

BMD T-Score Values Expeditions 1-23 (n=30)

Science.gov (United States)

Sibonga, Jean

2010-01-01

This chart shows the T-Values for the Bone Mass Density (BMD) of three areas of the body (i.e., lumbar spine, femoral neck and trochanter) for both pre-spaceflight and post-spaceflight for 30 subjects.

ROL' POLOVYKh GORMONOV V REGULYaTsII KOSTNOGO OBMENA i mineral'noy plotnostikostnoy tkani u muzhchin v pozdnie sroki posle allotransplantatsii trupnoy pochki

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I A PRONChENKO

2006-08-01

Full Text Available Lumbal spine and hip bone mineral density (BMD, bone turnover markers [bone alkaline phosphatase (bALP, osteocalcin (OC, aminoterminal procollagen I propeptide, bone acid phosphatase (bACP, ß-crosslaps (CTX], sex hormones [testosterone, estradiol (E2, sex hormone-binding globulin (SHBG, free androgen index (FAI, free estrogen index (FEI], parathyroid hormone (PTH, osteoprotegerin (OPG and insulin-like growth factor-1 (IGF-1] were determined in 39 men in age 42±10 years (33 with well renal function and 6 - with renal failure (RF 44±26 months following KT receiving triple immunosuppressive therapy (CysA, prednisolone and azathioprine. Increased CTX, bACP, OC and decreased bALP so as BMD were associated in men following KT with low testosterone, SHBG and IGF-1 and high E2, OPG and PTH. There was more degree of bone turnover disturbances, decreased BMD, PTH hypersecretion and low FAI in RF. There were significant positive relationships between serum testosterone and E2, FEI and FAI, bALP and E2, bALP and FEI, femur BMD and FAI, femur BMD and FEI, OPG and E2, IGF-1 and PTH. There were significant inverse correlations between serum CTX and FAI, CTX and FEI, hip (spine BMD and SHBG, hip (spine BMD and PTH so as between PTH and FAI, PTH and FEI. So bone turnover disturbances, hip BMD losses and PTH hypersecretion in men at late time following KT associated with sex hormone deficiency. Predictor of high bone turnover and as vertebral as femur bone losses after KT besides PTH hypersecretion was serum SHBG. Decreased IGF-1 was the reason of bone forming suppression and possibly was following cyclosporine hepatotoxicity. OPG increasing was associated partly with high estradiol and was compensatory to attenuation of bone resorption and bone losses.

A STUDY OF CLINICAL AND SURGICAL OUTCOME OF FRACTURE NECK OF FEMUR

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Anish G. Cherian

2016-09-01

Full Text Available BACKGROUND Fracture neck of femur has high incidence of complications even with treatment, hence it is also termed as unsolved fracture. Factors making treatment difficult are the blood supply to head, which gets cut off and difficulty in achieving reduction. Impacted fractures can be treated conservatively. If the fracture is undisplaced, a conservative approach may be done or multiple cancellous screws can be used. If the patient’s age is less than 60 years, a closed reduction under C-arm control can be tried. If the reduction is possible, then multiple screw fixations can be done. If reduction is not achieved, then open screw reduction and screw fixation can be done. If the patient is above 60 years of age, then it is preferable to excise the head off and replace it with prosthesis. If the hip is normal, then hemiarthroplasty with a unipolar or bipolar prosthesis can be done. If the hip has pre-existing arthritis, then total hip replacement surgery is advisable. A sincere effort has been put to understand the clinical and surgical outcome of fracture neck of femur in elderly. This paper is intended to help the practicing orthopaedicians to understand the various treatment modalities which is commonly used in practice and also the complications which are associated with the pathology. METHODS  The study was done in the Department of Orthopaedics, Travancore Medical College at Kollam.  The study was done from August 2014 to June 2016.  Eighty cases who attended in the Department of Orthopaedics were taken for the study.  Detailed History and Clinical Examination was conducted. INCLUSION CRITERIA  Both traumatic and pathological fractures were taken up for the study.  Individuals who were aged more than 55 years were taken up for the study. EXCLUSION CRITERIA  Aged less than 55 years were not considered.  All the statistical analysis was done using the latest SPSS software 2015 (California. RESULT Fracture neck of femur

Development and testing of texture discriminators for the analysis of trabecular bone in proximal femur radiographs

International Nuclear Information System (INIS)

Huber, M. B.; Carballido-Gamio, J.; Fritscher, K.; Schubert, R.; Haenni, M.; Hengg, C.; Majumdar, S.; Link, T. M.

2009-01-01

Purpose: Texture analysis of femur radiographs may serve as a potential low cost technique to predict osteoporotic fracture risk and has received considerable attention in the past years. A further application of this technique may be the measurement of the quality of specific bone compartments to provide useful information for treatment of bone fractures. Two challenges of texture analysis are the selection of the best suitable texture measure and reproducible placement of regions of interest (ROIs). The goal of this in vitro study was to automatically place ROIs in radiographs of proximal femur specimens and to calculate correlations between various different texture analysis methods and the femurs' anchorage strength. Methods: Radiographs were obtained from 14 femoral specimens and bone mineral density (BMD) was measured in the femoral neck. Biomechanical testing was performed to assess the anchorage strength in terms of failure load, breakaway torque, and number of cycles. Images were segmented using a framework that is based on the usage of level sets and statistical in-shape models. Five ROIs were automatically placed in the head, upper and lower neck, trochanteric, and shaft compartment in an atlas subject. All other subjects were registered rigidly, affinely, and nonlinearly, and the resulting transformation was used to map the five ROIs onto the individual femora. Results: In each ROI, texture features were extracted using gray level co-occurence matrices (GLCM), third-order GLCM, morphological gradients (MGs), Minkowski dimensions (MDs), Minkowski functionals (MFs), Gaussian Markov random fields, and scaling index method (SIM). Coefficients of determination for each texture feature with parameters of anchorage strength were computed. In a stepwise multiregression analysis, the most predictive parameters were identified in different models. Texture features were highly correlated with anchorage strength estimated by the failure load of up to R 2 =0.61 (MF

Curvature reduces bending strains in the quokka femur

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Kyle McCabe

2017-03-01

Full Text Available This study explores how curvature in the quokka femur may help to reduce bending strain during locomotion. The quokka is a small wallaby, but the curvature of the femur and the muscles active during stance phase are similar to most quadrupedal mammals. Our hypothesis is that the action of hip extensor and ankle plantarflexor muscles during stance phase place cranial bending strains that act to reduce the caudal curvature of the femur. Knee extensors and biarticular muscles that span the femur longitudinally create caudal bending strains in the caudally curved (concave caudal side bone. These opposing strains can balance each other and result in less strain on the bone. We test this idea by comparing the performance of a normally curved finite element model of the quokka femur to a digitally straightened version of the same bone. The normally curved model is indeed less strained than the straightened version. To further examine the relationship between curvature and the strains in the femoral models, we also tested an extra-curved and a reverse-curved version with the same loads. There appears to be a linear relationship between the curvature and the strains experienced by the models. These results demonstrate that longitudinal curvature in bones may be a manipulable mechanism whereby bone can induce a strain gradient to oppose strains induced by habitual loading.

Bone mineral density in lifelong trained male football players compared with young and elderly untrained men

DEFF Research Database (Denmark)

Hagman, Marie; Helge, Eva Wulff; Hornstrup, Therese

2018-01-01

Purpose: The purpose of the present controlled cross-sectional study was to investigate proximal femur and whole-body bone mineral density (BMD), as well as bone turnover profile, in lifelong trained elderly male football players and young elite football players compared with untrained age....... All participants underwent a regional Dual-Energy X-ray Absorptiometry (DXA) scan of the proximal femur and a whole-body DXA scan to determine BMD. From a resting blood sample, the bone turnover markers (BTMs) osteocalcin, carboxy-terminal type-1 collagen crosslinks (CTX-1), procollagen type-1 amino...

Bone mineral density in healthy Syrian women measured by dual energy X-ray absorptiometry

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Bakir Mohamed Adel

2018-03-01

Full Text Available Assessment of bone mineral density (BMD using dual energy X-ray absorptiometry (DXA technique is considered as a standard technique for diagnosing osteopenia and osteoporosis and evaluating the severity of such diseases. Numerous studies have demonstrated the necessity to establish an ethnic-specific reference data for Bone mineral density measurements. Such data are lacking for the Syrian population. The objectives of this study are (1 to establish BMD reference values in a group of healthy Syrian women using DXA technique, (2 to compare with values from other populations, (3 to study the prevalence of osteopenia and osteoporosis in Syrian women using the manufacturer reference values. A total of 951 healthy Syrian women aged 20-79 years participated in this study. Weight, height, and BMI have been determined. BMD measurements were performed using Lunar Prodigy Advance System (GE. The data were compared with those from other populations. The results have demonstrated the expected decline in BMD with age after peaking at 30-39 years old group. The peak values of the lumbar spine and femur neck were 1.16 (0.12, and 0.95 (0.13 g/cm2, respectively. The results of the Syrian women were compared with those from other populations and the differences were presented. Osteopenia was diagnosed in 35.80% and 60.31% and osteoporosis in 6.23% and 2.72% in lumbar spine and femur neck, respectively, of women 50-59 years of age. These ratios increased to 36.84%, 68.42% and 23.68%, 13.10%, respectively, in the age group more than 59 years. BMD values of the Syrian women were determined for the first time. The results demonstrate the importance of establishing population-specific reference range for BMD values for an accurate assessment of Osteoporosis. High prevalence of osteopenia and osteoporosis was demonstrated in Syrian using the manufacturer reference values.

Effects of increasing age, dosage, and duration of PTH treatment on BMD increase--a meta-analysis

DEFF Research Database (Denmark)

Schwarz, Peter; Jorgensen, Niklas Rye; Mosekilde, Leif

2012-01-01

were included. By metaregression analysis, we found that the increase in spine BMD (Z-score) after PTH treatment was blunted by increasing age (R (2) = 0.27; 2p = 0.01, slope -0.023 Z-scores per year, 11 studies). By increasing PTH dosage (μg/d), spine BMD increased significantly (2p = 0.......002) with a slope of +0.011 Z-scores/μg/d of teriparatide. Furthermore, the duration of treatment was positively correlated to spine BMD (P ......We studied the effects of increasing age, dosage, and duration of parathyroid hormone (PTH) treatment on changes in bone mineral density (BMD). Randomized placebo controlled trials on PTH treatment in men or women were retrieved from PubMed (1951 to present), Web of Science (1945 to present...

Association of Insulin Resistance with Bone Strength and Bone Turnover in Menopausal Chinese-Singaporean Women without Diabetes

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Kalimeri, Maria; Leek, Francesca; Wang, Nan Xin; Koh, Huann Rong; Totman, John J.

2018-01-01

Insulin resistance (IR) is accompanied by increased areal or volumetric bone mineral density (aBMD or vBMD), but also higher fracture risk. Meanwhile, imbalances in bone health biomarkers affect insulin production. This study investigates the effect of IR on proximal femur and lumbar spine BMD, femoral neck bending, compressive and impact strength indices (Composite Strength Indices) and circulating levels of parathyroid hormone (PTH), C-telopeptide of Type I collagen (CTx-1) and 25(OH) Vitamin D3, in a cohort of 97 healthy, non-obese, menopausal Chinese-Singaporean women. Lumbar spine aBMD was inversely associated with IR and dependent on lean body mass (LBM) and age. No such associations were found for vBMD of the third lumbar vertebra, aBMD and vBMD of the proximal femur, or circulating levels of PTH, CTx-1 and 25(OH) Vitamin D3. Composite Strength Indices were inversely associated with IR and independent of LBM, but after adjusting for fat mass and age, this association remained valid only for the impact strength index. Composite Strength Indices were significantly lower in participants with a high degree of IR. Our findings on IR and Composite Strength Indices relationships were in agreement with previous studies on different cohorts, but those on IR and BMD associations were not. PMID:29710852

Relationships of muscle strength and bone mineral density in ambulatory children with cerebral palsy.

Science.gov (United States)

Chen, C-L; Lin, K-C; Wu, C-Y; Ke, J-Y; Wang, C-J; Chen, C-Y

2012-02-01

This work explores the relationships of muscle strength and areal bone mineral density (aBMD) in ambulatory children with cerebral palsy (CP). The knee extensor strength, but not motor function, was related to aBMD. Thus, muscle strength, especially antigravity muscle strength, was more associated with aBMD in these children than motor function. Muscle strength is related to bone density in normal children. However, no studies have examined these relationships in ambulatory children with CP. This work explores the relationships of muscle strength and aBMD in ambulatory children with CP. Forty-eight ambulatory children with spastic CP, aged 5-15 years, were classified into two groups based on Gross Motor Function Classification System levels: I (n = 28) and II (n = 20). Another 31 normal development (ND) children were recruited as the comparison group for the aBMD. Children with CP underwent assessments of growth, lumbar and distal femur aBMD, Gross Motor Function Measure-66 (GMFM-66), and muscle strength of knee extensor and flexor by isokinetic dynamometer. The distal femur aBMD, but not lumbar aBMD, was lower in children with CP than in ND children (p antigravity muscle strength, were more associated with the bone density of ambulatory children with CP than motor function. The data may allow clinicians for early identifying the ambulatory CP children of potential low bone density.

Association of Insulin Resistance with Bone Strength and Bone Turnover in Menopausal Chinese-Singaporean Women without Diabetes

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Maria Kalimeri

2018-04-01

Full Text Available Insulin resistance (IR is accompanied by increased areal or volumetric bone mineral density (aBMD or vBMD, but also higher fracture risk. Meanwhile, imbalances in bone health biomarkers affect insulin production. This study investigates the effect of IR on proximal femur and lumbar spine BMD, femoral neck bending, compressive and impact strength indices (Composite Strength Indices and circulating levels of parathyroid hormone (PTH, C-telopeptide of Type I collagen (CTx-1 and 25(OH Vitamin D3, in a cohort of 97 healthy, non-obese, menopausal Chinese-Singaporean women. Lumbar spine aBMD was inversely associated with IR and dependent on lean body mass (LBM and age. No such associations were found for vBMD of the third lumbar vertebra, aBMD and vBMD of the proximal femur, or circulating levels of PTH, CTx-1 and 25(OH Vitamin D3. Composite Strength Indices were inversely associated with IR and independent of LBM, but after adjusting for fat mass and age, this association remained valid only for the impact strength index. Composite Strength Indices were significantly lower in participants with a high degree of IR. Our findings on IR and Composite Strength Indices relationships were in agreement with previous studies on different cohorts, but those on IR and BMD associations were not.

The BMD threat: when and how to intercept - Opinion

NARCIS (Netherlands)

Bouquet, F.

2007-01-01

NATO and the US are involved in developing Ballistic missile defense (BMD) capabilities that must provide protection against various threats, which has received global attention. One needs to carefully consider the consequences of employing the defensive missiles. It is assumed that there will be no

Time-course of exercise and its association with 12-month bone changes

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Vainionpää Aki

2009-11-01

Full Text Available Abstract Background Exercise has been shown to have positive effects on bone density and strength. However, knowledge of the time-course of exercise and bone changes is scarce due to lack of methods to quantify and qualify daily physical activity in long-term. The aim was to evaluate the association between exercise intensity at 3, 6 and 12 month intervals and 12-month changes in upper femur areal bone mineral density (aBMD and mid-femur geometry in healthy premenopausal women. Methods Physical activity was continuously assessed with a waist-worn accelerometer in 35 healthy women (35-40 years participating in progressive high-impact training. To describe exercise intensity, individual average daily numbers of impacts were calculated at five acceleration levels (range 0.3-9.2 g during time intervals of 0-3, 0-6, and 0-12 months. Proximal femur aBMD was measured with dual x-ray absorptiometry and mid-femur geometry was evaluated with quantitative computed tomography at the baseline and after 12 months. Physical activity data were correlated with yearly changes in bone density and geometry, and adjusted for confounding factors and impacts at later months of the trial using multivariate analysis. Results Femoral neck aBMD changes were significantly correlated with 6 and 12 months' impact activity at high intensity levels (> 3.9 g, r being up to 0.42. Trochanteric aBMD changes were associated even with first three months of exercise exceeding 1.1 g (r = 0.39-0.59, p r = 0.38-0.52, p Conclusion The number of high acceleration impacts during 6 months of training was positively associated with 12-month bone changes at the femoral neck, trochanter and mid-femur. These results can be utilized when designing feasible training programs to prevent bone loss in premenopausal women. Trial registration Clinical trials.gov NCT00697957

Three-dimensional microarchitecture of the proximal femur in osteoarthritis and rheumatoid arthritis

DEFF Research Database (Denmark)

Wang, B. L.; Ding, Ming; Overgaard, Søren

2015-01-01

microstructure has an important impact on bone quality. Recently, the quantification of bone architecture based on micro-CT has been widely used in the research of various bone diseases. OBJECTIVE: To observe the osteoarthritis- and rheumatoid arthritis-related changes in the properties of the proximal femur...... based on micro-CT, thus to compare the bone microstructure in osteoarthritis and rheumatoid arthritis patients. METHODS: Femoral heads were collected from primary osteoarthritis (n=10) and rheumatoid arthritis (n=7) patients undergoing total hip replacement. A 10-mm segment of the femoral neck was cut...... from each individual femur, perpendicular to the main trabecular direction on X-ray films. The specimens were analyzed by using micro-CT system. After scanning, the data were transferred to three-dimensional images, and then detailed structural parameters of the cortical bone, cancellous bone...

Long-term radiographic follow-up of bisphosphonate-associated atypical femur fractures

Energy Technology Data Exchange (ETDEWEB)

Favinger, Jennifer L. [University of Washington, Department of Radiology, 1959 N.E. Pacific Street, Box 357115, Seattle, WA (United States); Hippe, Daniel [University of Washington, Department of Radiology, Seattle, WA (United States); Ha, Alice S. [University of Washington, Department of Radiology, 4245 Roosevelt Way NE, Box 354755, Seattle, WA (United States)

2016-05-15

To evaluate the appearance of bisphosphonate-related femur insufficiency fractures on long-term follow-up radiographic studies and to describe the rate of fracture line obscuration and cortical beak healing over time. In this retrospective study, bisphosphonate-related femur fracture radiographs were reviewed by two radiologists for the presence of a fracture line, callus, and the characteristic cortical beak. Kaplan-Meier curves were used to analyze the time to first indication of healing. Femurs were also subdivided into those who underwent early versus late surgical fixation and those who underwent early versus late discontinuation of bisphosphonate. Clinical data including pain level and medication history were collected. Forty-seven femurs with a bisphosphonate-related femur fracture were identified in 28 women. Eighty-five percent took a bisphosphonate for greater than 5 years and 59 % for greater than 10 years. The median time to beak healing was 265 weeks and the median time to fracture line healing was 56 weeks in the 31 femurs with a baseline fracture. No statistically significant difference was identified between surgical fixation and conservative management. Bisphosphonate-related fractures demonstrate notably prolonged healing time on long-term follow-up. (orig.)

Subcutaneous administration of insulin-like growth factor (IGF)-II/IGF binding protein-2 complex stimulates bone formation and prevents loss of bone mineral density in a rat model of disuse osteoporosis

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Conover, Cheryl A.; Johnstone, Edward W.; Turner, Russell T.; Evans, Glenda L.; John Ballard, F. John; Doran, Patrick M.; Khosla, Sundeep

2002-01-01

Elevated serum levels of insulin-like growth factor binding protein-2 (IGFBP-2) and a precursor form of IGF-II are associated with marked increases in bone formation and skeletal mass in patients with hepatitis C-associated osteosclerosis. In vitro studies indicate that IGF-II in complex with IGFBP-2 has high affinity for bone matrix and is able to stimulate osteoblast proliferation. The purpose of this study was to determine the ability of the IGF-II/IGFBP-2 complex to increase bone mass in vivo. Osteopenia of the femur was induced by unilateral sciatic neurectomy in rats. At the time of surgery, 14-day osmotic minipumps containing vehicle or 2 microg IGF-II+9 microg IGFBP-2/100g body weight/day were implanted subcutaneously in the neck. Bone mineral density (BMD) measurements were taken the day of surgery and 14 days later using a PIXImus small animal densitometer. Neurectomy of the right hindlimb resulted in a 9% decrease in right femur BMD (P<0.05 vs. baseline). This loss in BMD was completely prevented by treatment with IGF-II/IGFBP-2. On the control limb, there was no loss of BMD over the 14 days and IGF-II/IGFBP-2 treatment resulted in a 9% increase in left femur BMD (P<0.05). Bone histomorphometry indicated increases in endocortical and cancellous bone formation rates and in trabecular thickness. These results demonstrate that short-term administration of the IGF-II/IGFBP-2 complex can prevent loss of BMD associated with disuse osteoporosis and stimulate bone formation in adult rats. Furthermore, they provide proof of concept for a novel anabolic approach to increasing bone mass in humans with osteoporosis.

Quantitative computed tomography derived structural geometric accuracy using custom built anthropometric phantom of the proximal femur

International Nuclear Information System (INIS)

Khoo, B.C.C.; Price, R.; Hicks, N.

2011-01-01

Full text: Material and structural properties influence bone strength. Structural strength may be determined through imaging methods, though currently there is no commercially available phantom to assess structural geometrical (SG) accuracy. This paper describes the design of an anthropometric SG phantom of the proximal femur and the performance testing on quantitative computed tomography (QCT) derived SG outcomes. Aims of study were to determine accuracy of QCT-derived SG outcomes and its effects from kYp. The phantom consists of three basic components; femoral head, a modular and interchangeable neck insert and shaft. The interchangeable neck modules were designed with different cortical thickness and shape. QCT scans were performed with Mindways QA (Mindways Software Inc., USA) phantom, then with anthropometric phantom in water bath together with Mindways calibration phantom. All QCT scans were done on Philips 64 MDCT (Philips Healthcare, USA). Three neck modules were selected and scanned. Each neck module was repeated scanned five times at 120 mAs, 0.67 mm slice thickness and 0.33 mm increment and at 80, 120 and 140 kYps. SG parameters analysed included bone mineral density(aBMD) and outer-diameter (OD).

Characteristics of bone turnover in the long bone metaphysis fractured patients with normal or low Bone Mineral Density (BMD.

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Christoph Wölfl

Full Text Available The incidence of osteoporotic fractures increases as our population ages. Until now, the exact biochemical processes that occur during the healing of metaphyseal fractures remain unclear. Diagnostic instruments that allow a dynamic insight into the fracture healing process are as yet unavailable. In the present matched pair analysis, we study the time course of the osteoanabolic markers bone specific alkaline phosphatase (BAP and transforming growth factor β1 (TGFβ1, as well as the osteocatabolic markers crosslinked C-telopeptide of type-I-collagen (β-CTX and serum band 5 tartrate-resistant acid phosphatase (TRAP5b, during the healing of fractures that have a low level of bone mineral density (BMD compared with fractures that have a normal BMD. Between March 2007 and February 2009, 30 patients aged older than 50 years who suffered a metaphyseal fracture were included in our study. BMDs were verified by dual energy Xray absorptiometry (DXEA scans. The levels of BTMs were examined over an 8-week period. Osteoanabolic BAP levels in those with low levels of BMD were significantly different from the BAP levels in those with normal BMD. BAP levels in the former group increased constantly, whereas the latter group showed an initial strong decrease in BAP followed by slowly rising values. Osteocatabolic β-CTX increased in the bone of the normal BMD group constantly, whereas these levels decreased significantly in the bone of the group with low BMD from the first week. TRAP5b was significantly reduced in the low level BMD group. With this work, we conduct first insights into the molecular biology of the fracture healing process in patients with low levels of BMD that explains the mechanism of its fracture healing. The results may be one reason for the reduced healing qualities in bones with low BMD.

Steroid Induced Bilateral Avascular Necrosis of Head of Femur in an Adult Male Patient - A Case Report.

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Jadeja, Dharamvirsinh; Solanki, Vipul; Chavada, Bhavesh; Tripathi, Chandrabhanu

2016-01-01

A 28 year old male patient, known case of pemphigus vulgaris was on dexamethasone pulse therapy. Total 7 pulses were given after that he developed avascular necrosis of head of femur on both sides, which was confirmed by digital X- ray and MRI. Avascular necrosis is a disabling and progressive condition in young patients gradually leads to femoral head collapse and eventual total hip arthroplasty. As per WHO-UMC causality assessment criteria, the association between reaction and drug was possible, Naranjo's score was 7. According to Modified Schumock and Thornton's criteria, this reaction was not preventable. The Modified Hartwig and Siegel's scale showed that the reaction was severe (level 6). Here we present a case where the use of steroid for pemphigus vulgaris resulting in the development of bilateral avascular necrosis of head of femur.

Effect of Teriparatide or Risedronate in Elderly Patients With a Recent Pertrochanteric Hip Fracture

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Malouf-Sierra, Jorge; Tarantino, Umberto; Garcia-Hernandez, Pedro A.

2017-01-01

-dummy treatment plus calcium and vitamin D, followed by 52-week open-label treatment with the same assigned active drug. Primary endpoint was change from baseline in lumbar spine (LS) BMD at 78 weeks. Secondary and exploratory endpoints were change in BMD at the proximal femur, function, hip pain (Charnley score...

Identification of a gene module associated with BMD through the integration of network analysis and genome-wide association data.

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Farber, Charles R

2010-11-01

Bone mineral density (BMD) is influenced by a complex network of gene interactions; therefore, elucidating the relationships between genes and how those genes, in turn, influence BMD is critical for developing a comprehensive understanding of osteoporosis. To investigate the role of transcriptional networks in the regulation of BMD, we performed a weighted gene coexpression network analysis (WGCNA) using microarray expression data on monocytes from young individuals with low or high BMD. WGCNA groups genes into modules based on patterns of gene coexpression. and our analysis identified 11 gene modules. We observed that the overall expression of one module (referred to as module 9) was significantly higher in the low-BMD group (p = .03). Module 9 was highly enriched for genes belonging to the immune system-related gene ontology (GO) category "response to virus" (p = 7.6 × 10(-11)). Using publically available genome-wide association study data, we independently validated the importance of module 9 by demonstrating that highly connected module 9 hubs were more likely, relative to less highly connected genes, to be genetically associated with BMD. This study highlights the advantages of systems-level analyses to uncover coexpression modules associated with bone mass and suggests that particular monocyte expression patterns may mediate differences in BMD. © 2010 American Society for Bone and Mineral Research.

Bone edema on magnetic resonance imaging is highly associated with low bone mineral density in patients with ankylosing spondylitis.

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Danmin Wang

Full Text Available This study aimed to assess the relationship between bone marrow edema (BME on magnetic resonance imaging (MRI and bone mineral density (BMD in patients with ankylosing spondylitis (AS.The study included 333 patients with AS who underwent BMD measurements and axial MRI. Additionally, 106 normal controls were included. The modified New York criteria were used as the classification criteria of AS. Clinical, laboratory, and imaging data were collected and analyzed. Lumbar spine and proximal femur BMD were assessed using dual-energy X-ray absorptiometry. Low BMD was defined by a Z-score ≤-2. The Spondyloarthritis Research Consortium of Canada (SPARCC MRI index was used to assess inflammation at the sacroiliac joint (SIJ and spine.Among the 333 patients, the male:female ratio was 4.6:1, mean patient age was 28.5±10.6 years, and mean disease duration was 7.3±6.8 years. The prevalences of low BMD, osteopenia, and osteoporosis were significantly higher among AS patients than among controls (19.8%, 62.8%, and 5.7% vs. 4.7%, 33.0%, and 0%, respectively, P = 0.000. The BMD values were significantly lower and prevalences of low BMD at both the spine and femur were significantly higher among patients with BME on MRI than among those without BME. Multivariate logistic regression analysis showed that male sex (OR 3.87, 95% CI 1.21-7.36, P = 0.023, high ASDAS-CRP score (OR 2.83, 95% CI 1.36-4.76, P = 0.015, the presence of BME on sacroiliac MRI (OR 2.83, 95% CI 1.77-6.23, P = 0.000 and spinal MRI (OR 4.06, 95% CI 1.96-8.46, P = 0.000, and high grade of sacroiliitis (OR 2.93, 95% CI 1.82-4.45, P = 0.002 were risk factors for low BMD (any site. The SPARCC scores of the SIJ were negatively correlated with femoral BMD (r = -0.22, 95% CI -0.33 to -0.10, P = 0.000. Additionally, the SPARCC scores of the spine were negatively correlated with BMD values (r = -0.23, 95% CI -0.36 to -0.09, P = 0.003 and Z-scores (r = -0.24, 95% CI -0.36 to -0.12, P = 0.001 at the

99mTc-MDP bone scintigraphy findings representing osteoporosis

International Nuclear Information System (INIS)

Nam, Dae Gun; Moon, Tae Geon; Kim, Ji Hong; Son, Seok Man; Kim, In Ju; Kim, Yong Ki

2001-01-01

Bone scintigraphy with 99m Tc-labeled phosphates is one of the most common procedures in evaluation of various skeletal disorders. Metabolic bone diseases show involvement of the whole skeleton and are associated with increased bone turnover and increased uptake of 99m Tc-labeled phosphates. In this study, we investigated apparently normal women who were examined with routine bone scintigraphy applied bone densitometry to correlate it with skeletal uptake in bone scan. This study includes 79 women who were performed both of bone mineral density(BMD) and bone scintigraphy. We investigated the relation of bone scan findings and BMD of lumbar, femur, radius. Regional BMD were negatively correlated with increased age. Among the bone scintigraphy findings representing metabolic bone disease, uptakes by the long bones, skull and mandible increased with age in women, while that in the costochondral junction decreased. Increased skull and mandible uptakes is associated with decreased BMD, and it has statistically significance. Our results show that increased radionuclide uptake in bone scintigraphy, especially skull and mandible uptake was associated with decreased lumbar, femur BMD in women. So that, increased skull and mandible uptake in women would be a scintigraphic sign of osteopenia or osteoporosis

Comparison of femoral morphology and bone mineral density between femoral neck fractures and trochanteric fractures.

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Maeda, Yuki; Sugano, Nobuhiko; Saito, Masanobu; Yonenobu, Kazuo

2011-03-01

Many studies that analyzed bone mineral density (BMD) and skeletal factors of hip fractures were based on uncalibrated radiographs or dual-energy xray absorptiometry (DXA). Spatial accuracy in measuring BMD and morphologic features of the femur with DXA is limited. This study investigated differences in BMD and morphologic features of the femur between two types of hip fractures using quantitative computed tomography (QCT). Forty patients with hip fractures with normal contralateral hips were selected for this study between 2003 and 2007 (trochanteric fracture, n=18; femoral neck fracture, n=22). Each patient underwent QCT of the bilateral femora using a calibration phantom. Using images of the intact contralateral femur, BMD measurements were made at the point of minimum femoral-neck cross-sectional area, middle of the intertrochanteric region, and center of the femoral head. QCT images also were used to measure morphologic features of the hip, including hip axis length, femoral neck axis length, neck-shaft angle, neck width, head offset, anteversion of the femoral neck, and cortical index at the femoral isthmus. No significant differences were found in trabecular BMD between groups in those three regions. Patients with trochanteric fractures showed a smaller neck shaft angle and smaller cortical index at the femoral canal isthmus compared with patients with femoral neck fractures. We conclude that severe osteoporosis with thinner cortical bone of the femoral diaphysis is seen more often in patients with trochanteric fracture than in patients with femoral neck fracture. Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

The Effect of Alendronate and Calcitonin Treatments on Bone Mineral Density and Quality of Life in Women With Postmenopausal Osteoporosis

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F. Taşçıoğlu

2002-06-01

Full Text Available The aim of this study was to compare the effect of alendronate and calcitonin treatments on bone mineral density (BMD and quality of life of women with postmenopausal osteoporosis. One hundred ninety-three patients were randomly assigned to two groups: 93 patients received daily doses of 10 mg alendronate and calcium 1000 mg, and 98 patients used intranasal salmon calcitonin (sCt at a dosage of 200 IU/day and they also received daily doses of 1000 mg calcium supplements. DXA was used for the measurement of BMD of the lumbar spine and proximal femur before and after the study period. SF-36 was used as a measure of health-related quality of life. At the end of the treatment, ALN produced significant increases in BMD at the lumbar spine (p< 0.001, femur neck (p<0.05, trochanteric region (p<0.001 and at the Ward triangle (p<0.05. In contrast, intranasal sCt treatment resulted in a significant bone loss in the femur neck (p<0.01 and Ward triangle (p<0.05, and only a significant increase in BMD of the lumbar spine was observed with calcitonin treatment(p< 0.05. Quality of life as assessed by SF-36 improved significantly in both groups(p<0.05. In conclusion, alendronate seemed to be more effective than calcitonin, increasing both spinal and femoral BMD, for the treatment of postmenopausal osteoporosis. Both treatments were found to be effective for the improvement of quality of life.

Osteoporosis in clinical practice – bone densitometry and fracture risk

African Journals Online (AJOL)

Osteoporosis is a condition of decreased bone mass and bone density associated with an increase in fracture risk. Bone mineral density (BMD) of the lumbar spine and femur can be reliably measured by double-beam X-ray absorptiometry (DEXA), which provides a measure of bone strength. Reduction in BMD is a ...

A frequent regulatory variant of the estrogen-related receptor alpha gene associated with BMD in French-Canadian premenopausal women.

Science.gov (United States)

Laflamme, Nathalie; Giroux, Sylvie; Loredo-Osti, J Concepción; Elfassihi, Latifa; Dodin, Sylvie; Blanchet, Claudine; Morgan, Kenneth; Giguère, Vincent; Rousseau, François

2005-06-01

Genes are important BMD determinants. We studied the association of an ESRRA gene functional variant with BMD in 1335 premenopausal women. The ESRRA genotype was an independent predictor of L2-L4 BMD, with an effect similar to smoking and equivalent to a 10-kg difference in weight. Several genetic polymorphisms have been associated with osteoporosis or osteoporosis fractures, but no functional effect has been shown for most of these gene variants. Because functional studies have implicated estrogen-related receptor alpha (ESRRA) in bone metabolism, we evaluated whether a recently described regulatory variant of the ESRRA gene is associated with lumbar and hip BMD as measured by DXA and with heel bone parameters as measured by quantitative ultrasound (QUS). Heel bone parameters were measured by right calcaneal QUS in 1335 healthy French-Canadian premenopausal women, and one-half of these women also had their BMD evaluated at two sites: femoral neck and lumbar spine (L2-L4) by DXA. All bone measures were tested separately for association with the ESRRA genotype by analysis of covariance. The significance of the ESRRA contribution to the model was also assessed by two different permutation tests. A statistically significant association between ESRRA genotype and lumbar spine BMD was observed: women carrying the long ESRRA genotype had a 3.9% (0.045 g/cm2) higher lumbar spine BMD than those carrying the short ESRRA genotype (p = 0.004), independently of other risk factors measured. This effect of ESRRA genotype is similar to the effect of smoking and equivalent to a 10-kg difference in weight. This association was confirmed by permutation tests (p = 0.004). The same trend was observed for femoral neck BMD (2.6%, p = 0.07). However, no association was observed between ESRRA and QUS heel bone measures. These results support the genetic influence of this ESRRA regulatory variant on BMD.

EXPERIMENTAL APPROVAL OF COMBINED FIXATION FOR FEMUR LENGTHENING

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M. A. Stepanov

2017-01-01

Full Text Available Elimination of congenital shortening of lower limb still remains a complex and unsolved orthopaedic task which requires an improved fixation technique as well as adjusted tactics of treatment and rehabilitation procedures.Purpose of the study — experimental approval of femur lengthening technique by external fixation with Ilizarov apparatus and internal fixation by plate.Materials and methods. Femur lengthening was performed in 6 mongrel dogs. Average animal age was 1,5±0,3 years, average weight — 20±5 kg, femur length — 22±2 sm. External apparatus with two supports and a titanium plate of an original design were applied under general anesthesia on the right femur of animals. Lengthening was performed manually at a rate of1 mm per day in 4 stages at a distance of 10% from initial segment length. External apparatus was removed on the last day of distraction after locking the plate. X-ray examination was done on the day of surgery, in 7, 14 and 25 days from the onset of distraction as well as in 14, 30, 60 and 90 days after completion of distraction and removal of external apparatus. Three animals were taken out of experiment in 30 days of fixation, remaining three animals — in 90 days. After euthanasia the authors performed autopsy of the organic femur complex and tissues contacting the plate.Results. The use of operated limb was not restricted during the whole distraction period. The authors observed first roentgenological signs of distraction osteogenesis on 7th day of lengthening. By the end of distraction period, at 25th day, shadows of regenerates demonstrated longitudinal striated structures in all cases. Median lucency area of 1–5 mm was located diagonally and across the regenerate or was intermittent. In 60 days of fixation X-rays demonstrated homogeneous regenerate. External fixation index was 13,9±1,5 days/sm (p≤0,05. The authors observed no cases of implants fracture or deformity during the experiment

Bone mineral analysis through dual energy X-ray absorptiometry in laboratory animals

International Nuclear Information System (INIS)

Tsujio, Masashi; Mizorogi, Toshihiro; Kitamura, Itsuko

2009-01-01

To determine how to eliminate species difference in animal bone experiment, bone mineral content (BMC) was measured using dual energy X-ray absorptiometry (DXA) on the femurs of laboratory mice (Mus musculus) and rats (Rattus norvegicus), and common marmosets (Callithrix jacchus). Measures were taken on femurs in situ, detached from the body, skinned and defleshed, or dried completely. When the BMC of the bone measured in the intact limb attached to the trunk was set at 100%, the actual BMC of the dry bone was 58.7±11.5% in mice and 103.2±3.2% in rats. Similarly, the bone area (Area) and bone mineral density (BMD) of the dried femur was significantly lower in the mouse femurs than intact limb. Thus, soft limb tissue such as skin and muscle modified the BMC, Area, and BMD only in mouse but not in those from rats or marmosets. The bone mineral ratio (BMR; BMC divided by dry bone weight) was nearest to the human bone value in the rat femurs, whereas the mouse femur BMR was the most different. The BMR was proved to be a practical index in evaluating bone characteristics in laboratory animals, but the mouse femur might not be suitable as an animal model for research into the aging of human bone. (author)

The relation between bone demineralization, physical activity and anthropometric standards

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Milena Barbosa Camara

2017-03-01

Full Text Available This paper aimed to verify the correlation between bone mineral density and the level of physical activity, as well as the food intake and the anthropometric parameters. It intended to analyse the bone mineral density (BMD of menopausal women through the bone densitometry test (DO in the lumbar region (L1 to L4, femoral neck and total femur, and also use Bouchard’s self-recall of daily activities; employing the food record from Buker and Stuart to dose and quantify the daily intake of calcium and vitamin D. The data were analysed via Kolmogorov-Smirnov’s test, and default value of α = 0.05 was set to compare the BMD averages. It was observed that one hundred percent of the assessed individuals had a BMD level below the average fixed by WHO: 14.4% with osteopenia and 85.6% with osteoporosis; a lower BMD in the femoral area (0.721g and the biggest loss among the sedentary ones (0.698g. It was noticed that there was a correlation between the physical activities and the BMD only when associated with anthropometric standards and the daily ingestion of vitamin D.

Ipsilateral Fracture Shaft Femur with Neglected Dislocation of Prosthesis: A Case Report

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Mantu Jain

2013-10-01

Full Text Available Introduction: Neglected hip dislocation is rare in today’s world and after prosthesis replacement even rarer finding. However such patients may not report to surgeons until they develop secondary complications. Management of such patient’s is a challenge to the treating surgeon and need to be tailored suiting to patient’s demands, expectations and constraints of financial resources. We did not find a similar case in the electronic and print media and therefore report this case which was innovatively managed. Case Report: A 60 year farmer presented with fracture shaft femur and ipsilateral dislocation prosthesis of right hip. He had a hemiarthroplasty done for fracture neck of femur in the past but used to walk with a lurch since he started to ambulate after discharge. However he was satisfied despite “some problems” which had caused shortening of his limb. The patient was informed of the various treatment options and their possible complications. He expressed his inability to afford a Total Hip Arthroplasty (THA at any stage and consented for other options discussed with him. The patient was positioned supine and adductor tenotomy done. Next he was positioned laterally and the fracture was fixed with heavy duty broad dynamic compression plate and screws. The wound was temporarily closed. Now through the previous scar via posterior approach the hip was exposed. The prosthesis was found to be firmly fixed to the proximal femur. The acetabulum was cleared with fibrous tissue. All attempts the prosthesis to relocate the prosthesis failed after several attempts and it was best decided to leave alone. Post operatively period was uneventful. At follow up he refused for any further manoeuvre in future inform of heavy traction and attempts to reduce the same. At one year when he was walking unaided and his X-rays showed that fracture had well united his SF-36 score was PCS – 49.6 and MCS – 51.9. Conclusion: Ipsilateral shaft femur fracture

Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

Energy Technology Data Exchange (ETDEWEB)

Tian, Qing-Hua, E-mail: ddqinghua-tian@163.com; He, Cheng-Jian, E-mail: tianhechengjian@163.com; Wu, Chun-Gen, E-mail: 649514608@qq.com; Li, Yong-Dong, E-mail: tianliyongdong@163.com; Gu, Yi-Feng, E-mail: tianyifenggu@163.com; Wang, Tao, E-mail: tianandwangtao@163.com; Xiao, Quan-Ping, E-mail: tianxiaoquanping@163.com; Li, Ming-Hua, E-mail: tianminghuali@163.com [Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Department of Diagnostic and Interventional Radiology (China)

2016-01-15

PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor.

Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

International Nuclear Information System (INIS)

Tian, Qing-Hua; He, Cheng-Jian; Wu, Chun-Gen; Li, Yong-Dong; Gu, Yi-Feng; Wang, Tao; Xiao, Quan-Ping; Li, Ming-Hua

2016-01-01

PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor

Anorexia nervosa: slow regain of bone mass.

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Valla, A; Groenning, I L; Syversen, U; Hoeiseth, A

2000-01-01

In a retrospective study of women aged 18-30 years, aimed at assessing factors associated with peak bone mass (PBM), 13 of 239 study cases reported having had anorexia nervosa. The mean total femoral and lumbar bone mineral density (BMD) values were not significantly lower in women who had had anorexia than in the pooled group (mean Z-scores of -0.60 and -0.48). Cases with less than 6 years since the anorexia had on average a present weight 5.7 kg less than their premorbid weights, while cases with more than 6 years since the eating disorder had an average weight 22.5 kg above their pre-morbid weights. The cases who had not regained their weight had BMD values significantly lower than the pooled material (mean Z-scores -1.15 and -0.9 in the lumbar spine and total femur respectively). Those who had regained their weight had BMD values as predicted from their present anthropometric data, while those who had not regained their weight had BMD values that were substantially below that predicted from their present weight. Anorexia nervosa seems to be associated with a low BMD which is even lower than that which can be predicted from the weight loss alone. This suggests that weight loss and other factors, such as menstrual dysfunction and estrogen deficiency, are independent and thus additive causes of bone loss in anorexia nervosa. Recovery of BMD seems slow, but the BMD may become as predicted from the anthropometric data after restoration of body weight and menses. The potential for recovery of BMD seems intact for several years after menarche.

Using the benchmark dose (BMD) methodology to determine an appropriate reduction of certain ingredients in food products.

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Bi, Jian

2010-01-01

As the desire to promote health increases, reductions of certain ingredients, for example, sodium, sugar, and fat in food products, are widely requested. However, the reduction is not risk free in sensory and marketing aspects. Over reduction may change the taste and influence the flavor of a product and lead to a decrease in consumer's overall liking or purchase intent for the product. This article uses the benchmark dose (BMD) methodology to determine an appropriate reduction. Calculations of BMD and one-sided lower confidence limit of BMD are illustrated. The article also discusses how to calculate BMD and BMDL for over dispersed binary data in replicated testing based on a corrected beta-binomial model. USEPA Benchmark Dose Software (BMDS) were used and S-Plus programs were developed. The method discussed in the article is originally used to determine an appropriate reduction of certain ingredients, for example, sodium, sugar, and fat in food products, considering both health reason and sensory or marketing risk.

Combined Effects of Spaceflight and Age in Astronauts as Assessed by Areal Bone Mineral Density [BMD] and Trabecular Bone Score

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Sibonga, Jean D.; Spector, Elizabeth R.; Ploutz-Snyder, R.; Evans, H. J.; King, L.; Watts, N. B.; Hans, D.; Smith, S. A.

2013-01-01

Spaceflight is a potential risk factor for secondary osteoporosis in astronauts. Although lumbar spine (LS) BMD declines rapidly, more than expected for age, there have been no fragility fractures in astronauts that can clearly be attributed to spaceflight. Recently, astronauts have been returning from 6-month spaceflights with absolute BMD still above young adult mean BMD. In spite of these BMD measurements, we project that the rapid loss in bone mass over long-duration spaceflight affects the bone microarchitecture of the LS which might predispose astronauts to premature vertebral fractures. Thus, we evaluated TBS, a novel texture index correlated with vertebral bone microarchitecture, as a means of monitoring changes to bone microarchitecture in astronauts as they age. We previously reported that TBS detects an effect of spaceflight (6-month duration), independent of BMD, in 51 astronauts (47+/-4 y) (Smith et al, J Clin Densitometry 2014). Hence, TBS was evaluated in serial DXA scans (Hologic Discovery W) conducted triennially in all active and retired astronauts and more frequently (before spaceflight, after spaceflight and until recovery) in the subset of astronauts flying 4-6- month missions. We used non-linear models to describe trends in observations (BMD or TBS) plotted as a function of astronaut age. We fitted 1175 observations of 311 astronauts, pre-flight and then postflight starting 3 years after landing or after astronaut's BMD for LS was restored to within 2% of preflight BMD. Observations were then grouped and defined as follows: 1) LD: after exposure to at least one long-duration spaceflight > 100 days and 2) SD: before LD and after exposure to at least one short-duration spaceflight < 30 days. Data from males and females were analyzed separately. Models of SD observations revealed that TBS and BMD had similar curvilinear declines with age for both male and female astronauts. However, models of LD observations showed TBS declining with age while

Bone mineral density (BMD) and computer tomographic measurements of the equine proximal phalanx in correlation with breaking strength.

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Tóth, P; Horváth, C; Ferencz, V; Tóth, B; Váradi, A; Szenci, O; Bodó, G

2013-01-01

Despite the fact that bone mineral density (BMD) is an important fracture risk predictor in human medicine, studies in equine orthopedic research are still lacking. We hypothesized that BMD correlates with bone failure and fatigue fractures of this bone. Thus, the objectives of this study were to measure the structural and mechanical properties of the proximal phalanx with dual energy X-ray absorptiometry (DXA), to correlate the data obtained from DXA and computer tomography (CT) measurements to those obtained by loading pressure examination and to establish representative region of interest (ROI) for in vitro BMD measurements of the equine proximal phalanx for predicting bone failure force. DXA was used to measure the whole bone BMD and additional three ROI sites in 14 equine proximal phalanges. Following evaluation of the bone density, whole bone, cortical width and area in the mid-diaphyseal plane were measured on CT images. Bones were broken using a manually controlled universal bone crusher to measure bone failure force and reevaluated for the site of fractures on follow-up CT images. Compressive load was applied at a constant displacement rate of 2 mm/min until failure, defined as the first clear drop in the load measurement. The lowest BMD was measured at the trabecular region (mean +/- SD: 1.52 +/- 0.12 g/cm2; median: 1.48 g/cm2; range: 1.38-1.83 g/cm2). There was a significant positive linear correlation between trabelcular BMD and the breaking strength (P = 0.023, r = 0.62). The trabecular region of the proximal phalanx appears to be the only significant indicator of failure of strength in vitro. This finding should be reassessed to further reveal the prognostic value of trabecular BMD in an in vivo fracture risk model.

Osteosynthesis of a periprosthetic fracture of the proximal femur with the distal femur LISS system

DEFF Research Database (Denmark)

Tarnowski, Jan Robert; Holck, Kim

2008-01-01

In this case report, we show how it is possible to perform osteosynthesis using minimal invasive techniques instead of conventional methods. In this instance the osteosynthesis was performed on a patient in poor general condition who had presented a periprosthetic fracture of the proximal femur. ...

Safe zones and a technical guide for cerclage wiring of the femur: a computed topographic angiogram (CTA) study.

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Apivatthakakul, Theerachai; Siripipattanamongkol, P; Oh, Chang-Wug; Sananpanich, K; Phornphutkul, C

2018-01-01

Cerclage wiring for reduction of complex femoral shaft fractures can create iatrogenic vascular injury. To describe the anatomical relation of blood vessels to the femur and develop a technical guide for safe passage of cerclage wire. CT lower-limb angiographs (CTA) of 80 patients were reviewed and analysed to identify the superficial femoral artery (SFA) and the deep femoral artery (DFA) as well as the relation of those arteries to the femoral cortex. The total length of the femur was measured and divided into eight equal segments (seven levels). At each level, the medial half of the femur was divided into eight sectors labelled A through H and the position of the SFA and DFA was recorded. The shortest distance between the femoral cortex and the SFA and DFA at each level was measured. The data was analysed using STATA version 10.0. The average total femoral length from the tip of greater trochanter to lateral joint line was 402.98 ± 26.16 cm. The average distances from the SFA to the femur (d1) for levels 1 through 7 were 37.20 ± 5.0, 32.09 ± 4.74, 27.13 ± 4.19, 27.71 ± 5.46, 23.71 ± 4.40, 13.63 ± 3.59 and 10.08 ± 3.09 mm, respectively. The average distances between the DFA and the femur (d2) for levels 1 through 3 were 26.70 ± 4.13, 14.76 ± 3.27 and 9.58 ± 3.79 mm, respectively. The position of the SFA is located in sectors B through E at levels 1-3 and in sectors E through H at levels 4-7 and the position of the DFA located in sectors B through F at levels 1-3. Cerclage wiring should be started from the posterior intermuscular septum at the linea aspera. The safe area is the proximal half (midshaft) of the femur where the SFA and DFA lie at a safe distance from the femur. Between the midshaft and the distal 1/4, insertion of the passer must be done meticulously with the tip kept close to posteromedial cortex. Below the distal 1/4, the tip of the passer should be kept close to the posterior cortex to avoid injury to the SFA and

The relationship of total body composition with bone mineral density in postmenopausal women with type 2 diabetes

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Vadim Valer'evich Klimontov

2015-03-01

Full Text Available Aim. To determine the relationship between bone mineral density (BMD and total body composition in postmenopausal women with type 2 diabetes. Materials and Methods. The study included 78 women, from 50 to 70 years of age (median 63 years. Twenty women had normal body mass index (BMI, 29 ones were overweight and 29 had obesity. The body composition and BMD was studied by dual-energy X-ray absorptiometry. Results. Women with normal BMD had higher BMI, total and truncal fat mass, as well lean mass as compared to women with osteoporosis and osteopenia (all p

Longitudinal shapes of the tibia and femur are unrelated and variable.

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Howell, Stephen M; Kuznik, Kyle; Hull, Maury L; Siston, Robert A

2010-04-01

In general practice, short films of the knee are used to assess component position and define the entry point for intramedullary femoral alignment in TKAs; however, whether it is justified to use the short film commonly used in research settings and everyday practice as a substitute for the whole leg view is controversial and needs clarification. In 138 long leg CT scanograms we measured the angle formed by the anatomic axis of the proximal fourth of the tibia and the mechanical axis of the tibia, the angle formed by the anatomic axis of the distal fourth of the femur and the mechanical axis of the femur, the "bow" of the tibia (as reflected by the offset of the anatomic axis from the center of the talus), and the "bow" of the femur (as reflected by the offset of the anatomic axis from the center of the femoral head). Because the angle formed by these axes and the bow of the tibia and femur have wide variability in females and males, a short film of the knee should not be used in place of the whole leg view when accurate assessment of component position and limb alignment is essential. A previous study of normal limbs found that only 2% of subjects have a neutral hip-knee-ankle axis, which can be explained by the wide variability of the bow in the tibia and femur and the lack of correlation between the bow of the tibia and femur in a given limb as shown in the current study.

Discriminative ability of total body bone-mineral measured by dual photon absorptiometry

International Nuclear Information System (INIS)

Gotfredsen, A.; Poedenphant, J.; Nilas, L.; Christiansen, C.

1989-01-01

We investigated the descriminative ability of total body bone-mineral expressed as the total body bone-density (TBBD) measured by dual photon absorptiometry (DPA) in 79 healthy premenopausal women, 27 healthy postmenopausal women, and 120 female osteoporotic fracture patients presenting with either Colles' fracture, vertebral fracture or femoral neck-fracture. TBBD was compared to the bone-mineral density of the lumbar spine (BMD spine ) also measured by DPA, and to the bone-mineral content of the forearms (BMC forearm ) measured by single photon absorptiometry (SPA). TBBD, BMD spine and BMC forearm showed that all the fracture patient groups had significantly reduced bone-mass. Using receiver operating characteristic (ROC) analysis, we found that TBBD had a tendency towards better discriminative ability than BMD spine or BMC forearm with regard to the discrimination between healthy premenopausal women and the three types of osteoporotic fractures. BMC forearm had an intermediate position, whereas BMD spine had the smallest discriminative ability. TBBD also discriminated better between healthy postmenopausal women and hip-fracture patients than BMD spine or BMC forearm , whereas there was no significant difference between the three methods regarding the discrimination between the healthy postmenopausal women and the Colles' and spinal fracture patients. We conclude that the TBBD measurement by DPA has a discriminative potential which is better than the local spine or forearm measurements. (author)

Correlation between Parameters of Calcaneal Quantitative Ultrasound and Hip Structural Analysis in Osteoporotic Fracture Patients.

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Licheng Zhang

Full Text Available Calcaneal quantitative ultrasound (QUS, which is used in the evaluation of osteoporosis, is believed to be intimately associated with the characteristics of the proximal femur. However, the specific associations of calcaneal QUS with characteristics of the hip sub-regions remain unclear.A cross-sectional assessment of 53 osteoporotic patients was performed for the skeletal status of the heel and hip.We prospectively enrolled 53 female osteoporotic patients with femoral fractures. Calcaneal QUS, dual energy X-ray absorptiometry (DXA, and hip structural analysis (HSA were performed for each patient. Femoral heads were obtained during the surgery, and principal compressive trabeculae (PCT were extracted by a three-dimensional printing technique-assisted method. Pearson's correlation between QUS measurement with DXA, HSA-derived parameters and Young's modulus were calculated in order to evaluate the specific association of QUS with the parameters for the hip sub-regions, including the femoral neck, trochanteric and Ward's areas, and the femoral shaft, respectively.Significant correlations were found between estimated BMD (Est.BMD and BMD of different sub-regions of proximal femur. However, the correlation coefficient of trochanteric area (r = 0.356, p = 0.009 was higher than that of the neck area (r = 0.297, p = 0.031 and total proximal femur (r = 0.291, p = 0.034. Furthermore, the quantitative ultrasound index (QUI was significantly correlated with the HSA-derived parameters of the trochanteric area (r value: 0.315-0.356, all p<0.05 as well as with the Young's modulus of PCT from the femoral head (r = 0.589, p<0.001.The calcaneal bone had an intimate association with the trochanteric cancellous bone. To a certain extent, the parameters of the calcaneal QUS can reflect the characteristics of the trochanteric area of the proximal hip, although not specifically reflective of those of the femoral neck or shaft.

X-ray imaging characterization of femoral bones in aging mice with osteopetrotic disorder.

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Tu, Shu-Ju; Huang, Hong-Wen; Chang, Wei-Jeng

2015-04-01

Aging mice with a rare osteopetrotic disorder in which the entire space of femoral bones are filled with trabecular bones are used as our research platform. A complete study is conducted with a micro computed tomography (CT) system to characterize the bone abnormality. Technical assessment of femoral bones includes geometric structure, biomechanical strength, bone mineral density (BMD), and bone mineral content (BMC). Normal aging mice of similar ages are included for comparisons. In our imaging work, we model the trabecular bone as a cylindrical rod and new quantitative which are not previously discussed are developed for advanced analysis, including trabecular segment length, trabecular segment radius, connecting node number, and distribution of trabecular segment radius. We then identified a geometric characteristic in which there are local maximums (0.0049, 0.0119, and 0.0147 mm) in the structure of trabecular segment radius. Our calculations show 343% higher in percent trabecular bone volume at distal-metaphysis; 38% higher in cortical thickness at mid-diaphysis; 11% higher in cortical cross-sectional moment of inertia at mid-diaphysis; 42% higher in cortical thickness at femur neck; 26% higher in cortical cross-sectional moment of inertia at femur neck; 31% and 395% higher in trabecular BMD and BMC at distal-metaphysis; 17% and 27% higher in cortical BMD and BMC at distal-metaphysis; 9% and 53% higher in cortical BMD and BMC at mid-diaphysis; 25% and 64% higher in cortical BMD and BMC at femur neck. Our new quantitative parameters and findings may be extended to evaluate the treatment response for other similar bone disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Study of bony trabecular characteristics using bone morphometry and micro-CT

International Nuclear Information System (INIS)

Song, Young Han; Lee, Wan; Lee, Chang Jin; Ji, Jung Hyun; Lee, Byung Do

2007-01-01

The research was done to investigate the effectiveness of 2D bony morphometry and microstructure of micro-computed tomography (micro-CT) on the osteoporotic bony change. We performed the bone morphometric analysis of proximal femur in ovariectomized rabbits with BMD and micro-CT examination. Twenty-one female (Newzeland, about 16 weeks old, 2.9-3.4 kg) rabbits were used. Three rabbits were sacrificed on the day when experiment began (Basline). The remaining 18 rabbits were divided into two groups. One group was ovariectomized bilaterally (OVX) and the other animals were subjected to sham operation (Sham). Bone specimens were obtained from the right and left femur of sacrificed rabbits. At intervals of 1,2,3,5,6 months respectively, BMD tests were performed on the proximal on the proximal femur by using PIXImus 2 (GE Lunar Co. USA), 2-dimensional bone morphometric analysis by custom computer program and 2D / 3D bone structure analysis by micro-CT (Skyscan1072, Antwerpen, Belgium). Statistical analysis was carried out for the correlation between bone morphometry, micro-CT and BMD. BV/TV, Tb.Th, Tb.N of micro-CT parameters showed higher values in sham group than OVX group. N.Nd/Ar.RI, N.NdNd, N.NdTm, N. TmTm, PmB/Ar.RI, 3-D BoxSlope of 2D morphometric parameters showed higher values in Sham group than OVX group. The micro-CT parameters of Tb.Sp. Tb.N were statistically significant correlated with BMD respectively. Several 2D morphometric parameters were statistically significant correlated with BMD respectively. Several parameters of 2D bony morphometry and micro-CT showed effective aspects on the osteoporotic bony change

Higher BMC and areal BMD in children and grandchildren of individuals with hip or knee replacement.

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Specker, Bonny L; Wey, Howard E; Binkley, Teresa L; Beare, Tianna M; Smith, Eric P; Rauch, Frank

2010-04-01

The relationship between aBMD and osteoarthritis (OA) remains unclear. We compared aBMD, BMC and bone size among children and grandchildren of Hutterites with hip or knee replacement (n=23 each) to children and grandchildren of age- and sex-matched controls (178 children and 267 grandchildren). There were no differences in anthropometric measures or activity levels between case and control probands, but femoral neck (FN) and spine (LS) aBMD and Z-scores were greater in cases than controls (0.89 vs. 0.80 g/cm2; 1.15 vs. 1.03 g/cm2; 1.5 vs. 0.8; 2.4 vs. 1.2: all pBMC (34.1 vs. 32.0, 4.58 vs. 4.27, 69.5 vs. 62.4 g) and Z-scores (1.0 vs. 0.4; 0.9 vs. 0.2; 1.3 vs. 0.2) were greater in daughters of cases than controls (hip BMC p=0.06, others p or =2 years post-menarcheal or males> or =18 years): 33 were not classified. Post-menarcheal, but not premenarcheal, granddaughters of cases had greater hip, FN and LS aBMD Z-scores (0.7 vs. -0.1; 0.6 vs. -0.1; 0.8 vs. -0.3); greater hip and spine aBMD (1.03 vs. 0.95, 1.10 vs. 0.98 g/cm2); greater femoral neck and spine BMC (4.77 vs. 4.21, 66.7 vs. 55.4 g); and greater spine bone area (60.7 vs. 56.6 cm2) compared to granddaughters of controls (all, p<0.05), which remained significant when height, weight, and age were included as covariates. Growing grandsons of cases were taller and heavier than control grandsons, and a greater hip aBMD among grandsons of cases (0.88 vs. 0.76 g/cm2) was the only bone difference that remained significant after taking into account body size differences. Grandsons who were not growing had greater spine bone area (1.19 vs. 1.08 cm2) if their grandparent had OA compared to grandsons whose grandparents did not have OA. We speculate that there is a genetic basis for OA that leads to early differences in growth patterns among boys and greater peak bone mass and aBMD among girls. Copyright 2010 Elsevier Inc. All rights reserved.

Longitudinal assessment of bone growth and development in a facility-based population of young adults with cerebral palsy.

Science.gov (United States)

Grossberg, Richard; Blackford, Martha G; Kecskemethy, Heidi H; Henderson, Richard; Reed, Michael D

2015-11-01

Osteoporosis is a significant clinical problem in persons with moderate to severe cerebral palsy (CP), causing fractures with minimal trauma. Over the past decade, most studies examining osteoporosis and CP have been cross-sectional in nature, focused exclusively on children and adolescents and only involving one evaluation of bone mineral density (BMD). The purpose of this study was to assess BMD in a group including adults with CP, and changes in each individual's BMD over a 5- to 6-year period. The study group included 40 residents of a long-term care facility aged 6 to 26 years at the time of their initial evaluation. Twenty-one patients (52.5%) were male, 35 (88%) were white, and 38 (95%) were in Gross Motor Function Classification System level V. BMD was assessed by dual-energy X-ray absorptiometry on the right and left distal femurs for three distinct regions of interest. Five residents had a fracture that occurred during the study period; this represented a fracture rate of 2.1% per year in the study group. Longitudinally, annualized change in the median BMD was 0.7% to 1.0% per year in the different regions of the distal femur, but ranged widely among the study group, with both increases and decreases in BMD. Increase in BMD over time was negatively correlated with age and positively correlated with change in weight. Changes in BMD over time in profoundly involved persons with CP can range widely, which is important to recognize when evaluating potential interventions to improve BMD. Age and changes in body weight appear the most relevant factors. © 2015 Mac Keith Press.

Test Bench Development for Femur Stability Assessment

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Samuel SANCHEZ-CABALLERO

2015-01-01

Full Text Available This paper shows the design and development of a test bench for humanfemurs. The main uses of this test bench will run from artificial femurs comparisonwith real femurs, to join stability assessment after bone a fracture repair. Amongthis uses is specially designed for condylar fractures testing. The test bench isdeveloped from a self-made existing tensile/compression testing machine. Thedesign procedure is supported by a literature review about the bone mechanicalbehavior and composition generally and the knee joint performance and repairparticularly. On the basis of this review, the machine was designed to simulate theadduction and abduction movements of the joint. The magnitudes to be measuredare: the compression force, the bone displacement (vertical and the knee jointrotation

Study of treatment of short oblique and transverse fractures near isthmus of femur

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Soumya Ghosh

2014-01-01

Full Text Available Background: Currently, the standard treatment for femoral shaft fractures in adults is intramedullary nailing. Objectives: Comparative assessment of results with open Kuntscher′s nailing (K-nailing and closed interlocking intramedullary nail in case of fracture shaft femur. Materials and Methods: This pilot project was conducted in a tertiary care hospital of a developing country on 40 patients in a time period of 1 year. A total of 20 patients were treated with intramedullary nailing in the tertiary care hospital while twenty received open fixation with K-nailing in a rural center. Results: There was no significant difference with regard to union rate, implant failure, infection, and fracture alignment between both groups. Conclusion: Open fixation with unlocked femoral nailing is technically less demanding and requires less operating time; additionally, there is no exposure to radiation and cost of the implant is cheaper. So, open K-nailing is still remains an option for the management of noncomminuted isthmus fractures of the femur in a developing country.

Significance of determination of bone mineral density and osteocalcin in diabetic patients with diabetic microvascular complications

International Nuclear Information System (INIS)

Kong Xianghui; Mu Junqing; Lu Kuan

2003-01-01

Objective: To study the influence of diabetic microvascular complications on bone mineral density (BMI) and osteocalcin (BGP). Methods: 60 patients with type 2 diabetes mellitus were studied, including 33 with microvascular complications (retinopathy, nephropathy, neuropathy) (group 1) and 27 without complications (group 2). Fasting blood glucose, serum fructosamine (GSP), total alkaline phosphatase (TALP), calcium (Ca 2+ ) levels were measured by biochemical method; osteocalcin (BGP) level was detected by RIA. BMD of the lumbar spine and femur was measured by dual energy X-ray absorptiometry in all patients. Body mass index (BMI) was calculated from the height and body weight. Results: The BMI, GSP, FBG, TALP and Ca 2+ values in the two groups were not much different, but BGP and BMD in group 1 were significantly lower than those in group 2. Conclusion: Bone mineral density (BMD) and BGP values were closely related to the microvascular complications in diabetes, which could decrease bone formation and increase the frequency of osteoporosis

Bone mineral content in the senescent rat femur: an assessment using single photon absorptiometry

International Nuclear Information System (INIS)

Kiebzak, G.M.; Smith, R.; Howe, J.C.; Sacktor, B.

1988-01-01

The single photon absorptiometry technique was evaluated for measuring bone mineral content (BMC) of the excised femurs of the rat, and the system was used to examine the changes in cortical and trabecular bone from young adult (6 mo), mature adult (12 mo), and senescent (24 mo) male and female animals. BMC of the femur midshaft, representing cortical bone, apparently increased progressively with advancing age. The width of the femur at the scan site also increased with age. Normalizing the midshaft BMC by width partially compensated for the age-associated increase. However, when bone mineral values were normalized by the cortical area at the scan site, to take into account the geometric differences in the femurs of different aged animals, maximum bone densities were found in the mature adult and these values decreased slightly in the femurs from senescent rats. In contrast, the BMC of the femur distal metaphysis, representing trabecular bone, decreased markedly in the aged rat. The loss of trabecular bone was also evident from morphological examination of the distal metaphysis. These findings indicated that bone mineral loss with age was site specific in the rat femur. These studies provided additional evidence that the rat might serve as a useful animal model for specific experiments related to the pathogenesis of age-associated osteopenia

Three-Dimensional Analysis of the Curvature of the Femoral Canal in 426 Chinese Femurs

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Xiu-Yun Su

2015-01-01

Full Text Available Purpose. The human femur has long been considered to have an anatomical anterior curvature in the sagittal plane. We established a new method to evaluate the femoral curvature in three-dimensional (3D space and reveal its influencing factors in Chinese population. Methods. 3D models of 426 femurs and the medullary canal were constructed using Mimics software. We standardized the positions of all femurs using 3ds Max software. After measuring the anatomical parameters, including the radius of femoral curvature (RFC and banking angle, of the femurs using the established femur-specific coordinate system, we analyzed and determined the relationships between the anatomical parameters of the femur and the general characteristics of the population. Results. Pearson’s correlation analyses showed that there were positive correlations between the RFC and height (r=0.339, p<0.001 and the femoral length and RFC (r=0.369, p<0.001 and a negative correlation between the femoral length and banking angle (r=-0.223, p<0.001. Stepwise linear regression analyses showed that the most relevant factors for the RFC and banking angle were the femoral length and gender, respectively. Conclusions. This study concluded that the banking angle of the femur was significantly larger in female than in male.

Dietary Calcium Intake and Calcium Supplementation in Hungarian Patients with Osteoporosis

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Gábor Speer

2013-01-01

Full Text Available Purpose. Adequate calcium intake is the basis of osteoporosis therapy—when this proves insufficient, even specific antiosteoporotic agents cannot exert their actions properly. Methods. Our representative survey analyzed the dietary intake and supplementation of calcium in 8033 Hungarian female and male (mean age: 68 years (68.01 (CI95: 67.81–68.21 patients with osteoporosis. Results. Mean intake from dietary sources was 665±7.9 mg (68.01 (CI95: 67.81–68.21 daily. A significant positive relationship could be detected between total dietary calcium intake and lumbar spine BMD (P=0.045, whereas such correlation could not be demonstrated with femoral T-score. Milk consumption positively correlated with femur (P=0.041, but not with lumbar BMD. The ingestion of one liter of milk daily increased the T-score by 0.133. Average intake from supplementation was 558±6.2 mg (68.01 (CI95: 67.81–68.21 daily. The cumulative dose of calcium—from both dietary intake and supplementation—was significantly associated with lumbar (r=0.024, P=0.049, but not with femur BMD (r=0.021, P=0.107. The currently recommended 1000–1500 mg total daily calcium intake was achieved in 34.5% of patients only. It was lower than recommended in 47.8% of the cases and substantially higher in 17.7% of subjects. Conclusions. We conclude that calcium intake in Hungarian osteoporotic patients is much lower than the current recommendation, while routinely applied calcium supplementation will result in inappropriately high calcium intake in numerous patients.

X-Ray Exam: Femur (Upper Leg)

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... Staying Safe Videos for Educators Search English Español X-Ray Exam: Femur (Upper Leg) KidsHealth / For Parents / X- ... Muscles, and Joints Broken Bones Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...

Body composition and bone mineral density in breast cancer survivors and non-cancer controls: A 12- to 15-month follow-up.

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Artese, A L; Simonavice, E; Madzima, T A; Kim, J-S; Arjmandi, B H; Ilich, J Z; Panton, L B

2018-03-01

While prognosis for breast cancer in women has improved, adverse side effects of treatments may negatively affect body composition and bone mineral density (BMD). This study assessed body composition and BMD changes in breast cancer survivors (BCS) (n = 10, 57.9 ± 5.7 years) and age-matched women (non-cancer, n = 10, 56.5 ± 4.3 years) over a 12- to 15-month period via dual-energy X-ray absorptiometry. No differences were observed between groups at baseline except forearm BMD values were lower in BCS (BCS: 0.462 ± 0.070 g/cm 2 ; Control: 0.539 ± 0.052 g/cm 2 , p = .012). Body fat increased in both groups compared to baseline (BCS: 38.3-39.6 kg, p = .013; Control: 38.2-39.5 kg, p = .023) at the follow-up. Significant decreases in BMD at the lumbar spine, femoral neck, total femur and ulna were observed in both groups. Breast cancer survivors had a greater decrease in left femoral neck BMD. While BCS demonstrated lower baseline forearm BMD values and a greater decrease in left femoral neck BMD, both groups showed an increase in body fat and decrease in forearm BMD. These findings support the implementation of interventions to improve body composition and BMD in both BCS and women without cancer. © 2018 John Wiley & Sons Ltd.

Effect of nonphytate phosphorus and phytase levels on broiler femur.

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Luana Martins Schaly

2009-03-01

Full Text Available This experiment was carried out to evaluate the effect of nonphytate phosphorus (NPP and phytase levels on the weight, morphometry and weight/length index (WLI of broiler femurs at 21 and 42 days of age. One thousand, two hundred chicks were allocated in a completely randomized design and 4 x 3 factorial arrangement (NPP x phytase levels, with four replicates. The NPP levels, at each phase were of 0.45, 0.37, 0.29 and 0.21% in the initial phase, 0.41, 0.33, 0.25 and 0.17% in the growth phase, and of 0.37, 0.29, 0.21 and 0.13% in the final phase. The phytase levels used were 0, 500 and 1000U/kg of diet. At 21 and 42 days of age, 48 birds were sacrificed for femur collection. At 21 days, there was no effect (P > 0.05 of NPP x phytase interaction on bone parameters, but the NPP reduction decreased (P < 0.05 the weight, length and WLI of the femurs, and the inclusion of 500U/kg of phytase improved (P < 0.05 the weight and WLI of the bones. At 42 days of age, NPP x phytase interaction was significant (P < 0.05 for the weight and length, and birds fed diets with no phytase had femurs that were lighter and shorter when the lowest NPP levels were evaluated. However, the inclusion of 500 or 1000U/kg of phytase produced weights and lengths similar to those produced by treatment with recommended NPP levels, and the lower NPP levels evaluated caused a reduction (P < 0.05 in the diameter and WLI of femurs. It was concluded that diets with 0.29, 0.25 or 0.21% of NPP, with 500 U/kg of phytase, could be used with no negative effect on the femur quality in broilers from one to 42 days of age.

Influence of number of deliveries and total breast-feeding time on bone mineral density in premenopausal and young postmenopausal women.

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Tsvetov, Gloria; Levy, Sigal; Benbassat, Carlos; Shraga-Slutzky, Ilana; Hirsch, Dania

2014-03-01

Pregnancy and lactation have been associated with decline in bone mineral density (BMD). It is not clear if there is a full recovery of BMD to baseline. This study sought to determine if pregnancy or breast-feeding or both have a cumulative effect on BMD in premenopausal and early postmenopausal women. We performed single-center cohort analysis. Five hundred women aged 35-55 years underwent routine BMD screening from February to July 2011 at a tertiary medical center. Patients were questioned about number of total full-term deliveries and duration of breast-feeding and completed a background questionnaire on menarche and menopause, smoking, dairy product consumption, and weekly physical exercise. Weight and height were measured. Dual-energy X-ray absorptiometry was used to measure spinal, dual femoral neck, and total hip BMD. Associations between background characteristics and BMD values were analyzed. Sixty percent of the women were premenopausal. Mean number of deliveries was 2.5 and mean duration of breast-feeding was 9.12 months. On univariate analysis, BMD values were negatively correlated with patient age (p=0.006) and number of births (p=0.013), and positively correlated with body mass index (posteoporosis later in life. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The shape of the hominoid proximal femur: a geometric morphometric analysis

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Harmon, Elizabeth H

2007-01-01

As part of the hip joint, the proximal femur is an integral locomotor component. Although a link between locomotion and the morphology of some aspects of the proximal femur has been identified, inclusive shapes of this element have not been compared among behaviourally heterogeneous hominoids. Previous analyses have partitioned complex proximal femoral morphology into discrete features (e.g. head, neck, greater trochanter) to facilitate conventional linear measurements. In this study, three-dimensional geometric morphometrics are used to examine the shape of the proximal femur in hominoids to determine whether femoral shape co-varies with locomotor category. Fourteen landmarks are recorded on adult femora of Homo, Pan, Gorilla, Pongo and Hylobates. Generalized Procrustes analysis (GPA) is used to adjust for position, orientation and scale among landmark configurations. Principal components analysis is used to collapse and compare variation in residuals from GPA, and thin-plate spline analysis is used to visualize shape change among taxa. The results indicate that knucklewalking African apes are similar to one another in femoral shape, whereas the more suspensory Asian apes diverge from the African ape pattern. The shape of the human and orangutan proximal femur converge, a result that is best explained in terms of the distinct requirements for locomotion in each group. These findings suggest that the shape of the proximal femur is brought about primarily by locomotor behaviour. PMID:17310545

Bone involvement in adult patients affected with Ehlers-Danlos syndrome.

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Eller-Vainicher, C; Bassotti, A; Imeraj, A; Cairoli, E; Ulivieri, F M; Cortini, F; Dubini, M; Marinelli, B; Spada, A; Chiodini, I

2016-08-01

The Ehlers-Danlos syndrome is characterized by abnormal connective tissue but bone involvement is debated. We found a reduced BMD and bone quality and increased prevalence of asymptomatic vertebral fractures in eugonadal patients with Ehlers-Danlos syndrome. These findings suggest the need of a bone health evaluation in these patients. The Ehlers-Danlos (EDS) syndrome is characterized by abnormalities of the connective tissue leading to ligamentous laxity and skin and tissue fragility. We evaluated the bone metabolism, bone mineral density (BMD) and bone quality (measured by trabecular bone score, TBS), and the prevalence of vertebral fractures (VFx) in a group of eugonadal adult EDS patients. Fifty consecutive Caucasian patients, aged 30-50 years (36 females, 14 males) with classical or hypermobility EDS and 50 age-, gender-, and body mass index (BMI)-matched control subjects were enrolled. In all subjects' calcium-phosphorous metabolism, bone turnover, BMD at the lumbar spine (LS) and femur (femoral neck, FN and total femur, FT) and TBS by dual-energy X-ray absorptiometry, and the VFx presence by spine radiograph were assessed. Patients showed reduced BMD (Z-scores LS -0.45 ± 1.00, FN -0.56 ± 1.01, FT -0.58 ± 0.92) and TBS (1.299 ± 0.111) and increased prevalence of morphometric VFx (32 %) than controls (Z-scores LS 0.09 ± 1.22, FN 0.01 ± 0.97, FT 0.08 ± 0.89; TBS 1.382 ± 0.176; VFx 8 %, p <0.05 for all comparisons), while vitamin D levels, calcium-phosphorous metabolism, and bone turnover were comparable. Fractured EDS patients showed lower TBS values than non-fractured ones (1.245 ± 0.138 vs 1.325 ± 0.086, p < 0.05), despite comparable BMD. In EDS patients, the VFx presence was significantly associated with TBS even after adjusting for sex, age, BMD, EDS type, and falls frequency. EDS patients have reduced BMD and bone quality (as measured by TBS) and increased prevalence of VFx.

In Vivo Study on the Pharmacological Interactions between a Chinese Herbal Formula ELP and Antiresorptive Drugs to Counteract Osteoporosis

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Chun-Hay Ko

2012-01-01

Full Text Available Antiresorptive drugs, alendronate and raloxifene, are effective in lowering bone mineral density (BMD loss in postmenopausal women. However, long-term treatment may be associated with serious side effects. Our research group has recently discovered that a Chinese herbal formula, ELP, could significantly reduce BMD loss in animal and human studies. Therefore, the present study aimed to investigate the potential synergistic bone-protective effects of different herb-drug combinations using ovariectomized rats. To assess the efficacy of different combinations, the total BMD was monitored biweekly in the 8-week course of daily oral treatment. Bone microarchitecture, bone strength, and deoxypyridinoline level were also determined after 8 weeks. From our results, coadministration of ELP and raloxifene increased the total tibial BMD by 5.26% (2.5 mg/kg/day of raloxifene; P=0.014 and 5.94% (0.25 mg/kg/day of raloxifene; P=0.026 when compared with the respective dosage groups with raloxifene alone. Similar synergistic effects were also observed in BMD increase at distal femur (0.25 mg/kg/day; P=0.001 and reduction in urinary deoxypyridinoline crosslink excretion (2.5 and 0.25 mg/kg/day; both P=0.02. However, such interactions could not be observed in all alendronate-treated groups. Our data provide first evidence that ELP could synergistically enhance the therapeutic effects of raloxifene, so that the clinical dosage of raloxifene could be reduced.

Improving consent in patients undergoing surgery for fractured neck of femur.

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Thiruchandran, Gajendiran; McKean, Andrew R; Rudran, Branavan; Imam, Mohamed A; Yeong, Keefai; Hassan, Abdel

2018-05-02

Background Neck of femur fractures and their subsequent operative fixation are associated with high rates of perioperative morbidity and mortality. Consenting in this setting is suboptimal with the Montgomery court ruling changing the perspective of consent. This quality improvement project assessed the adequacy of consenting against British Orthopaedic Association-endorsed guidance and implemented a series of changes to improve the documentation of risks associated with surgery for fractured neck of femur. Methods Seventy consecutive patients who underwent any operative fixation of a neck of femur fracture were included over a 6-month period at a single centre. Patients unable to consent or without electronic notes were excluded. Consent forms were analysed and the documented potential risks or complications associated with surgery were compared to British Orthopaedic Association-endorsed guidance. A series of changes (using the plan, do study, act (PDSA) approach) was implemented to improve the adequacy of consent. Results Documentation of four out of 12 potential risks or complications was recorded in <50% of cases for patients with intracapsular fractures (n=35), and documentation of seven out of 12 potential risks or complications was recorded in <50% of cases for patients with extracapsular fractures (n=35). Re-audit following raising awareness and attaching consent guidance showed 100% documentation of potential risks or complications in patients with intracapsular and extracapsular fractures (n=70). A neck of femur fracture-specific consent form has been implemented which will hopefully lead to sustained improvement. Conclusions Consenting patients with fractured neck of femur for surgery in the authors' unit was suboptimal when compared to British Orthopaedic Association-endorsed consent guidance. This project has shown that ensuring such guidance is readily available has improved the adequacy of consent. The authors hope that introduction of a neck of

Effect of ovariectomy on BMD, micro-architecture and biomechanics of cortical and cancellous bones in a sheep model.

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Wu, Zi-xiang; Lei, Wei; Hu, Yun-yu; Wang, Hai-qiang; Wan, Shi-yong; Ma, Zhen-sheng; Sang, Hong-xun; Fu, Suo-chao; Han, Yi-sheng

2008-11-01

Osteoporotic/osteopenia fractures occur most frequently in trabeculae-rich skeletal sites. The purpose of this study was to use a high-resolution micro-computed tomography (micro-CT) and dual energy X-ray absorptionmeter (DEXA) to investigate the changes in micro-architecture and bone mineral density (BMD) in a sheep model resulted from ovariectomy (OVX). Biomechanical tests were performed to evaluate the strength of the trabecular bone. Twenty adult sheeps were randomly divided into three groups: sham group (n=8), group 1 (n=4) and group 2 (n=8). In groups 1 and 2, all sheep were ovariectomized (OVX); in the sham group, the ovaries were located and the oviducts were ligated. In all animals, BMD for lumbar spine was obtained during the surgical procedure. BMD at the spine, femoral neck and femoral condyle was determined 6 months (group 1) and 12 months (group 2) post-OVX. Lumbar spines and femora were obtained and underwent BMD scan, micro-CT analysis. Compressive mechanical properties were determined from biopsies of vertebral bodies and femoral condyles. BMD, micro-architectural parameters and mechanical properties of cancellous bone did not decrease significantly at 6 months post-OVX. Twelve months after OVX, BMD, micro-architectural parameters and mechanical properties decreased significantly. The results of linear regression analyses showed that trabecular thickness (Tb.Th) (r=0.945, R2=0.886) and bone volume fraction (BV/TV) (r=0.783, R2=0.586) had strong (R2>0.5) correlation to compression stress. In OVX sheep, changes in the structural parameters of trabecular bone are comparable to the human situation during osteoporosis was induced. The sheep model presented seems to meet the criteria for an osteopenia model for fracture treatment with respect to morphometric and mechanical properties. But the duration of OVX must be longer than 12 months to ensure the animal model can be established successfully.

Proposing an adaptive mutation to improve XCSF performance to classify ADHD and BMD patients

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Sadatnezhad, Khadijeh; Boostani, Reza; Ghanizadeh, Ahmad

2010-12-01

There is extensive overlap of clinical symptoms observed among children with bipolar mood disorder (BMD) and those with attention deficit hyperactivity disorder (ADHD). Thus, diagnosis according to clinical symptoms cannot be very accurate. It is therefore desirable to develop quantitative criteria for automatic discrimination between these disorders. This study is aimed at designing an efficient decision maker to accurately classify ADHD and BMD patients by analyzing their electroencephalogram (EEG) signals. In this study, 22 channels of EEGs have been recorded from 21 subjects with ADHD and 22 individuals with BMD. Several informative features, such as fractal dimension, band power and autoregressive coefficients, were extracted from the recorded signals. Considering the multimodal overlapping distribution of the obtained features, linear discriminant analysis (LDA) was used to reduce the input dimension in a more separable space to make it more appropriate for the proposed classifier. A piecewise linear classifier based on the extended classifier system for function approximation (XCSF) was modified by developing an adaptive mutation rate, which was proportional to the genotypic content of best individuals and their fitness in each generation. The proposed operator controlled the trade-off between exploration and exploitation while maintaining the diversity in the classifier's population to avoid premature convergence. To assess the effectiveness of the proposed scheme, the extracted features were applied to support vector machine, LDA, nearest neighbor and XCSF classifiers. To evaluate the method, a noisy environment was simulated with different noise amplitudes. It is shown that the results of the proposed technique are more robust as compared to conventional classifiers. Statistical tests demonstrate that the proposed classifier is a promising method for discriminating between ADHD and BMD patients.

Comminuted distal femur closed fractures: a new application of the Ilizarov concept of compression-distraction.

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El-Tantawy, Ahmad; Atef, Ashraf

2015-04-01

The treatment of intra-articular distal femur fractures with severe metaphyseal comminution is challenging. It is important to choose a technique that provides secure fixation, minimum tissue handling, and early ambulation. The aim of this work was to evaluate the outcomes of application of Ilizarov concept as an early definitive treatment of comminuted distal femur closed fractures. A total of 17 male patients (mean age 28.53±6.33 years) presented with comminuted distal femur fractures (with 10 type C2 and 7 type C3-2 fractures according to AO/ASIF system) were included in this prospective study. Initial fixation of the articular fragments was done by inter-fragmentary screws, percutaneously through a limited open approach, and stabilization was completed by Ilizarov fixator. The procedure included acute shortening, through the comminution, followed by gradual re-distraction to compensate the created shortening. Radiological and functional results were assessed according to ASAMI evaluation system. The mean amount of intra-operative shortening was 3.68±0.53 cm. The mean external fixation index was 37.24±2.53 days/cm. The mean follow-up period was 18.18±1.91 months. All fractures united primarily in an average 137.65±4.12 days, with no evident angular deformity or limb-length discrepancy. None of the cases required a second major procedure or bone graft. The functional results were excellent in three cases, good in 12, and fair in two patients. The Ilizarov concept of acute compression-distraction is a valuable alternative for the treatment of distal femur fractures with severe metaphyseal comminution.

Comparative morphometric analysis of the proximal femur of African hominids and felids

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Andrew Gallagher

2015-09-01

Full Text Available Size and shape of the mammalian proximal femur and taxon-specific distinctions in the relative proportions of the proximal articulation, the femoral neck and the proximal femoral diaphysis, are critical determinants in its adaptation to differential biomechanical stresses and observed locomotor habitus in different taxa. The morphometrics of the proximal femur are considered equally critical in the assessment of locomotor habitus of extinct fossil mammals, particularly extinct Miocene anthropoids and Plio-Pleistocene hominins. Analyses of size and shape of k=10 dimensions of the proximal femur were undertaken for a large sample series of two extant mammal families the Felidae and Hominidae using conventional multivariate statistical procedures, commonly used size-correction methods, and post-hoc tests of significance. While significant differences in form do exist, there are equally striking convergences in the functional morphology of extant hominid and felid taxa. Multivariate and bivariate allometric analyses confirm that the proximal femur of these two mammalian families share a common underlying structure manifest in a shared first common principal component. Nevertheless, while considerable convergences in general form of the proximal femur of African hominids and large-bodied felids are apparent, there exist equally discreet distinctions which are consistent with the differential structural demands imposed by their distinct locomotor and behavioural habitus.

Effect of ¹⁸F-FDG administration on measurements of bone mineral density and body composition by dual-energy X-ray absorptiometry.

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Kim, Dae-Weung; Kim, Woo Hyoung; Kim, Myoung Hyoun; Kim, Seong Su; Mo, Eun Hee; Lee, Chun Ho; Kim, Chang Guhn

2013-01-01

The purpose of this study was to determine whether antecedent administration of ¹⁸F-fluorodeoxyglucose (FDG) used in positron emission tomography (PET) scanning results in corruption of bone mineral density (BMD) and body composition measured by dual-energy X-ray absorptiometry (DXA) system. DXA measurements of BMD and body composition had been performed twice, before and after ¹⁸F-FDG PET scan in 30 patients. The comparison of pre-values and post-values of all BMD values showed a decrease after the injection. However, only the decrease of whole-body BMD (WB-BMD) was statistically significant (p < 0.05). Whole-body fat mass had increased and whole-body lean body mass had decreased after the injection of ¹⁸F-FDG, and these were statistically significant (p < 0.05). There is statistically significant correlation between the injected ¹⁸F-FDG dose and a decrease of WB-BMD (r = -0.405; p < 0.05). The findings of this study suggest that when both ¹⁸F-FDG PET and DXA measurements for whole-body composition are performed in close-time proximity, ¹⁸F-FDG PET scans should follow the DXA measurement. Otherwise, BMD measurements of total femur or lumbar spine could be followed by ¹⁸F-FDG PET in close-time proximity. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Systematic review of spica casting for the treatment of paediatric diaphyseal femur fractures.

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Tisherman, R T; Hoellwarth, J S; Mendelson, S A

2018-04-01

Paediatric femur fractures are commonly encountered and often successfully managed with spica casting. Despite spica casting's long history there is little formal guidance for optimal outcomes and no consolidation of existing literature. The purpose of this study is to review the available literature regarding the use of spica casting for the management of paediatric diaphyseal femur fractures. The PubMed database was queried for all research articles including the phrase "spica". A total of 788 abstracts were reviewed for relevance to the current study. Data was extracted from all available research studies which specified tolerance for fracture angulation or shortening in the cast. Additionally, all articles describing alternative materials, methods for spica application, and complications of spica casting were reviewed. In all, 106 articles were found relevant to the management of diaphyseal femur fractures in the paediatric population. The aggregated, accepted fracture shortening decreased from 16 mm to 18 mm before age ten years to 12 mm to 14 mm after puberty. Aggregated, accepted angulation decreased from 14° to 16° varus/valgus and 18° to 22° pro/recurvatum before age two years, to 6° to 8° and 10° to 12° by puberty, respectively. The overall reported complication rate was 19.6%, with the most common complication being skin compromise in 8.2% of patients, followed by unacceptable angulation at the fracture site in 4.2% of patients and excessive limb shortening in 1.9% of patients. This article reviews the available spica casting literature and compiles the available data. Spica casting offers a safe, effective means for definitive management of paediatric diaphyseal femur fractures. Future research identifying the rate and pattern of remodelling as it relates to angulation and shortening at various patient ages, particularly beyond the aforementioned norms, would be valuable to identify true biological tolerances versus accepted expert opinion

The relationship between developmental lumbar spinal stenosis and its BMD value : comparison by single energy quantitative CT

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Kim, Hak Jin; Kim, Kun Il; Song, Keun Sung

1996-01-01

The purpose of this study is to evaluate the relationship between developmental lumbar spinal stenosis and its BMD value by using the single energy quantitative CT(SEQCT). Eighty normal volunteers(20-60years) were selected as a control group and 28 patients with developmental lumbar spinal stenosis were selected as a disease group. The two groups were divided into a younger (20-39 years) and an older subgroup (40-60 years), and were further divided into male and female subgroups. All the cases showed no evidence of metabolic disease, fracture, herniated nucleus pulposus, degererative spondylosis, infectious disease, tumors or had no history of absolute immobilization of more than two weeks. All underwent lumbar spine CT and SEQCT. we measured bone mineral density(BMD) at the cancellous bone of L1, 2, 3 and obtained the mean and its one standard deviation, and compared the data between each sub-group of the control and the disease group using ANOVA. There was a significant low BMD value in the younger male patient subgroup compared with the control subgroup(p<0.005). Developmental lumbar spinal stenosis in a young male may be a factor of decreasing BMD of the body of the spine

The relationship between developmental lumbar spinal stenosis and its BMD value : comparison by single energy quantitative CT

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Kim, Hak Jin; Kim, Kun Il; Song, Keun Sung [Pusan National Univ. Hospital, Pusan (Korea, Republic of)

1996-03-01

The purpose of this study is to evaluate the relationship between developmental lumbar spinal stenosis and its BMD value by using the single energy quantitative CT(SEQCT). Eighty normal volunteers(20-60years) were selected as a control group and 28 patients with developmental lumbar spinal stenosis were selected as a disease group. The two groups were divided into a younger (20-39 years) and an older subgroup (40-60 years), and were further divided into male and female subgroups. All the cases showed no evidence of metabolic disease, fracture, herniated nucleus pulposus, degererative spondylosis, infectious disease, tumors or had no history of absolute immobilization of more than two weeks. All underwent lumbar spine CT and SEQCT. we measured bone mineral density(BMD) at the cancellous bone of L1, 2, 3 and obtained the mean and its one standard deviation, and compared the data between each sub-group of the control and the disease group using ANOVA. There was a significant low BMD value in the younger male patient subgroup compared with the control subgroup(p<0.005). Developmental lumbar spinal stenosis in a young male may be a factor of decreasing BMD of the body of the spine.

Low volumetric BMD is linked to upper-limb fracture in pubertal girls and persists into adulthood: a seven-year cohort study.

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Cheng, Sulin; Xu, Leiting; Nicholson, Patrick H F; Tylavsky, Frances; Lyytikäinen, Arja; Wang, Qingju; Suominen, Harri; Kujala, Urho M; Kröger, Heikki; Alen, Markku

2009-09-01

The aetiology of increased incidence of fracture during puberty is unclear. This study aimed to determine whether low volumetric bone mineral density (vBMD) in the distal radius is associated with upper-limb fractures in growing girls, and whether any such vBMD deficit persists into adulthood. Fracture history from birth to 20 years was obtained and verified by medical records in 1034 Finnish girls aged 10-13 years. Bone density and geometry at distal radius, biomarkers and lifestyle/behavioural factors were assessed in a subset of 396 girls with a 7.5-year follow-up. We found that fracture incidence peaked during puberty (relative risk 3.1 at age of 8-14 years compared to outside this age window), and 38% of fractures were in the upper-limb. Compared to the non-fracture cohort, girls who sustained upper-limb fracture at ages 8-14 years had lower distal radial vBMD at baseline (258.9+/-37.5 vs. 287.5+/-34.1 mg/cm(3), p=0.001), 1-year (252.0+/-29.3 vs. 282.6+/-33.5 mg/cm(3), p=0.001), 2-year (258.9+/-32.2 vs. 289.9+/-40.1 mg/cm(3), p=0.003), and 7-year follow-ups (early adulthood, 307.6+/-35.9 vs. 343.6+/-40.9 mg/cm(3), p=0.002). There was a consistent trend towards larger bone cross-sectional area in the fracture cohort compared to non-fracture. In a logistic regression model, lower vBMD (p=0.001) was the only significant predictor of upper-limb fracture during the period of 8-14 years. Our results indicate that low BMD is an important factor underlying elevated upper-limb fracture risk during puberty, and that low BMD in pubertal girls with fracture persists into adulthood. Hence low vBMD during childhood is not a transient deficit. Methods to monitor vBMD and to maximise bone mineral accrual and reduce risks of falling in childhood should be developed.

Serum biomarker profile associated with high bone turnover and BMD in postmenopausal women.

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Bhattacharyya, Sudeepa; Siegel, Eric R; Achenbach, Sara J; Khosla, Sundeep; Suva, Larry J

2008-07-01

Early diagnosis of the onset of osteoporosis is key to the delivery of effective therapy. Biochemical markers of bone turnover provide a means of evaluating skeletal dynamics that complements static measurements of BMD by DXA. Conventional clinical measurements of bone turnover, primarily the estimation of collagen and its breakdown products in the blood or urine, lack both sensitivity and specificity as a reliable diagnostic tool. As a result, improved tests are needed to augment the use of BMD measurements as the principle diagnostic modality. In this study, the serum proteome of 58 postmenopausal women with high or low/normal bone turnover (training set) was analyzed by surface enhanced laser-desorption/ionization time-of-flight mass spectrometry, and a diagnostic fingerprint was identified using a variety of statistical and machine learning tools. The diagnostic fingerprint was validated in a separate distinct test set, consisting of serum samples from an additional 59 postmenopausal women obtained from the same Mayo cohort, with a gap of 2 yr. Specific protein peaks that discriminate between postmenopausal patients with high or low/normal bone turnover were identified and validated. Multiple supervised learning approaches were able to classify the level of bone turnover in the training set with 80% sensitivity and 100% specificity. In addition, the individual protein peaks were also significantly correlated with BMD measurements in these patients. Four of the major discriminatory peaks in the diagnostic profile were identified as fragments of interalpha-trypsin-inhibitor heavy chain H4 precursor (ITIH4), a plasma kallikrein-sensitive glycoprotein that is a component of the host response system. These data suggest that these serum protein fragments are the serum-borne reflection of the increased osteoclast activity, leading to the increased bone turnover that is associated with decreasing BMD and presumably an increased risk of fracture. In conjunction with the

Reactive oxygen species on bone mineral density and mechanics in Cu,Zn superoxide dismutase (Sod1) knockout mice

International Nuclear Information System (INIS)

Smietana, Michael J.; Arruda, Ellen M.; Faulkner, John A.; Brooks, Susan V.; Larkin, Lisa M.

2010-01-01

Research highlights: → Reactive oxygen species (ROS) are considered to be a factor in the onset of a number of age-associated conditions, including loss of BMD. → Cu,Zn-superoxide dismutase (Sod1) deficient mice have increased ROS, reduced bone mineral density, decreased bending stiffness, and decreased strength compared to WT controls. → Increased ROS caused by the deficiency of Sod1, may be responsible for the changes in BMD and bone mechanics and therefore represent an appropriate model for studying mechanisms of age-associated bone loss. -- Abstract: Reactive oxygen species (ROS) play a role in a number of degenerative conditions including osteoporosis. Mice deficient in Cu,Zn-superoxide dismutase (Sod1) (Sod1 -/- mice) have elevated oxidative stress and decreased muscle mass and strength compared to wild-type mice (WT) and appear to have an accelerated muscular aging phenotype. Thus, Sod1 -/- mice may be a good model for evaluating the effects of free radical generation on diseases associated with aging. In this experiment, we tested the hypothesis that the structural integrity of bone as measured by bending stiffness (EI; N/mm 2 ) and strength (MPa) is diminished in Sod1 -/- compared to WT mice. Femurs were obtained from male and female WT and Sod1 -/- mice at 8 months of age and three-point bending tests were used to determine bending stiffness and strength. Bones were also analyzed for bone mineral density (BMD; mg/cc) using micro-computed tomography. Femurs were approximately equal in length across all groups, and there were no significant differences in BMD or EI with respect to gender in either genotype. Although male and female mice demonstrated similar properties within each genotype, Sod1 -/- mice exhibited lower BMD and EI of femurs from both males and females compared with gender matched WT mice. Strength of femurs was also lower in Sod1 -/- mice compared to WT as well as between genders. These data indicate that increased oxidative stress

The effect of canal fill on paediatric femur fractures treated with titanium elastic nails.

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Nielsen, E; Bonsu, N; Andras, L M; Goldstein, R Y

2018-02-01

Traditional teaching for fixation of paediatric femur fractures recommends 80% nail diameter/medullary canal diameter ratio (ND/MCD) for successful maintenance of reduction. Prior studies have investigated this with stainless steel Enders nails. Our aim was to assess the impact of ND/MCD on maintenance of reduction and malunion rates in paediatric femur fractures treated with flexible intramedullary nails (FINs). Retrospective data was collected on all paediatric patients treated with FINs for diaphyseal femur fractures at a single tertiary care institution over a ten-year period. Patients with co-morbidities affecting bone quality were excluded. Patients were subdivided into groups based on ND/MCD. A total of 66 patients met inclusion criteria. Mean ND/MCD was 76.3% (32.9% to 98.8%, SD 14.3). In all, 50% (n = 33/66) of patients had > 80% ND/MCD, and only 13.6% (n = 9/66) of patients had less than 60% ND/MCD. When controlling for fracture stability, ND/MCD had no correlation with mean shortening (p = 0.07) There was no correlation between ND/MCD and angulation in the sagittal (p = 0.96) or coronal plane (p = 0.20). Three patients fit malunion criteria. ND/MCD for these patients were 40%, 67% and 79%. There was no correlation between ND/MCD and shortening or malangulation. The majority of patients in this series with less than 80% fill with FIN healed within acceptable parameters. III.

Attenuating trabecular morphology associated with low magnesium diet evaluated using micro computed tomography.

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Shu-Ju Tu

Full Text Available The literature shows that bone mineral density (BMD and the geometric architecture of trabecular bone in the femur may be affected by inadequate dietary intake of Mg. In this study, we used microcomputed tomography (micro-CT to characterize and quantify the impact of a low-Mg diet on femoral trabecular bones in mice.Four-week-old C57BL/6J male mice were randomly assigned to 2 groups and supplied either a normal or low-Mg diet for 8weeks. Samples of plasma and urine were collected for biochemical analysis, and femur tissues were removed for micro-CT imaging. In addition to considering standard parameters, we regarded trabecular bone as a cylindrical rod and used computational algorithms for a technical assessment of the morphological characteristics of the bones. BMD (mg-HA/cm3 was obtained using a standard phantom.We observed a decline in the total tissue volume, bone volume, percent bone volume, fractal dimension, number of trabecular segments, number of connecting nodes, bone mineral content (mg-HA, and BMD, as well as an increase in the structural model index and surface-area-to-volume ratio in low-Mg mice. Subsequently, we examined the distributions of the trabecular segment length and radius, and a series of specific local maximums were identified. The biochemical analysis revealed a 43% (96% decrease in Mg and a 40% (71% decrease in Ca in plasma (urine excretion.This technical assessment performed using micro-CT revealed a lower population of femoral trabecular bones and a decrease in BMD at the distal metaphysis in the low-Mg mice. Examining the distributions of the length and radius of trabecular segments showed that the average length and radius of the trabecular segments in low-Mg mice are similar to those in normal mice.

BMD in elite female triathletes is related to isokinetic peak torque without any association to sex hormone concentrations

DEFF Research Database (Denmark)

Helge, Eva Wulff; Melin, Anna; Waaddegaard, Mette

2012-01-01

Female endurance athletes suffering from low energy availability and reproductive hormonal disorders are at risk of low BMD. Muscle forces acting on bone may have a reverse site-specific effect. Therefore we wanted to test how BMD in female elite triathletes was associated to isokinetic peak torque...... (IPT) and reproductive hormone concentrations (RHC). A possible effect of oral contraceptives (OCON's) is taken into consideration....

Support for total hip replacement surgery: Structures modeling, Gait Data Analysis and Report system

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Gianluca Mario Izzo

2012-03-01

Full Text Available For the treatment of advanced damages of hip joints, Total Hip Arthroplasty is well proven. Due to the different mechanical properties of the prosthesis material and the bone tissue, a partial unloading of the periprosthetic bone occurs. The bone cement causes reduction in bone density as a result of removal of normal stress from the bone, leading to weakening of the bone in that area and the fracture risk increases. Bone loss is identified as one of the main reasons for loosening of the stem. Otherwise, thanks to the press-fit of the non-cemented stem achieved by surgery, the bone layers immediately adjacent to the stem are preloaded, thus encouraged growing, and the bone getting stronger. The non-cemented stem would be the better choice for every patient, but the question remains if the femur can handle the press- fitting surgery. This studies aim to develop a monitoring techniques based on Gait analysis and bone density changes to assess patient recovery after Total Hip Arthroplasty. Furthermore, to validate computational processes based on 3D modeling and Finite Element Methods for optimizing decision making in the operation process and selecting the suited surgical procedure. A vision could be minimizing risk of periprosthetic fracture during and after surgery. Patients: The sample presents 11 patients receiving cemented implant and 13 for the uncemented. Patients are grouped by type of implant. Three checkpoints were considered: before, after operation and one year later. CT scans, gaitrite and kinepro measurements have been realized. Main outcome measures: Fracture risk probability is higher in bone with low bone mineral density; therefore bones are more fragile in elderly people. BMD is indeed one parameter considered among all the observations. Periprosthetic fracture of the femur is a rare but complex complication of THA, and requires demanding surgery. As such, they result in considerable morbidity and dysfunction. Thus, tests of

Impact of Weight Loss With Intragastric Balloon on Bone Density and Microstructure in Obese Adults.

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Madeira, Eduardo; Madeira, Miguel; Guedes, Erika Paniago; Mafort, Thiago Thomaz; Moreira, Rodrigo Oliveira; de Mendonça, Laura Maria Carvalho; Lima, Inayá Correa Barbosa; Neto, Leonardo Vieira; de Pinho, Paulo Roberto Alves; Lopes, Agnaldo José; Farias, Maria Lucia Fleiuss

2018-03-21

The historical concept that obesity protects against bone fractures has been questioned. Weight loss appears to reduce bone mineral density (BMD); however, the results in young adults are inconsistent, and data on the effects of weight loss on bone microstructure are limited. This study aimed to evaluate the impact of weight loss using an intragastric balloon (IGB) on bone density and microstructure. Forty obese patients with metabolic syndrome (mean age 35.1 ± 7.3 yr) used an IGB continuously for 6 mo. Laboratory tests, areal BMD, and body composition measurements via dual-energy X-ray absorptiometry, and volumetric BMD and bone microstructure measurements via high-resolution peripheral quantitative computed tomography were conducted before IGB placement and after IGB removal. The mean weight loss was 11.5%. After 6 mo, there were significant increases in vitamin D and carboxyterminal telopeptide of type 1 collagen levels. After IGB use, areal BMD increased in the spine but decreased in the total femur and the 33% radius. Cortical BMD increased in the distal radius but tended to decrease in the distal tibia. The observed trabecular bone loss in the distal tibia contributed to the decline in the total volumetric BMD at this site. There was a negative correlation between the changes in leptin levels and the measures of trabecular quality in the tibia on high-resolution peripheral quantitative computed tomography. Weight loss may negatively impact bone microstructure in young patients, especially for weight-bearing bones, in which obesity has a more prominent effect. Copyright © 2018 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Lateral gastrocnemius myocutaneous flap transposition to the midlateral femur: extending the arc of rotation.

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Agarwal, Rishi Raj; Broder, Kevin; Kulidjian, Anna; Bodor, Richard

2014-05-01

We report the successful use of an extended lateral gastrocnemius myocutaneous flap for coverage of the midlateral femur using successive delayed elevations. A 62-year-old man underwent wide resection of a liposarcoma of the right anterior thigh with free flap reconstruction and subsequent radiation therapy 10 years before. Four years later, the patient fractured his irradiated femur and was treated with a retrograde intramedullary nail, which subsequently became infected, causing osteomyelitis of the distal femur, septic arthritis of the knee joint, and nonunion of his pathologic fracture. Although advised by numerous surgeons to undergo above-knee amputation, we offered our motivated patient a multidisciplinary approach to clear his infection and pathology; implanted new orthopedic hardware; performed delayed flap reconstruction; and rehabilitated him back to painless, unassisted ambulation. The extended lateral gastrocnemius myocutaneous flap used provided perfused soft tissues and durable coverage for the patient's exposed orthopedic hardware of the midlateral femur, 14 cm above the joint line of the knee. By using this flap to cover a femur defect well above published heights, our patient avoided amputation after years of worsening incapacitation.

Endoscopic Surgery for Symptomatic Unicameral Bone Cyst of the Proximal Femur.

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Miyamoto, Wataru; Takao, Masato; Yasui, Youichi; Miki, Shinya; Matsushita, Takashi

2013-11-01

Recently, surgical treatment of a symptomatic unicameral cyst of the proximal femur has been achieved with less invasive procedures than traditional open curettage with an autologous bone graft. In this article we introduce endoscopic surgery for a symptomatic unicameral cyst of the proximal femur. The presented technique, which includes minimally invasive endoscopic curettage of the cyst and injection of a bone substitute, not only minimizes muscle damage around the femur but also enables sufficient curettage of the fibrous membrane in the cyst wall and the bony septum through direct detailed visualization by an endoscope. Furthermore, sufficient initial strength after curettage can be obtained by injecting calcium phosphate cement as a bone substitute.

Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

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Elaine W Chong

Full Text Available Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49. Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02. The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured

Total Hip Intraoperative Femur Fracture: Do the Design Enhancements of a Second-Generation Tapered-Wedge Stem Reduce the Incidence?

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Colacchio, Nicholas D; Robbins, Claire E; Aghazadeh, Mehran S; Talmo, Carl T; Bono, James V

2017-10-01

Intraoperative femur fracture (IFF) is a well-known complication in primary uncemented total hip arthroplasty (THA). Variations in implant instrumentation design and operative technique may influence the risk of IFF. This study investigates IFF between a standard uncemented tapered-wedge femoral stem and its second-generation successor with the following design changes: size-specific medial curvature, proportional incremental stem growth, modest reduction in stem length, and distal lateral relief. A single experienced surgeon's patient database was retrospectively queried for IFF occurring during primary uncemented THA using a standard tapered-wedge femoral stem system or a second-generation stem. All procedures were performed using soft tissue preserving anatomic capsule repair and posterior approach. The primary outcome measure was IFF. A z-test of proportions was performed to determine significant difference between the 2 stems with respect to IFF. Patient demographics, Dorr classification, and implant characteristics were also examined. Forty-one of 1510 patients (2.72%) who received a standard tapered-wedge femoral stem sustained an IFF, whereas 5 of 800 patients (0.63%) using the second-generation stem incurred an IFF. No other significant associations were found. A standard tapered-wedge femoral stem instrumentation system resulted in greater than 4 times higher incidence of IFF than its second-generation successor used for primary uncemented THA. Identifying risk factors for IFF is necessary to facilitate implant system improvements and thus maximize patient outcomes. Copyright © 2017. Published by Elsevier Inc.

Ten-year absolute risk of osteoporotic fractures according to BMD T score at menopause: the Danish Osteoporosis Prevention Study

DEFF Research Database (Denmark)

Abrahamsen, Bo; Vestergaard, Peter; Rud, Bo

2006-01-01

was 10.9% as opposed to an expected risk of 5.7%. Relative risk gradients were similar to those of the recent meta-analysis. CONCLUSIONS: In healthy women, examined in the first year or two after menopause, 10-year fracture risk was higher at each level of BMD T score than expected from the model...... by Kanis et al. Inclusion of HRT users in the cohorts used may have led to higher BMD values and lower absolute fracture risk in the Kanis model. These longitudinal data can be used directly in estimating absolute fracture risk in untreated north European women from BMD at menopause....

Three-dimensional quantitative CT of the proximal femur: Relationship to vertebral trabecular bone density

International Nuclear Information System (INIS)

Bhasin, S.; Zlatkin, M.B.; Sartoris, D.J.; Andre, M.; Resnick, D.

1987-01-01

Integrated cancellous, cortical, and total bone density in the femoral neck and inter-trochanteric region was measured bilaterally in 25 women aged 35-90 years (mean age, 65). Contiguous-section (1-cm-thick) data were analyzed using three-dimensional histogram software on a Cemax 1000 image processor. Single-section quantitative CT was used to determine mean mineral equivalent values for vertebral cancellous bone from T-11 to L-3 in each woman. Significant correlation was found between cancellous bone density at the two sites. Cortical and total bone densities in the proximal femur were predicted less well with vertebral cancellous data, suggesting a greater dependence on weight-bearing and activity factors

Comparison of explicit finite element and mechanical simulation of the proximal femur during dynamic drop-tower testing.

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Ariza, O; Gilchrist, S; Widmer, R P; Guy, P; Ferguson, S J; Cripton, P A; Helgason, B

2015-01-21

Current screening techniques based on areal bone mineral density (aBMD) measurements are unable to identify the majority of people who sustain hip fractures. Biomechanical examination of such events may help determine what predisposes a hip to be susceptible to fracture. Recently, drop-tower simulations of in-vitro sideways falls have allowed the study of the mechanical response of the proximal human femur at realistic impact speeds. This technique has created an opportunity to validate explicit finite element (FE) models against dynamic test data. This study compared the outcomes of 15 human femoral specimens fractured using a drop tower with complementary specimen-specific explicit FE analysis. Correlation coefficient and root mean square error (RMSE) were found to be moderate for whole bone stiffness comparison (R(2)=0.3476 and 22.85% respectively). No correlation was found between experimentally and computationally predicted peak force, however, energy absorption comparison produced moderate correlation and RMSE (R(2)=0.4781 and 29.14% respectively). By comparing predicted strain maps to high speed video data we demonstrated the ability of the FE models to detect vulnerable portions of the bones. Based on our observations, we conclude that there exists a need to extend the current apparent level material models for bone to cover higher strain rates than previously tested experimentally. Copyright © 2014 Elsevier Ltd. All rights reserved.

Robust femur condyle disambiguation on biplanar X-rays.

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Serrurier, Antoine; Quijano, Sergio; Nizard, Remy; Skalli, Wafa

2012-12-01

Three-dimensional (3D) reconstruction of the skeleton from biplanar X-rays relies on scarce information digitalised by an operator on both frontal and lateral radiographs. In clinical routine, difficulties occur for non-skilled operators to discriminate the medial from the lateral femur condyle on the lateral view. Our study proposes an algorithm able to detect automatically a possible inversion of the two condyles by the operator at an early stage of the reconstruction process. It relies on the computation of two 3D femur surfaces, one directly from the operator digitalisation and the other from the same digitalisation with medial and lateral condyles automatically swapped. Pairs of virtual biplanar X-rays are computed for both reconstructions and the closest pair to the original X-rays is selected on the basis of similarity measures, pointing the correct 3D surface. The algorithm shows a success rate higher than 85% for both asymptomatic and pathological femurs whatever the initial condyle digitalisation of the operator, bringing automatically non-skilled operators acting in clinical routine to the level of skilled operators. This study validates moreover the proof-of-concept of automatic shape adjustments of a 3D surface on the basis of similarity measures in the process of 3D reconstruction from biplanar X-rays. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

Bone density of women who have recovered from anorexia nervosa.

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Hartman, D; Crisp, A; Rooney, B; Rackow, C; Atkinson, R; Patel, S

2000-07-01

To examine bone density in 19 women who had previously experienced classical anorexia nervosa from which they had been fully recovered for a mean of 21 years (current characteristics: median age 40.2 years; Eating Attitudes Test [EAT] score 2; body mass index [BMI] 21.1; average 1.8 offspring). Probands were compared, blindly, in respect of bone density, with 13 control subjects matched for age and sex and with no history of eating disorders. Dual energy X-ray absorptiometry (DXA) was used to evaluate the bone mineral density (BMD) of the lumbar spine and the head of the femur. Femur BMD was still significantly less among ex-anorectic sufferers. Two subjects had experienced pathological fractures while anorectic, both having been strenuous exercisers. None appeared to have suffered post illness fractures. BMD at follow-up did not relate to the severity or chronicity of previous anorexia nervosa. Full clinical recovery from anorexia nervosa does not quite confer full establishment of normal bone density. However, pathological fractures are not a feature thereafter, within middle life. Copyright 2000 John Wiley & Sons, Inc.

The Effect of Weight-Bearing Exercise on the Strength of Femur Bone in Ovariectomized Rats

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GH Sharifi

2011-08-01

Full Text Available Introduction & Objective: Fractures due to osteoporosis after menopause in women is widespread. Osteoporosis may occur in case of inadequate lack of physical activity .The aim of this study was to determine the effect of running training on femur bone strength in ovariectomized rats. Materials & Methods Forty matured Sprague Dawley rats were chosen for this study. A group of 10 were killed randomly to measure their initial femur strength. The remaining rats had ovarian surgery. After three months, in order to reach menopause period, they were randomly divided into 3 groups, including pre test, running training and control groups. The running training program was carried out for one hour a day, five days a week, for eight weeks. Femur bone strength was measured by HOUNSFIELD system. Data was analyzed by using one-way analysis of variance and dependent T- tests by the SPSS software. Results: Results of this study showed that ovariectomy leads to significant decrease of femur bone strength. On the other hand the eight weeks running training lead to significant increase of femur bone strength. Conclusion: The results of this study suggest that life style is important factors in preventing of osteoporosis and running training program had an inhibitory or reversal effect on decrease of menopause-induced femur bone strength.

Use of anti-depressants and the risk of fracture of the hip or femur.

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van den Brand, M W M; Pouwels, S; Samson, M M; van Staa, T P; Thio, B; Cooper, C; Leufkens, H G M; Egberts, A C G; Verhaar, H J J; de Vries, F

2009-10-01

Anti-depressants are used largely, but have serious side effects. We show that both selective serotonin re-uptake inhibitors (SSRIs) and tricyclic anti-depressants (TCAs) increase the risk of hip/femur fracture and that this risk is time related and depends on the degree of serotonin transporter inhibition. This should be considered when prescribing anti-depressants to patients. Anti-depressants are known to have serious side effects. We examined the association between the use of anti-depressants and the risk of hip/femur fractures with a special focus on the relation with the degree of 5-hydroxytryptamine transporter (5-HTT) inhibition and the duration of use. A case-control study was conducted within the Dutch PHARMO-RLS database. Cases (n = 6,763) were adult patients with a first hip/femur fracture during the study period. For each case, four controls (n = 26341) were matched by age, gender and geographic region. The risk of hip/femur fracture increased with current use of SSRIs (adjusted odds ratio (OR(adj)) 2.35 [95% confidence interval (CI) 1.94-2.84]) and TCAs (ORadj 1.76 [95% CI 1.45-2.15]). The risk of hip/femur fracture declined rapidly after discontinuation of use. The risk of hip/femur fracture increased as the degree of 5-HTT inhibition of all anti-depressants increased from OR(adj) 1.64 [95% CI 1.14-2.35] for drugs with low 5-HTT inhibition to OR(adj) 2.31 [95% CI 1.94-2.76] for those with high 5-HTT inhibiting properties. Current use of both SSRIs and TCAs increase hip/femur fracture risk. Further studies are needed to elucidate the mechanistic pathways and the relation with the underlying pathophysiology. Until then, the elevated fracture risk should be considered when prescribing anti-depressants.

Modular endoprosthetic replacement for metastatic tumours of the proximal femur

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Carter Simon R

2008-11-01

Full Text Available Abstract Background and aims Endoprosthetic replacements of the proximal femur are commonly required to treat destructive metastases with either impending or actual pathological fractures at this site. Modular prostheses provide an off the shelf availability and can be adapted to most reconstructive situations for proximal femoral replacements. The aim of this study was to assess the clinical and functional outcomes following modular tumour prosthesis reconstruction of the proximal femur in 100 consecutive patients with metastatic tumours and to compare them with the published results of patients with modular and custom made endoprosthetic replacements. Methods 100 consecutive patients who underwent modular tumour prosthetic reconstruction of the proximal femur for metastases using the METS system from 2001 to 2007 were studied. The patient, tumour and treatment factors in relation to overall survival, local control, implant survival and complications were analysed. Functional scores were obtained from surviving patients. Results and conclusion There were 45 male and 55 female patients. The mean age was 60.2 years. The indications were metastases. Seventy five patients presented with pathological fracture or with failed fixation and 25 patients were at a high risk of developing a fracture. The mean follow up was 15.9 months [range 0–77]. Three patients died within 2 weeks following surgery. 69 patients have died and 31 are alive. Of the 69 patients who were dead 68 did not need revision surgery indicating that the implant provided single definitive treatment which outlived the patient. There were three dislocations (2/5 with THR and 1/95 with unipolar femoral heads. 6 patients had deep infections. The estimated five year implant survival (Kaplan-Meier analysis was 83.1% with revision as end point. The mean TESS score was 64% (54%–82%. We conclude that METS modular tumour prosthesis for proximal femur provides versatility; low implant related

Gender differences of the morphology of the distal femur and proximal tibia in a Korean population.

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Lim, Hong-Chul; Bae, Ji-Hoon; Yoon, Ji-Yeol; Kim, Seung-Ju; Kim, Jae-Gyoon; Lee, Jae-Moon

2013-01-01

We conducted this study to determine whether the sizes of distal femurs and proximal tibiae in Korean men and women are different, and to assess suitability of the sizes of prostheses currently used in Korea. We performed morphological analysis of proximal tibia and distal femur on 115 patients (56 male, 59 female) using MRI to investigate a gender difference. Tibial mediolateral dimension (tMAP), tibial medial anteroposterior dimension (tMAP), tibial lateral anteroposterior dimension (tLAP) femoral mediolateral dimension (fML), femoral medial anteroposterior dimension (fMAP), and femoral lateral anteroposterior dimension (fLAP) were measured. The ratio of tMAP and tLAP to tML (plateau aspect ratio, tAP/tML×100%), and that of fMAP and fLAP to fML (condylar aspect ratio, fAP/fML×100%) were calculated. The measurements were compared with the similar dimensions of four total knee implants currently used. The tML and tAP lengths showed a significant gender difference (PtMAP/tML) revealed a significant difference between male (0.74±0.05) and female (0.68±0.04, P<0.05). For morphotype of distal femur, males were found to have significantly large values (P<0.05) in the parameters, except for fLAP. With regards to the ratio of the ML width to the AP length, the women showed a narrower ML width than the men. Both genders were distributed within the range of the dimensions of the prostheses currently used prostheses. Korean population revealed that women have smaller dimensions than male counterparts. In both genders, a relatively small size of prostheses matches distal femur and proximal tibia better among the implants currently used in Korea. Copyright © 2012 Elsevier B.V. All rights reserved.

Evaluation of bone mineral density and osteonecrosis in the recovered severe acute respiratory syndrome patients

International Nuclear Information System (INIS)

Shang Wei; Yu Wei; Lin Qiang; Li Taisheng; Fan Hongwei; Tian Junping; Meng Wei

2005-01-01

Objective: To evaluate the bone mineral density (BMD) and osteonecrosis in the recovered patients with severe acute respiratory syndrome (SARS). Methods: Sixty-four patients with SARS were recruited in the study. There were 19 males with mean age 37 years (26-57 years) and 45 females with mean age 39 years (21-67 years) who divided into ten year cohorts for the analysis. BMD measurements were obtained by dual X-ray absorptiometry (DXA) at the sites of both lumbar spine (L2-4) and hip (neck, Ward's triangle, greater trochanter) which compared with those of the control groups. In addition to BMD measurements, hip MRI examinations were performed on 55 patients among the 64 patients for evaluating the osteonecrosis during an average of 10-12 months follow up after discharged from hospital. The BMD were also compared between the patients with osteonecrosis and without osteonecrosis. Results: BMD results of the 19 male SARS patients were not different from those of the normal reference, except that the 40-49 age-group at the site of L2-4 whose BMD was significantly higher than that of the normal group (P=0.016). For the 45 female recovered SARS patients, the BMD at femur neck of 20-29 age-group and greater trochanter of 40-49 age-group were significantly higher than those of normal reference respectively (P=0.0013, P=0.041). Besides that there were no significant BMD differences between any other age-groups when comparison with each site, although the BMD results of the female group were slightly higher than those of the normal reference in general. Osteonecrosis of the femur was diagnosed by MRI in 6 of the 55 patients. Although BMD results in the patients with osteonecrosis were slightly lower than those patients without osteonecrosis for each site, the difference was not statistically significant (P>0.05). Conclusion: Therapy with glucocorticoids in short period may not influence the BMD results in the recovered SARS patients within this near 10-12 months follow up

Assesment of Osteoporosis in Medulla Spinalis Injured Patients

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Zuhal Bayırlı Karakoyun

2011-12-01

Full Text Available Aim: To investigate the relationship between osteoporosis and demographic features, clinical characteristics,risk factors in younger SCI patients. Materials and Methods: Between January-June 2009, all SCI patients admitted to our hospital evaluated and 58 patients who were younger than 50 years who had osteoporosis were enrolled.Patients age, gender, educational status, duration of injury, smoking, sunlight exposure and dietary habits were questioned. Neurological level, completeness, ambulation status and spasticity were assessed. Relationship between these findings with the severity of osteoporosis has been viewed. Results: There were 19 women. Mean age was 35,7 years. The mean time since injury were 117.7 months. 42 patients were paraplegia (17 complete, 16 were tetraplegia (4 complete.The most common osteoporotic site where the legs. There was no correlation between BMD values with age. In men, the legs and total body BMD were significantly lower.The effect of educational level on BMD was not found. No significant correlation was found between time since injury and BMD. In paraplegics, femoral neck and total femur Z-scores were significantly lower. In tetraplegics, Z scores of the arms were lower, but was not significant. Lumbar BMD values of complete patients were significantly lower than incompletes. Sunlight exposure and consumption of milk/milk products had not a significant positive effect on BMD. 8 patients had therapeutic ambulation, whereas 23 of them had community ambulation. Ambulation status of patients and the presence of spasticity was no effect on BMD. There was no significant correlation between BMD and the severity of spasticity. Smokers (n=19, bone density was lower in all regions except for femoral neck but were not significantly. Conclusion: Male gender, paraplegia, and incompleteness negatively effects the bone density. Age, time since injury, education level, spasticity, ambulation level, smoking, sunlight exposure and

Morphometrical and Topographical Anatomy of Position of Nutrient Foramen on Fully Ossified Left Femur

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Tanvir Hossain Parash

2013-05-01

Full Text Available Background: The femur is the typical long bone of lower limb which extends from the pelvis to the knee. It forms the skeleton of the thigh, bears body weight, supports movement of legs; provide attachment to muscles, form blood cells and acts as a store house for calcium and phosphate. The nutrient foramina are cavities that conduct the nutrient arteries and the peripheral nerves. The majority blood supply for femur originates from the nutrient arteries, mainly during the growing period and during the early phase of ossification. In bone grafts the nutrient blood supply is crucial and it should be preserved in order to promote the fracture healing.Objective: The anatomy of nutrient foramen of femur is very essential for orthopedic & vascular surgeons as well as to radiologists for planning of treatment.Materials and method: This cross sectional study was carried out in the department of Anatomy, Sir Salimullah Medical College, Dhaka, Bangladesh from July 2011 to June 2012. The study comprised 199 fully ossified left sided dry femur of both sex (n=89 male, n=110 female. Sampling technique was purposive. Morphometric and topographic study was carried out on all samples by direct physical and photographic methods.Results: The most common position of nutrient foramen on the shaft of femur was found on the middle 1/5th in both male and female femur (50.78% in male and 56.86% in female respectively.Conclusion: The anatomical knowledge about this study might be useful in certain surgical procedures as well as micro vascular bone transfer to preserve the circulation.

MR imaging of proximal femur: age-related changes

International Nuclear Information System (INIS)

Kim, Ju Heon; Jeon, Woo Jin; Sohn, Cheol Ho; Park, Mi Ok; Lee, Seong Mun; Joo, Yang Gu; Suh, Soo Jhi; Pyun, Young Sik

1995-01-01

The purpose of this study is to illustrate MR patterns of signal intensity of proximal femur in normal subjects according to the age distribution. T1-weighted MR images of the proximal femur in 125 subjects, aged 13 days to 25 years, were retrospectively analyzed. Age distribution was classified to 4 groups; below 4 months, 5 months to 4 years, 5 years to 14 years, and 15 years to 25 years. By the age of 4 months, the non-ossified femoral epiphysis was seen as intermediate-signal-intensity cartilage. At 5 months-4 years, the ossified femoral capital epiphysis was seen within intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow surrounded by a rim of low-signal-intensity cortical bone. At 5-14 years, the ossified femoral capital and greater trochanteric epiphysis were seen within the intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow. At 15-25 years, the proximal metaphyseal marrow showed increased signal intensity. Four patterns of the metaphyseal marrow were recognized by Ricci et al. The frequency of pattern 1 a progressively decreased with age. Pattern 2 and 3 were visible in the 15-25 years age group. An understanding of the spectrum of normal age-related change of the proximal femoral cartilage and marrow patterns serves as the foundation for interpretation of proximal femur pathologies

Compartment syndrome of the thigh complicating surgical treatment of ipsilateral femur and ankle fractures

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Moore, M. R.; Garfin, S. R.; Hargens, A. R.

1987-01-01

A 26-year-old man presented with ipsilateral femur and ankle fractures. The patient was treated with interlocking nail of his femur fracture, followed by open reduction and internal fixation of his ankle fracture under tourniquet control. Postoperatively, the patient developed compartment syndrome of his thigh with elevated pressures, requiring decompressive fasciotomies. This case illustrates the possible complication of treating a femur fracture with intramedullary nailing and then immediately applying a tourniquet to treat an ipsilateral extremity fracture. Because of the complication with this patient, we feel the procedure should be staged, or a tourniquet should be avoided if possible.

Effects of total gastrectomy on plasma silicon and amino acid concentrations in men.

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Tatara, Marcin R; Krupski, Witold; Szpetnar, Maria; Dąbrowski, Andrzej; Bury, Paweł; Szabelska, Anna; Charuta, Anna; Boguszewska-Czubara, Anna; Maciejewski, Ryszard; Wallner, Grzegorz

2015-12-01

The aim of the study was to determine one-year effects of total gastrectomy on plasma silicon and free amino acid concentrations in patients and evaluate changes of volumetric bone mineral density (vBMD) in lumbar spine. Eight patients were enrolled to the control (CTR) group. Six patients subjected to total gastrectomy (GX group) were included to the experimental group. vBMD in trabecular and cortical bone was measured in lumbar vertebrae at baseline (before surgery) and one year later using quantitative computed tomography. Plasma concentrations of silicon and free amino acids were determined at baseline and one year later using photometric method and ion-exchange chromatography. Body weights within CTR and GX groups were not different after one-year follow-up when compared to the baseline values (P > 0.05). An average annual decrease of vBMD in the trabecular bone in the gastrectomized patients reached 15.0% in lumbar spine and was significantly different in comparison to the percentage changes observed in CTR group (P = 0.02). One-year percentage change of vBMD in the cortical bone in L1 and L2 has shown significantly decreased values by 10.5 and 9.1% in the GX group when compared to the percentage change observed in the controls (P silicon was significantly lowered by 26.7% one year after the total gastrectomy when compared to the baseline value (P = 0.009). Total gastrectomy in patients has induced severe osteoporotic changes in lumbar spine within one-year period. The observed osteoporotic changes were associated with decreased plasma concentration of silicon indicating importance of exocrine and endocrine functions of stomach for silicon homeostasis maintenance. Gastrectomy-induced bone loss was not related to decreased amino acid concentration in plasma obtained from overnight fasted patients. © 2015 by the Society for Experimental Biology and Medicine.

Effects of short-term swimming exercise on bone mineral density, geometry, and microstructural properties in sham and ovariectomized rats

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Foong Kiew Ooi

2014-12-01

Full Text Available Little information exists about the effects of swimming exercise on bone health in ovariectomized animals with estrogen deficiency, which resembles the postmenopausal state and age-related bone loss in humans. This study investigated the effects of swimming exercise on tibia and femur bone mineral density (BMD, geometry, and microstructure in sham and ovariectomized rats. Forty 3-month-old female rats were divided into four groups: sham operated-sedentary control (Sham-control, sham operated with swimming exercise group (Sham-Swim, ovariectomy-sedentary control (OVx-control, and ovariectomy and swimming exercise (OVx-Swim groups. Swimming sessions were performed by the rats 90 minutes/day for 5 days/week for a total of 8 weeks. At the end of the study, tibial and femoral proximal volumetric total BMD, midshaft cortical volumetric BMD, cross-sectional area, and cross-sectional moment of inertia (MOI, and bone microstructural properties were measured for comparison. Data were analyzed using one-way analysis of variance (ANOVA. The Sham-Swim group exhibited significantly (p < 0.05; one-way ANOVA greater values in bone geometry parameters, that is, tibial midshaft cortical area and MOI compared to the Sham-control group. However, no significant differences were observed in these parameters between the Ovx-Swim and Ovx-control groups. There were no significant differences in femoral BMD between the Sham-Swim and Sham-control groups. Nevertheless, the Ovx-Swim group elicited significantly (p < 0.05; one-way ANOVA higher femoral proximal total BMD and improved bone microstructure compared to the Ovx-Sham group. In conclusion, the positive effects of swimming on bone properties in the ovariectomized rats in the present study may suggest that swimming as a non- or low-weight-bearing exercise may be beneficial for enhancing bone health in the postmenopausal population.

Case report 473: Tuberculosis of the distal metaphysis of the femur

Energy Technology Data Exchange (ETDEWEB)

Abdelwahab, I.F.; Gould, E.; Present, D.A.; Klein, M.J.; Nelson, J.

1988-04-01

In summary, a case of tuberculous osteomyelitis of the femur in a 16-month-old male child has been presented. The parents illegally immigrated to the United States from Central America before the birth of their child. Both parents had active pulmonary tuberculosis and the child presented with calcified granulomas in his lungs in addition to the lesion in the femur. This presentation is uncommon among the white population in the United States and Europe and is usually limited to non-white immigrants. (orig./SHA).

Case report 473: Tuberculosis of the distal metaphysis of the femur

International Nuclear Information System (INIS)

Abdelwahab, I.F.; Gould, E.; Present, D.A.; Klein, M.J.; Nelson, J.

1988-01-01

In summary, a case of tuberculous osteomyelitis of the femur in a 16-month-old male child has been presented. The parents illegally immigrated to the United States from Central America before the birth of their child. Both parents had active pulmonary tuberculosis and the child presented with calcified granulomas in his lungs in addition to the lesion in the femur. This presentation is uncommon among the white population in the United States and Europe and is usually limited to non-white immigrants. (orig./SHA)

Fermented dairy products consumption is associated with attenuated cortical bone loss independently of total calcium, protein, and energy intakes in healthy postmenopausal women.

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Biver, E; Durosier-Izart, C; Merminod, F; Chevalley, T; van Rietbergen, B; Ferrari, S L; Rizzoli, R

2018-05-03

A longitudinal analysis of bone microstructure in postmenopausal women of the Geneva Retirees Cohort indicates that age-related cortical bone loss is attenuated at non-bearing bone sites in fermented dairy products consumers, not in milk or ripened cheese consumers, independently of total energy, calcium, or protein intakes. Fermented dairy products (FDP), including yogurts, provide calcium, phosphorus, and proteins together with prebiotics and probiotics, all being potentially beneficial for bone. In this prospective cohort study, we investigated whether FDP, milk, or ripened cheese consumptions influence age-related changes of bone mineral density (BMD) and microstructure. Dietary intakes were assessed at baseline and after 3.0 ± 0.5 years with a food frequency questionnaire in 482 postmenopausal women enrolled in the Geneva Retirees Cohort. Cortical (Ct) and trabecular (Tb) volumetric (v) BMD and microstructure at the distal radius and tibia were assessed by high-resolution peripheral quantitative computerized tomography, in addition to areal (a) BMD and body composition by dual-energy X-ray absorptiometry, at the same time points. At baseline, FDP consumers had lower abdominal fat mass and larger bone size at the radius and tibia. Parathyroid hormone and β-carboxyterminal cross-linked telopeptide of type I collagen levels were inversely correlated with FDP consumption. In the longitudinal analysis, FDP consumption (mean of the two assessments) was associated with attenuated loss of radius total vBMD and of Ct vBMD, area, and thickness. There was no difference in aBMD and at the tibia. These associations were independent of total energy, calcium, or protein intakes. For other dairy products categories, only milk consumption was associated with lower decrease of aBMD and of failure load at the radius. In this prospective cohort of healthy postmenopausal women, age-related Ct bone loss was attenuated at non-bearing bone sites in FDP consumers, not in milk

Semi-automated landmark-based 3D analysis reveals new morphometric characteristics in the trochlear dysplastic femur.

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Van Haver, Annemieke; De Roo, Karel; De Beule, Matthieu; Van Cauter, Sofie; Audenaert, Emmanuel; Claessens, Tom; Verdonk, Peter

2014-11-01

The authors hypothesise that the trochlear dysplastic distal femur is not only characterised by morphological changes to the trochlea. The purpose of this study is to describe the morphological characteristics of the trochlear dysplastic femur in and outside the trochlear region with a landmark-based 3D analysis. Arthro-CT scans of 20 trochlear dysplastic and 20 normal knees were used to generate 3D models including the cartilage. To rule out size differences, a set of landmarks were defined on the distal femur to isotropically scale the 3D models to a standard size. A predefined series of landmark-based reference planes were applied on the distal femur. With these landmarks and reference planes, a series of previously described characteristics associated with trochlear dysplasia as well as a series of morphometric characteristics were measured. For the previously described characteristics, the analysis replicated highly significant differences between trochlear dysplastic and normal knees. Furthermore, the analysis showed that, when knee size is taken into account, the cut-off values of the trochlear bump and depth would be 1 mm larger in the largest knees compared to the smallest knees. For the morphometric characteristics, the analysis revealed that the trochlear dysplastic femur is also characterised by a 10% smaller intercondylar notch, 6-8% larger posterior condyles (lateral-medial) in the anteroposterior direction and a 6% larger medial condyle in the proximodistal direction compared to a normal femur. This study shows that knee size is important in the application of absolute metric cut-off values and that the posterior femur also shows a significantly different morphology.

Decreased fracture rate, pharmacogenetics and BMD response in 79 Swedish children with osteogenesis imperfecta types I, III and IV treated with Pamidronate.

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Lindahl, K; Kindmark, A; Rubin, C-J; Malmgren, B; Grigelioniene, G; Söderhäll, S; Ljunggren, Ö; Åström, E

2016-06-01

Osteogenesis imperfecta (OI) is an inherited heterogeneous bone fragility disorder, usually caused by collagen I mutations. It is well established that bisphosphonate treatment increases lumbar spine (LS) bone mineral density (BMD), as well as improves vertebral geometry in severe OI; however, fracture reduction has been difficult to prove, pharmacogenetic studies are scarce, and it is not known at which age, or severity of disease, treatment should be initiated. COL1A1 and COL1A2 were analyzed in 79 children with OI (type I n=33, type III n=25 and type IV n=21) treated with Pamidronate. Data on LS BMD, height, and radiologically confirmed non-vertebral and vertebral fractures were collected prior to, and at several time points during treatment. An increase in LS BMD Z-score was observed for all types of OI, and a negative correlation to Δ LS BMD was observed for both age and LS BMD Z-score at treatment initiation. Supine height Z-scores were not affected by Pamidronate treatment, The fracture rate was reduced for all OI types at all time points during treatment (overall p4yrs Pamidronate. Twice as many boys as girls with OI type I were treated with Pamidronate, and the fracture rate the year prior treatment was 2.2 times higher for boys (p=0.0236). Greater Δ LS BMD, but smaller Δ fracture numbers were observed on Pamidronate for helical glycine mutations in COL1A1 vs. COL1A2. Vertebral compression fractures did not progress in any individual during treatment; however, they did not improve in 9%, and these individuals were all >11years of age at treatment initiation (p<0.0001). Pamidronate treatment in children with all types of OI increased LS BMD, decreased fracture rate, and improved vertebral compression fractures. Fracture reduction was prompt and maintained during treatment, irrespective of age at treatment initiation and collagen I mutation type. Copyright © 2016 Elsevier Inc. All rights reserved.

Femur Neck Fracture in a Young Marfan Syndrome Patient.

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Kwon, Yong-Uk; Kong, Gyu-Min; Park, Jun-Ho

2016-12-01

Marfan syndrome is an autosomal dominant and could decrease bone mineral density. So patients with Marfan syndrome could vulnerable to trauma in old ages. We present the first report, to the best of our knowledge, of a rare fracture of the femoral neck with a minor traumatic history in a juvenile Marfan syndrome patient whose physis is still open. Although the patient is young, her bone mineral density was low and the geometry of femur is changed like old ages. The femur neck fracture in children is very rare and only caused by high energy trauma, we concluded that the Marfan syndrome makes the bone weaker in young age and preventative medications to avoid fractures in younger Marfan syndrome patients are necessary in early ages.

Paediatric diaphyseal femur fracture treated with intramedullary titanium elastic nail system

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Shrawan Kumar Thapa

2015-11-01

Full Text Available noBackground & Objectives: Over the few years there has been a marked increase in the use of intramedullary fixation in the management of fracture of shaft of femur in children. The goals should be to stabilize the fracture, to control length and alignment, to promote bone healing and to minimize the morbidity and complications for the child. In this prospective study we intend to evaluate the functional and radiological outcome of diaphyseal fracture of shaft of femur treated with elastic intramedullary nail.Materials & Methods: All 56 patients with diaphyseal fracture shaft of femur were treated with titanium elastic nail and followed for period of 32 weeks.Results: The In this study, outcome was assessed by using Flynn’s criteria of titanium flexible nail outcome score and we found excellent result in 49 cases, satisfactory in six cases and poor in one case. We faced one major complication in form of implant failure and six minor complications inform of superficial wound infection.Conclusion: Elastic intramedullary nail used in treatment of diaphyseal fracture shaft of femur yield excellent functional and radiological outcome. It is easy and simple procedure has low rate of complication. It is physeal-protective, cost effective, does not involve heavy instrumentation and can be performed in small set up. It has minimal risk of infection and no risk of injury to the neurovascular structure.JCMS Nepal. 2015; 11(2:20-22

A prospective randomised study of periprosthetic femoral bone remodeling using four different bearings in hybrid total hip arthroplasty

DEFF Research Database (Denmark)

Zerahn, Bo; Borgwardt, Lotte; Ribel-Madsen, Søren

2011-01-01

in all Gruen zones with the largest declines in group D. BMD changes in Gruen zones 1, 2, 3, 6, and 7 correlated with height, and body weight. Advanced age was associated with an increase in bone loss in Gruen zones 1, 2, 3, 6, and 7. A large stem size was associated with a decline in BMD in Gruen zones......Abstract: We performed a study to assess whether different bearing materials have an impact on femoral bone remodeling within the first four years after a hybrid total hip arthroplasty. 205 of 300 patients were available for 4 years follow-up after being randomly allocated to four prosthetic...... 1, 6, and 7.Bone remodeling after total hip arthroplasty may depend on the composition of bearing materials, but age, height, weight, and stem size are also related to changes in BMD....

The pattern of trabecular bone microarchitecture in the distal femur of typically developing children and its effect on processing of magnetic resonance images.

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Modlesky, Christopher M; Whitney, Daniel G; Carter, Patrick T; Allerton, Brianne M; Kirby, Joshua T; Miller, Freeman

2014-03-01

Magnetic resonance imaging (MRI) is used to assess trabecular bone microarchitecture in humans; however, image processing can be labor intensive and time consuming. One aim of this study was to determine the pattern of trabecular bone microarchitecture in the distal femur of typically developing children. A second aim was to determine the proportion and location of magnetic resonance images that need to be processed to yield representative estimates of trabecular bone microarchitecture. Twenty-six high resolution magnetic resonance images were collected immediately above the growth plate in the distal femur of 6-12year-old typically developing children (n=40). Measures of trabecular bone microarchitecture [i.e., apparent trabecular bone volume to total volume (appBV/TV), trabecular number (appTb.N), trabecular thickness (appTb.Th) and trabecular separation (appTb.Sp)] in the lateral aspect of the distal femur were determined using the twenty most central images (20IM). The average values for appBV/TV, appTb.N, appTb.Th and appTb.Sp from 20IM were compared to the average values from 10 images (10IM), 5 images (5IM) and 3 images (3IM) equally dispersed throughout the total image set and one image (1IM) from the center of the total image set using linear regression analysis. The resulting mathematical models were cross-validated using the leave-one-out technique. Distance from the growth plate was strongly and inversely related to appBV/TV (r(2)=0.68, p0.05). However, there was a progressive decrease in the strength of the relationships as a smaller proportion of images were used to predict estimates from 20IM (r(2)=0.98 to 0.99 using 10IM, 0.94 to 0.96 using 5IM, 0.87 to 0.90 using 3IM and 0.66 to 0.72 using 1IM; all pimage sets agreed extremely well with estimates from 20IM. The findings indicate that partial magnetic resonance image sets can be used to provide reasonable estimates of trabecular bone microarchitecture status in the distal femur of typically

A trans-ethnic genome-wide association study identifies gender-specific loci influencing pediatric aBMD and BMC at the distal radius.

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Chesi, Alessandra; Mitchell, Jonathan A; Kalkwarf, Heidi J; Bradfield, Jonathan P; Lappe, Joan M; McCormack, Shana E; Gilsanz, Vicente; Oberfield, Sharon E; Hakonarson, Hakon; Shepherd, John A; Kelly, Andrea; Zemel, Babette S; Grant, Struan F A

2015-09-01

Childhood fractures are common, with the forearm being the most common site. Genome-wide association studies (GWAS) have identified more than 60 loci associated with bone mineral density (BMD) in adults but less is known about genetic influences specific to bone in childhood. To identify novel genetic factors that influence pediatric bone strength at a common site for childhood fractures, we performed a sex-stratified trans-ethnic genome-wide association study of areal BMD (aBMD) and bone mineral content (BMC) Z-scores measured by dual energy X-ray absorptiometry at the one-third distal radius, in a cohort of 1399 children without clinical abnormalities in bone health. We tested signals with P BMC-Z). Signals at the CPED1-WNT16-FAM3C locus have been previously associated with BMD at other skeletal sites in adults and children. Our result at the distal radius underscores the importance of this locus at multiple skeletal sites. The 9p21.3 locus is within a gene desert, with the nearest gene flanking each side being MIR31HG and MTAP, neither of which has been implicated in BMD or BMC previously. These findings suggest that genetic determinants of childhood bone accretion at the radius, a skeletal site that is primarily cortical bone, exist and also differ by sex. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Accuracy of dual photon absorptiometry in excised femurs

International Nuclear Information System (INIS)

Erman, J.; Ott, S.M.

1988-01-01

We investigated the accuracy of assessment of bone mineral content (BMC) by dual photon absorptiometry (DPA). Measurements were compared between BMC and ashed weight using two related scanners. The BMC in different locations of the femur was determined. Twelve cadaver femurs were cleaned of all soft tissue, divided into four parts (head, neck, trochanteric region, and shaft), and measured for BMC in an ethanol/water solution. The bones were then ashed and weighed. Volumetric density was also determined. The correlation coefficient between ash weight and BMC was 0.99 with an s.e.e. of 0.51 g and relative error of 4.8%. Similar correlations were seen within each region. The correlation between the machines was 0.99. Differences in volumetric density were found, with the density of the shaft greater than other regions, and the neck greater than the head or trochanteric regions

Comparing BMD-derived genotoxic potency estimations across variants of the transgenic rodent gene mutation assay.

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Wills, John W; Johnson, George E; Battaion, Hannah L; Slob, Wout; White, Paul A

2017-12-01

There is growing interest in quantitative analysis of in vivo genetic toxicity dose-response data, and use of point-of-departure (PoD) metrics such as the benchmark dose (BMD) for human health risk assessment (HHRA). Currently, multiple transgenic rodent (TGR) assay variants, employing different rodent strains and reporter transgenes, are used for the assessment of chemically-induced genotoxic effects in vivo. However, regulatory issues arise when different PoD values (e.g., lower BMD confidence intervals or BMDLs) are obtained for the same compound across different TGR assay variants. This study therefore employed the BMD approach to examine the ability of different TGR variants to yield comparable genotoxic potency estimates. Review of over 2000 dose-response datasets identified suitably-matched dose-response data for three compounds (ethyl methanesulfonate or EMS, N-ethyl-N-nitrosourea or ENU, and dimethylnitrosamine or DMN) across four commonly-used murine TGR variants (Muta™Mouse lacZ, Muta™Mouse cII, gpt delta and BigBlue® lacI). Dose-response analyses provided no conclusive evidence that TGR variant choice significantly influences the derived genotoxic potency estimate. This conclusion was reliant upon taking into account the importance of comparing BMD confidence intervals as opposed to directly comparing PoD values (e.g., comparing BMDLs). Comparisons with earlier works suggested that with respect to potency determination, tissue choice is potentially more important than choice of TGR assay variant. Scoring multiple tissues selected on the basis of supporting toxicokinetic information is therefore recommended. Finally, we used typical within-group variances to estimate preliminary endpoint-specific benchmark response (BMR) values across several TGR variants/tissues. We discuss why such values are required for routine use of genetic toxicity PoDs for HHRA. Environ. Mol. Mutagen. 58:632-643, 2017. © 2017 Her Majesty the Queen in Right of Canada

Bone architecture adaptations after spinal cord injury: impact of long-term vibration of a constrained lower limb.

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Dudley-Javoroski, S; Petrie, M A; McHenry, C L; Amelon, R E; Saha, P K; Shields, R K

2016-03-01

This study examined the effect of a controlled dose of vibration upon bone density and architecture in people with spinal cord injury (who eventually develop severe osteoporosis). Very sensitive computed tomography (CT) imaging revealed no effect of vibration after 12 months, but other doses of vibration may still be useful to test. The purposes of this report were to determine the effect of a controlled dose of vibratory mechanical input upon individual trabecular bone regions in people with chronic spinal cord injury (SCI) and to examine the longitudinal bone architecture changes in both the acute and chronic state of SCI. Participants with SCI received unilateral vibration of the constrained lower limb segment while sitting in a wheelchair (0.6g, 30 Hz, 20 min, three times weekly). The opposite limb served as a control. Bone mineral density (BMD) and trabecular micro-architecture were measured with high-resolution multi-detector CT. For comparison, one participant was studied from the acute (0.14 year) to the chronic state (2.7 years). Twelve months of vibration training did not yield adaptations of BMD or trabecular micro-architecture for the distal tibia or the distal femur. BMD and trabecular network length continued to decline at several distal femur sub-regions, contrary to previous reports suggesting a "steady state" of bone in chronic SCI. In the participant followed from acute to chronic SCI, BMD and architecture decline varied systematically across different anatomical segments of the tibia and femur. This study supports that vibration training, using this study's dose parameters, is not an effective anti-osteoporosis intervention for people with chronic SCI. Using a high-spatial-resolution CT methodology and segmental analysis, we illustrate novel longitudinal changes in bone that occur after spinal cord injury.

[MRI characteristic of proximal femur bone marrow edema syndrome].

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Wu, Xi-Yuan

2014-07-01

To study the MRI features of proximal femur bone marrow edema syndrome for further improve the understanding of the disease. MRI imaging of 10 patients with proximal femur bone marrow edema syndrome was retrospectively reviewed,including 6 males and 4 females with an average age of 41.5 years old ranging from 36 to 57. The courses of diseases ranged from 1 week to 3 months. Among them, 9 cases had clinical manifestations of sudden hip pain, 7 cases had limited ability of walking and hip movement;all patients had no obvious injury history, non of the female patients was pregnant. All patients were followed up from 3 to 12 months, the following-up were topped after MRI when the symptoms disappeared for 3 months. The MRI demonstrated diffuse bone marrow edema involving the femoral head, neck and the inter-trochanteric region, 13 hips of 10 patients with bone marrow edema included 6 cases in grade 1, 5 cases in grade 2,2 cases in grade 3; 9 hips with hip hydrarthrosis included 6 hips in grade I ,1 hip in grade II, 2 hips in grade III. After treatment for 3 to 12 months the hip symptoms of the patients disappeared and MRI images were normal. MRI is useful in defining the location and extent of proximal femur bone marrow edema syndrome.

Burkitt`s lymphoma involving the femur in a 12 year old girl a rare ...

African Journals Online (AJOL)

The Diagnosis of Burkitt`s lymphoma with multicentre involvement of the left femur and abdominal visceral was reached.However it was not established whether femur was the primary or secondarily involved. This patient was started on Chemotherapy and she recovered well. Burkitt`s Lymphoma of a long bone are very rare ...

The effects of once-weekly teriparatide on hip structure and biomechanical properties assessed by CT

OpenAIRE

Ito, M.; Oishi, R.; Fukunaga, M.; Sone, T.; Sugimoto, T.; Shiraki, M.; Nishizawa, Y.; Nakamura, T.

2013-01-01

Summary Once-weekly administration of 56.5 μg teriparatide improved cortical bone parameters and biomechanical parameters at the proximal femur by CT geometry analysis. Introduction The aim of this study was to evaluate the effects of weekly administration of teriparatide [human PTH (1–34)] on bone geometry, volumetric bone mineral density (vBMD), and parameters of bone strength at the proximal femur which were longitudinally investigated using computed tomography (CT). Methods The subjects w...

A Systematic Review and Meta-Analysis of Ilizarov Methods in the Treatment of Infected Nonunion of Tibia and Femur.

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Peng Yin

Full Text Available Infected nonunion of tibia and femur are common in clinical practice, however, the treatment of these diseases has still been a challenge for orthopaedic surgeons. Ilizarov methods can eradicate infection, compensate bone defects and promote the bone union through progressive bone histogenesis. The objective of this systematic review was to review current available studies reporting on Ilizarov methods in the treatment of infected nonunion of tibia and femur, and to perform meta-analysis of bone and functional results and complications to evaluate the efficacy of Ilizarov methods.A comprehensive literature search was performed from the SCI, PubMed, Cochrane Library; and Embase between January 1995 and August 2015. Some major data were statistically analyzed using weighted means based on the sample size in each study by SPSS 13.0, including number of patients, mean age, mean previous surgical procedures, mean bone defects, mean length of follow-up, bone union, complications per patient, external fixation time, and external fixation index(EFI. Bone results (excellent, good, fair and poor rate, functional results (excellent, good, fair and poor rate and complications were analyzed by Stata 9.0.A total of 590 patients from 24 studies were included in this systematic review. The average of bone union rate was 97.26% in all included studies. The poor rate in bone results and functional results was 8% (95%CI, 0.04-0.12; I2 = 44.1%, P = 0.065 and 10% (95%CI, 0.05-0.14; I2 = 34.7%, P = 0.121 in patients with infected nonunion of tibia and femur treated by Ilizarov methods. The rate of refracture, malunion, infectious recurrence, knee stiffness, amputation, limb edema and peroneal nerve palsy was respectively 4%, 7%, 5%, 12%, 4%, 13% and 13%.Our systematic review showed that the patients with infected nonunion of tibia and femur treated by Ilizarov methods had a low rate of poor bone and functional results. Therefore, Ilizarov methods may be a good choice

Generation of induced pluripotent stem cells from a Becker muscular dystrophy patient carrying a deletion of exons 45-55 of the dystrophin gene (CCMi002BMD-A-9 ∆45-55

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Aoife Gowran

2018-04-01

Full Text Available Becker muscular dystrophy (BMD is a dystrophinopathy caused by mutations in the dystrophin gene on chromosome Xp21. BMD mutations result in truncated semi-functional dystrophin isoforms. Consequently, less severe clinical symptoms become apparent later in life compared to Duchenne muscular dystrophy. Dermal fibroblasts from a BMD patient were electroporated with episomal plasmids containing reprogramming factors to create the induced pluripotent stem cell line: CCMi002BMD-A-9 that showed pluripotent markers, were karyotypically normal and capable of trilineage differentiation. MLPA analyses performed on DNA extracted from CCMi002BMD-A-9 showed an in-frame deletion of exons 45 to 55 (CCMi002BMD-A-9 Δ45-55.

Association of vitamin D receptor and estrogen receptor-α gene polymorphism with peak bone mass and bone size in Chinese women

Institute of Scientific and Technical Information of China (English)

Yue-juan QIN; Zhen-lin ZHANG; Qi-ren HUANG; Jin-wei HE; Yun-qiu HU; Qi ZHOU; Jing-hui LU; Miao LI; Yu-juan LIU

2004-01-01

AIM: To investigate if vitamin D receptor (VDR) gene Apa I polymorphism and estrogen receptor-α (ER-α) gene Pvu II, Xba I polymorphisms are related to bone mineral density (BMD), bone mineral content (BMC) and bone size in premenopausal Chinese women. METHODS: The VDR Apa I genotype and ER-α Pvu II, Xba I genotype were determined by PCR-restriction fragment length polymorphism (RFLP) in 493 unrelated healthy women aged 20-40 years of Hah nationality in Shanghai city. BMD (g/cm2), BMC (g), and bone areal size (BAS, cm2) at lumbar spine 1-4 (L1-4) and proximal femur (femoral neck, trochanter and Ward's triangle) were measured by duel-energy X-ray absorptionmetry. RESULTS: All allele frequencies did not deviate from Hardy-Weinberg equilibrium. After phenotypes were adjusted for age, height, and weight, a significant association was found between VDR Apa I genotype and BMC variation at L1-4 and Ward's triangle (P<0.05), but not in BMD or BAS at lumbar spine and proximal femur.ER-α Pvu II, Xba I genotype was not related to BMC, BMD, and BAS at all sites. CONCLUSION: The study suggested that Apa I polymorphism in VDR gene may influence on attainment and maintenance of peak bone mass in premenopausal Chinese women.

Precision of dual-energy X-ray absorptiometry of the knee and heel: methodology and implications for research to reduce bone mineral loss after spinal cord injury.

Science.gov (United States)

Peppler, W T; Kim, W J; Ethans, K; Cowley, K C

2017-05-01

Methodological validation of dual-energy x-ray absorptiometry (DXA)-based measures of leg bone mineral density (BMD) based on the guidelines of the International Society for Clinical Densitometry. The primary objective of this study was to determine the precision of BMD estimates at the knee and heel using the manufacturer provided DXA acquisition algorithm. The secondary objective was to determine the smallest change in DXA-based measurement of BMD that should be surpassed (least significant change (LSC)) before suggesting that a biological change has occurred in the distal femur, proximal tibia and calcaneus. Academic Research Centre, Canada. Ten people with motor-complete SCI of at least 2 years duration and 10 people from the general population volunteered to have four DXA-based measurements taken of their femur, tibia and calcaneus. BMDs for seven regions of interest (RIs) were calculated, as were short-term precision (root-mean-square (RMS) standard deviation (g cm -2 ), RMS-coefficient of variation (RMS-CV, %)) and LSC. Overall, RMS-CV values were similar between SCI (3.63-10.20%, mean=5.3%) and able-bodied (1.85-5.73%, mean=4%) cohorts, despite lower absolute BMD values at each RIs in those with SCI (35%, heel to 54%, knee; P10% are needed to detect differences between treated and untreated groups in studies aimed at reducing bone mineral loss after SCI.

Intact and Implanted Femur Behavior During Walking and Jogging

National Research Council Canada - National Science Library

Papathanasopoulou, V

2001-01-01

... not only at a single moment in time, but during the complete range of motion. In this study, a three-dimensional dynamic finite element model of the human femur during the gait cycle is developed...

Generation of induced pluripotent stem cells from a Becker muscular dystrophy patient carrying a deletion of exons 45-55 of the dystrophin gene (CCMi002BMD-A-9 ∆45-55).

Science.gov (United States)

Gowran, Aoife; Spaltro, Gabriella; Casalnuovo, Federica; Vigorelli, Vera; Spinelli, Pietro; Castiglioni, Elisa; Rovina, Davide; Paganini, Stefania; Di Segni, Marina; Gervasini, Cristina; Nigro, Patrizia; Pompilio, Giulio

2018-04-01

Becker muscular dystrophy (BMD) is a dystrophinopathy caused by mutations in the dystrophin gene on chromosome Xp21. BMD mutations result in truncated semi-functional dystrophin isoforms. Consequently, less severe clinical symptoms become apparent later in life compared to Duchenne muscular dystrophy. Dermal fibroblasts from a BMD patient were electroporated with episomal plasmids containing reprogramming factors to create the induced pluripotent stem cell line: CCMi002BMD-A-9 that showed pluripotent markers, were karyotypically normal and capable of trilineage differentiation. MLPA analyses performed on DNA extracted from CCMi002BMD-A-9 showed an in-frame deletion of exons 45 to 55 (CCMi002BMD-A-9 Δ45-55). Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

Normative Data for Bone Mass in Healthy Term Infants from Birth to 1 Year of Age

Directory of Open Access Journals (Sweden)

Sina Gallo

2012-01-01

Full Text Available For over 2 decades, dual-energy X-ray absorptiometry (DXA has been the gold standard for estimating bone mineral density (BMD and facture risk in adults. More recently DXA has been used to evaluate BMD in pediatrics. However, BMD is usually assessed against reference data for which none currently exists in infancy. A prospective study was conducted to assess bone mass of term infants (37 to 42 weeks of gestation, weight appropriate for gestational age, and born to healthy mothers. The group consisted of 33 boys and 26 girls recruited from the Winnipeg Health Sciences Center (Manitoba, Canada. Whole body (WB as well as regional sites of the lumbar spine (LS 1–4 and femur was measured using DXA (QDR 4500A, Hologic Inc. providing bone mineral content (BMC for all sites and BMD for spine. During the year, WB BMC increased by 200% (76.0±14.2 versus 227.0±29.7 g, spine BMC by 130% (2.35±0.42 versus 5.37±1.02 g, and femur BMC by 190% (2.94±0.54 versus 8.50±1.84 g. Spine BMD increased by 14% (0.266±0.044 versus 0.304±0.044 g/cm2 during the year. This data, representing the accretion of bone mass during the first year of life, is based on a representative sample of infants and will aid in the interpretation of diagnostic DXA scans by researchers and health professionals.

BMD PREDICTION OF DEATH IS ENCAPSULATED BY THE MORPHOLOGICAL ATHEROSCLEROSIS CALCIFICATION DISTRIBUTION (MACD) INDEX

DEFF Research Database (Denmark)

Ganz, Melanie; Nielsen, Mads; Karsdal, Morten

2009-01-01

.3±0.3 years and of which CVD, cancer, and all cause deaths were recorded. The spine BMD and aortic calcification markers, AC24 and the recently proposed Morphological Atherosclerosis Calcification Distribution (MACD) index, were quantified from DXA scans and lateral X-rays respectively. The MACD...

Ligament of the head of femur: A comprehensive review of its anatomy, embryology, and potential function.

Science.gov (United States)

Perumal, Vivek; Woodley, Stephanie J; Nicholson, Helen D

2016-03-01

The functional significance of the ligament of the head of femur (LHF), or ligamentum teres has often been debated. Having gained recent attention in clinical practice, it is suggested to partly provide some mechanical stability to the hip joint. However, the anatomy of this ligament is not well studied. This paper systematically reviews the anatomy of the LHF with the aim of exploring our current understanding of this structure and identifying any gaps in knowledge regarding its morphology and function. A systematic search of Medline, Embase, ProQuest, Web of Science, and Scopus databases was undertaken and relevant data extracted, analyzed. A total of 69 references were obtained, that included 53 full text articles, three published abstracts, and 13 textbooks. Many publications related to clinical studies (n = 11) rather than gross anatomy (n = 7), with one report on variation of the LHF. Considerable inconsistency in the naming and description of the LHF morphology was observed. Variable attachment sites were reported except for the acetabular notch, transverse acetabular ligament, and the femoral fovea. Presence and patency of the ligamental arteries supplying the head of the femur and their exact location were variably described and were often incomplete. The LHF is believed to be taught in extreme hip adduction, but there is little evidence to support this. In conclusions, further investigation of the anatomy of the LHF is recommended, particularly to clarify its mechanical role, innervation, and vascular contribution to the developing and adult femur, so to better inform clinical practice. © 2015 Wiley Periodicals, Inc.

Subtrochanteric and Distal Femur Fractures in a Patient with ...

African Journals Online (AJOL)

This study reports the surgical management for this rare case and the treatment ... car accident and presented closed femoral shaft fracture associated with a ... to fix the distal femur fracture, enhancing the construction stability [Figures 4 and 5].

Osteoporotic fractures of proximal femur: clinical and epidemiological features in a population of the city of São Paulo

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Ana Claudia Ramalho

Full Text Available CONTEXT: It is believed that about 25% of menopausal women in the USA will exhibit some kind of fracture as a consequence of osteoporosis. Fractures of the proximal femur are associated with a greater number of deaths and disabilities and higher medical expenses than all the other osteoporotic fractures together. OBJECTIVE: To study the clinical and epidemiological features of patients with proximal femur fracture in hospitals in São Paulo. DESIGN: Transversal and retrospective study. LOCAL: Hospital São Paulo and Hospital Servidor Público Estadual "Francisco Morato Oliveira". PARTICIPANTS: Patients aged sixty-five years or more hospitalized because of proximal femur fracture, from March to November 1996 (N = 73. This group was compared to patients of the same age without fracture of the proximal femur. INTERVENTION: Evaluation of weight, height, body mass index; lifestyle habits (physical activity at home, ingestion of dairy calcium, drinking of coffee, smoking habit, gynecological history (ages at menarche and menopause, number of pregnancies and lactations, previous morbidity, use of medications, history of previous fractures, family history of osteoporosis. MEASUREMENT: The comparison of the different data regarding lifestyle habits between the two groups was made using the chi-squared test. Other data were analyzed using the Mann -- Whitney test. P £ 0.05 was considered significant. RESULTS: We noted a predominance of proximal femur fracture among females in relation to males (a female/male ratio of 3.3:1 with a progressive increase in the frequency of proximal femur fracture with age in both sexes. The group with proximal femur fracture, in comparison with the control group, showed a lower body mass index, less physical activity, and a greater number of pregnancies and lactations. Other data were not different. CONCLUSION: In accordance with the literature, we found a predomination of proximal femur fracture in women in relation to men

Effect of fat mass and lean mass on bone mineral density in postmenopausal and perimenopausal Thai women

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Namwongprom S

2013-02-01

Full Text Available Sirianong Namwongprom,1 Sattaya Rojanasthien,2 Ampica Mangklabruks,3 Supasil Soontrapa,4 Chanpen Wongboontan,5 Boonsong Ongphiphadhanakul61Clinical Epidemiology Program and Department of Radiology, 2Department of Orthopaedics, 3Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 4Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 5Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 6Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandBackground: The purpose of this study was to investigate the association between fat mass, lean mass, and bone mineral density (BMD in postmenopausal and perimenopausal Thai women.Methods: A cross-sectional study was conducted in 1579 healthy Thai women aged 40–90 years. Total body, lumbar spine, total femur, and femoral neck BMD and body composition were measured by dual x-ray absorptiometry. To evaluate the associations between fat mass and lean mass and various measures of BMD, multivariable linear regression models were used to estimate the regression coefficients for fat mass and lean mass, first in separate equations and then with both fat mass and lean mass in the same equation.Results: Among the study population, 1448 subjects (91.7% were postmenopausal and 131 (8.3% were perimenopausal. In postmenopausal women, after controlling for age, height, and duration of menopause, both fat mass and lean mass were positively correlated with BMD when they were analyzed independently of each other. When included in the same equation, both fat mass and lean mass continued to show a positive effect, but lean mass had a significantly greater impact on BMD than fat mass at all regions except for total body. Lean mass but not fat mass had a positive effect on BMD at all skeletal sites except the lumbar spine, after controlling for age and height in perimenopausal

Administration of growth hormone in selectively protein-deprived rats decreases BMD and bone strength.

Science.gov (United States)

Ammann, Patrick; Brennan, Tara C; Mekraldi, Samia; Aubert, Michel L; Rizzoli, René

2010-06-01

Isocaloric protein undernutrition is associated with decreased bone mass and decreased bone strength, together with lower IGF-I levels. It remains unclear whether administration of growth hormone (GH) corrects these alterations in bone metabolism. Six-month-old female rats were fed isocaloric diets containing either 2.5% or 15% casein for 2 weeks. Bovine growth hormone (bGH, 0.5 or 2.5mg/kg of body weight) or vehicle was then administered as subcutaneous injections, twice daily, to rats on either diet for 4 weeks. At the proximal tibia, analysis of bone mineral density (BMD), maximal load and histomorphometry were performed. In addition, urinary deoxypyridinoline, plasma osteocalcin and IGF-I concentrations were measured. Weight was monitored weekly. bGH caused a dose-dependent increase in plasma IGF-I regardless of the dietary protein content. However, bGH dose-dependently decreased BMD and bone strength in rats fed the low-protein diet. There was no significant effect of bGH on BMD in rats fed the normal protein diet within this short-term treatment period, however bone formation as detected by histomorphometry was improved in this group but not the low-protein group. Osteoclast surface was increased in the low-protein bGH-treated animals only. Changes in bone turnover markers were detectable under both normal and low-protein diets. These results emphasize the major importance of dietary protein intake in the bone response to short-term GH administration, and highlight the need for further investigation into the effects of GH treatment in patients with reduced protein intake. Copyright 2010 Elsevier Inc. All rights reserved.

ORIGINAL ARTICLES

African Journals Online (AJOL)

... bone loss is a systemic feature of RA and that loss at the spine and femur .... Control. Fig. 1. Box and whisker plots of lumbar bone mineral density showing median .... patients a combination of femoral neck and Ward's BMD explained most ...

Case report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis.

Science.gov (United States)

Lampropoulou-Adamidou, Kalliopi; Trovas, George; Stathopoulos, Ioannis P; Papaioannou, Nikolaos A

2012-01-01

Pregnancy- and lactation-associated osteoporosis (PLO) is an uncommon disease. The majority of cases are seen in the third trimester or early post-partum in primagravid women and the prominent clinical feature of PLO is severe and prolonged back pain and height loss. The prevalence and aetiology of this disorder are as yet unclear and there are no guidelines for its treatment. We report the outcomes of teriparatide (TRP) treatment in a woman suffering from severe PLO with 6 vertebral fragility fractures, severe back pain and very low BMD. Thirteen months after the initiation of therapy, the patient was almost free of back pain. There was no new clinical vertebral fracture. Her laboratory tests were all normal. BMD increased by 24.4% at the lumbar spine, 9.9% and 4.6% at the left and the right total hip and 12.6% and 7.8% at the left and right femur neck, respectively. TRP treatment simultaneously with weaning and calcium and vitamin D supplementation seems to considerably increase BMD, improve severe back pain and quality of life and prevent further occurrence of vertebral fractures, making TRP a helpful tool in restoring bone strength in PLO patients.

Rare Event; Not Undergoing Surgical Treatment of Proximal Femur Fracture

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Mehmet Balik

2013-06-01

Full Text Available In concordance with the increase in elderly population, incidence of proximal femur fracture (PFF increases. In elderly people, decreased physical activity and bone density, and visual impairments increase the likelihood of falls and fracture of the long bones. Fractures in this population are most commonly due to low-energy traumas. These elderly patient commonly present with co-morbidities. Therefore the treatment of the fracture poses additional risks. Seventy-eight-years old male presents with inability to walk and pain on the right groin following a fall at home. Right intertrochanteric femur fracture was diagnosed. His medical history consisted of ischemic heart disease, hypertension and hypercholesterolemia. The patient was offered hospitalization for surgery, however the patient and his family declined the surgery.

Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis

OpenAIRE

M Erceg; K Becic

2014-01-01

A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years).To the best of the author′s knowledge, nobody has e...

Using Anisotropic 3D Minkowski Functionals for Trabecular Bone Characterization and Biomechanical Strength Prediction in Proximal Femur Specimens

Science.gov (United States)

Nagarajan, Mahesh B.; De, Titas; Lochmüller, Eva-Maria; Eckstein, Felix; Wismüller, Axel

2017-01-01

The ability of Anisotropic Minkowski Functionals (AMFs) to capture local anisotropy while evaluating topological properties of the underlying gray-level structures has been previously demonstrated. We evaluate the ability of this approach to characterize local structure properties of trabecular bone micro-architecture in ex vivo proximal femur specimens, as visualized on multi-detector CT, for purposes of biomechanical bone strength prediction. To this end, volumetric AMFs were computed locally for each voxel of volumes of interest (VOI) extracted from the femoral head of 146 specimens. The local anisotropy captured by such AMFs was quantified using a fractional anisotropy measure; the magnitude and direction of anisotropy at every pixel was stored in histograms that served as a feature vectors that characterized the VOIs. A linear multi-regression analysis algorithm was used to predict the failure load (FL) from the feature sets; the predicted FL was compared to the true FL determined through biomechanical testing. The prediction performance was measured by the root mean square error (RMSE) for each feature set. The best prediction performance was obtained from the fractional anisotropy histogram of AMF Euler Characteristic (RMSE = 1.01 ± 0.13), which was significantly better than MDCT-derived mean BMD (RMSE = 1.12 ± 0.16, p<0.05). We conclude that such anisotropic Minkowski Functionals can capture valuable information regarding regional trabecular bone quality and contribute to improved bone strength prediction, which is important for improving the clinical assessment of osteoporotic fracture risk. PMID:29170581

Influência da suplementação de creatina sobre a massa óssea de ratos espontaneamente hipertensos Influence of creatine supplementation on bone mass of spontaneously hypertensive rats

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Christiano Robles Rodrigues Alves

2012-06-01

Full Text Available INTRODUÇÃO: Recentes evidências indicam que a suplementação de creatina (Cr é capaz de aumentar a densidade mineral óssea (DMO no fêmur de ratos saudáveis em crescimento. Entretanto, há poucos estudos que testam a efetividade da suplementação desse nutriente em condições de perda óssea. OBJETIVO: Investigar o efeito da suplementação de Cr na DMO e no conteúdo mineral ósseo (CMO de ratos espontaneamente hipertensos (SHR, um modelo experimental de baixa massa óssea. MATERIAIS E MÉTODOS: Dezesseis ratos SHR machos com 8 meses de idade foram randomizados em dois grupos experimentais pareados pelo peso corporal, a saber: 1 Pl: SHR tratados com placebo (água destilada; n = 8; e 2 Cr: SHR tratados com Cr (n = 8. Após nove semanas de suplementação os animais foram eutanasiados e o fêmur e a coluna vertebral (L1-L4 foram analisados por densitometria óssea (Dual Energy X-Ray Absorptiometry. RESULTADOS: Não houve diferença significativa na DMO (Pl = 0,249 ± 0,003 g/cm² vs. Cr = 0,249 ± 0,004 g/cm²; P = 0,95 e no CMO (Pl = 0,509 ± 0,150 g vs. Cr = 0,509 ± 0,017 g; P = 0,99 da coluna vertebral e na DMO (Pl = 0,210 ± 0,004 g/cm² vs. Cr = 0,206 ± 0,004 g/cm2;P = 0,49 e no CMO (Pl = 0,407 ± 0,021 g vs. Cr = 0,385 ± 0,021 g; P = 0,46 do fêmur total entre os grupos experimentais. CONCLUSÃO: Neste estudo, usando um modelo experimental de baixa massa óssea, a suplementação de Cr não afetou a massa óssea.INTRODUCTION: Recent evidence has suggested that creatine supplementation (Cr can increase the bone mineral density (BMD of the femur in healthy growing rats. Nevertheless, studies assessing the efficacy of the Cr supplementation in conditions characterized by bone mass loss are scarce. OBJECTIVE: To investigate the effect of Cr supplementation on BMD and bone mineral content (BMC in spontaneously hypertensive rats (SHRs, an experimental model of osteoporosis. MATERIALS AND METHODS: Sixteen 8-month-old male SHRs were

Study on the changes of serum levels of PINP, ICTP and 25-OH-VitD3 in pre-menopausal women and their relationship with BMD changes

International Nuclear Information System (INIS)

Zhang Jinshan; Luo Liangping

2010-01-01

Objective: To study the changes of serum levels of procollagen type I N-terminal propeptide (PINP), pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) and 25-OH-VitD 3 in premenopausal women and their relationship with changes of bone mineral density (BMD). Methods: BMD (at L 1 -L 4 and hip region) was examined with dual energy X-ray absorptiometer (DEXA) and serum levels of PINP, ICTP, 25-OH-VitD 3 were determined with RIA in 67 pre-menopausal women. Results: (1) Of the 67 women tested, 19 (28.4%) were found to be with low BMD. The mean BMD values in this group were significantly lower than those in the other 48 women. (2) The serum levels of PINP and ICTP in the 19 women with lower BMD (56.9±18.2 μg/L and 3.78±0.83 μg/L respectively) were much higher than those in the other 48 women (43.8±15.1 μg/L and 3.45±0.98 μg/L respectively, for PINP, P 0.05). The serum 25-OH-VitD 3 levels in the two groups of pre-menopausal women were not significantly different (25.6±7.8 ng/ml vs 27.4±9.2 ng/ml, P>0.05). (3) PINP levels were positively correlated with BMD values (r=0.274∼0.402, P 3 levels were not significantly correlated with BMD levels (r=-0.226∼0.083, P>0.05). PINP levels were weakly positively correlated with 25-OH-VitD 3 levels (r=0.395, P<0.05). Conclusion: There was tendency of increasing rate of bone turnover in pre-menopausal women, which might lead to development of osteoporosis. Early detection with BMD and serum markers of bone resorption (e.q. ICTP) measurement would be highly valuable for implement of prophylactic measures. (authors)

Obesity as a protective factor for postmenopausal osteoporosis.

Science.gov (United States)

Albala, C; Yáñez, M; Devoto, E; Sostin, C; Zeballos, L; Santos, J L

1996-11-01

Obesity is considered a protective factor for osteoporosis improving bone mass and maintaining higher levels of estrogen during menopause. To determine the association of obesity with bone mineral density (BMD), and its relationship with sex hormone levels. A case-control study in Caucasian obese and non obese postmenopausal women. 113 obese and 50 non-obese postmenopausal women. BMD (dual-photon X-ray absorptiometry) at cervical femur. Ward's triangle, proximal radius and lumbar spine. Plasma levels of glucose, insulin, total estrogen, follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHA-S) and testosterone. Mean BMD at femoral sites were significantly higher in obese women (femoral neck: 0.849 +/- 0.124 g/cm2 vs 0.753 +/- 0.095 g/cm2, P obese women and 0.849 +/- 0.137 g/cm2 in non obese, P obese women was observed. Although total estrogen were similar in both groups, in obese women, SHBG was lower (68.6 +/- 26.84 nmol/l vs. 85.1 +/- 31.18 nmol/l, P obese (77.2 +/- 50.4 Ul/ml vs. 49.4 +/- 24.1 Ul/ml, P obese women and suggest that obesity exerts protection due to a decreased SHBG thus increasing free sex steroids. Besides, hyperinsulinemia may produce a decline in the production of IGFBG-1, leading to an increase of IGF-1, that may stimulate the proliferation of osteoblasts.

Genetic association study of WNT10B polymorphisms with BMD and adiposity parameters in Danish and Belgian males

DEFF Research Database (Denmark)

Van Camp, Jasmijn K; Beckers, Sigri; Zegers, Doreen

2013-01-01

. The second population, called SIBLOS, includes 922 Belgian men (34 ± 5 years old) and contains siblings selected from over 500 families. Four tagSNPs (rs833840, rs833841, rs10875902 and rs4018511) that capture variation of ten SNPs (MAF > 5 %) in a 15.2 kb region spanning the WNT10B gene and its flanking...... a previously shown negative effect on BMD. No significant associations were observed in the SIBLOS population. In the present study, no association between WNT10B polymorphisms and adiposity parameters was found. However, our results clearly illustrate a role for WNT10B variants in determining human BMD...

Primary total hip replacement for displaced subcapital fractures of the femur.

Science.gov (United States)

Taine, W H; Armour, P C

1985-03-01

The management of displaced subcapital fracture of the hip is still controversial because of the high incidence of complications after internal fixation or hemiarthroplasty. To avoid some of these complications we have used primary total hip replacement for independently mobile patients over 65 years of age. A total of 163 cases, operated on over four years, have been reviewed. There were relatively more dislocations after operation for fracture than after total replacement for arthritis, and these were associated with a posterior approach to the hip. Only seven revision operations have been required. Of 57 patients who were interviewed an average of 42 months after replacement, 62% had excellent or good results as assessed by the Harris hip score. All the others had major systemic disease which affected their assessment. This inadequacy of current systems of hip assessment is discussed. It is concluded that total hip replacement is the best management for a selected group of patients with this injury, and that further prospective studies are indicated.

Impact of Genomics Platform and Statistical Filtering on Transcriptional Benchmark Doses (BMD and Multiple Approaches for Selection of Chemical Point of Departure (PoD.

Directory of Open Access Journals (Sweden)

A Francina Webster

Full Text Available Many regulatory agencies are exploring ways to integrate toxicogenomic data into their chemical risk assessments. The major challenge lies in determining how to distill the complex data produced by high-content, multi-dose gene expression studies into quantitative information. It has been proposed that benchmark dose (BMD values derived from toxicogenomics data be used as point of departure (PoD values in chemical risk assessments. However, there is limited information regarding which genomics platforms are most suitable and how to select appropriate PoD values. In this study, we compared BMD values modeled from RNA sequencing-, microarray-, and qPCR-derived gene expression data from a single study, and explored multiple approaches for selecting a single PoD from these data. The strategies evaluated include several that do not require prior mechanistic knowledge of the compound for selection of the PoD, thus providing approaches for assessing data-poor chemicals. We used RNA extracted from the livers of female mice exposed to non-carcinogenic (0, 2 mg/kg/day, mkd and carcinogenic (4, 8 mkd doses of furan for 21 days. We show that transcriptional BMD values were consistent across technologies and highly predictive of the two-year cancer bioassay-based PoD. We also demonstrate that filtering data based on statistically significant changes in gene expression prior to BMD modeling creates more conservative BMD values. Taken together, this case study on mice exposed to furan demonstrates that high-content toxicogenomics studies produce robust data for BMD modelling that are minimally affected by inter-technology variability and highly predictive of cancer-based PoD doses.

Femoral neck BMD is a strong predictor of hip fracture susceptibility in elderly men and women because it detects cortical bone instability: the Rotterdam Study.

Science.gov (United States)

Rivadeneira, Fernando; Zillikens, M Carola; De Laet, Chris Edh; Hofman, Albert; Uitterlinden, André G; Beck, Thomas J; Pols, Huibert Ap

2007-11-01

We studied HSA measurements in relation to hip fracture risk in 4,806 individuals (2,740 women). Hip fractures (n = 147) occurred at the same absolute levels of bone instability in both sexes. Cortical instability (propensity of thinner cortices in wide diameters to buckle) explains why hip fracture risk at different BMD levels is the same across sexes. Despite the sexual dimorphism of bone, hip fracture risk is very similar in men and women at the same absolute BMD. We aimed to elucidate the main structural properties of bone that underlie the measured BMD and that ultimately determines the risk of hip fracture in elderly men and women. This study is part of the Rotterdam Study (a large prospective population-based cohort) and included 147 incident hip fracture cases in 4,806 participants with DXA-derived hip structural analysis (mean follow-up, 8.6 yr). Indices compared in relation to fracture included neck width, cortical thickness, section modulus (an index of bending strength), and buckling ratio (an index of cortical bone instability). We used a mathematical model to calculate the hip fracture distribution by femoral neck BMD, BMC, bone area, and hip structure analysis (HSA) parameters (cortical thickness, section modulus narrow neck width, and buckling ratio) and compared it with prospective data from the Rotterdam Study. In the prospective data, hip fracture cases in both sexes had lower BMD, thinner cortices, greater bone width, lower strength, and higher instability at baseline. In fractured individuals, men had an average BMD that was 0.09 g/cm(2) higher than women (p men and women. No significant differences were observed between the areas under the ROC curves of BMD (0.8146 in women and 0.8048 in men) and the buckling ratio (0.8161 in women and 0.7759 in men). The buckling ratio (an index of bone instability) portrays in both sexes the critical balance between cortical thickness and bone width. Our findings suggest that extreme thinning of cortices in

The combination of structural parameters and areal bone mineral density improves relation to proximal femur strength. An in vitro study with high resolution peripheral quantitative computed tomography

DEFF Research Database (Denmark)

Hansen, Stinus; Beck Nielsen, Jens-Erik; Ahrberg, Fabian

2011-01-01

, volumetric BMD (vBMD), and microarchitectural parameters were obtained. In addition, aBMD by dual-energy X-ray absorptiometry (DXA) was performed at conventional hip regions and maximal compressive strength (MCS) was determined in a side-impact biomechanical test. Twelve cervical and 19 trochanteric...... fractures were confirmed. Geometry, vBMD, microarchitecture, and aBMD correlated significantly with MCS, with Spearman's correlation coefficients up to 0.77, 0.89, 0.90, and 0.85 (P ...

Total hip arthroplasty for giant cell tumour.

Directory of Open Access Journals (Sweden)

Kulkarni S

1996-07-01

Full Text Available A 32 month follow up of an uncommon case of a Giant Cell Tumour affecting the proximal end of femur is presented. Following a wide excision, the hip was reconstructed using Charnley type of low friction total hip arthroplasty. At a 32 month review, there was no recurrence and the function was good.

Effects of 1.8 GHz radiofrequency field on microstructure and bone metabolism of femur in mice.

Science.gov (United States)

Guo, Ling; Zhang, Jun-Ping; Zhang, Ke-Ying; Wang, Huan-Bo; Wang, Huan; An, Guang-Zhou; Zhou, Yan; Meng, Guo-Lin; Ding, Gui-Rong

2018-04-30

To investigate the effects of 1.8 GHz radiofrequency (RF) field on bone microstructure and metabolism of femur in mice, C57BL/6 mice (male, age 4 weeks) were whole-body exposed or sham exposed to 1.8 GHz RF field. Specific absorption rates of whole body and bone were approximately 2.70 and 1.14 W/kg (6 h/day for 28 days). After exposure, microstructure and morphology of femur were observed by microcomputed tomography (micro-CT), Hematoxylin and Eosin (HE) and Masson staining. Subsequently, bone parameters were calculated directly from the reconstructed images, including structure model index, bone mineral density, trabecular bone volume/total volume, connectivity density, trabecular number, trabecular thickness, and trabecular separation. Biomarkers that reflect bone metabolism, such as serum total alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), and tartrate-resistant acid phosphatase 5b (TRACP-5b), were determined by biochemical assay methods. Micro-CT and histology results showed that there was no significant change in bone microstructure and the above parameters in RF group, compared with sham group. The activity of serum ALP and BALP increased 29.47% and 16.82%, respectively, in RF group, compared with sham group (P microstructure; however, it might promote metabolic function of osteoblasts in mice. Bioelectromagnetics. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

Ontogeny of the female femur: geometric morphometric analysis applied on current living individuals of a Spanish population

Science.gov (United States)

Pujol, Aniol; Rissech, Carme; Ventura, Jacint; Badosa, Joaquim; Turbón, Daniel

2014-01-01

In this study we describe the development of the female femur based on the analysis of high-resolution radiographic images by means of geometric morphometrics, while assessing the usefulness of this method in these kinds of studies. The material analysed consisted of digital images in DICOM format (telemetries), corresponding to 184 left femora in anterior view, obtained from the database of the Hospital Sant Joan de Déu of Barcelona (Spain). Bones analysed corresponded to individuals from 9 to 14 years old. Size and shape variation of the entire femur was quantified by 22 two-dimensional landmarks. Landmark digitisation errors were assessed using Procrustes anova test. Centroid size (CS) variation with age was evaluated by an anova test. Shape variation was assessed by principal component analysis. A mancova test between the first five principal components and age, using the CS as covariable, was applied. Results indicated that both size and shape vary significantly with age. Several age-related shape changes remained significant after removing the allometric effect. In general, an increase in the robustness of the bone and noticeable phenotypic changes in certain areas of the femur were observed. During growth in the proximal region of the femur, the collo-diaphyseal angle decreases, the neck of the femur widens and the fovea moves to a lower position, standing more in line with the plane of the neck. Likewise, the size of the greater and lesser trochanters increase. In the distal region, a significant increase of epiphyseal dimensions was recorded, mainly in the medial condyle. The angular remodelling of the neck and the bicondylar region of the femur in females continues until 13 years old. The information provided in the present study increases our knowledge on the timing and morphology of the femur during development, and in particular the morphology of the different femoral ossification centres during development. PMID:24975495

Pilot study on proximal femur strains during locomotion and fall-down scenario

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Klodowski, Adam, E-mail: adam.klodowski@lut.fi; Valkeapaeae, Antti, E-mail: antti.valkeapaa@lut.fi; Mikkola, Aki, E-mail: aki.mikkola@lut.fi [Lappeenranta University of Technology (Finland)

2012-09-15

The most common and severe type of fracture among the elderly is known as a proximal femur fracture. Aging-related bone loss is one of the major contributing factors to increased likelihood of bone fracture. Specific exercises can be used to strain bones and increase bone strength to counter the effects of bone loss. The flexible multibody simulation approach can be used as a non-invasive method for estimating bone strains caused by physical activity. This method was recently used to analyze the strain of locomotion in regard to human femur and tibia leg bones. The current study focuses on strain analysis of the femoral neck. The research test person was a clinically healthy 65-year old Caucasian male. The computed tomography was used to build a geometrically accurate finite element model of the femur with inhomogeneous material properties derived from the voxel data. The anthropometric data was used to model the musculoskeletal system of the test person. The multibody skeletal model was utilized to estimate loading on the femoral neck during walking, which represents a routine daily activity. The flexible multibody simulation results were compared to strains that occurred during a simulated fall onto the greater trochanter of the femur. The fall simulation was made entirely using finite element software. Results from the finite element analysis were compared with the previous study showing that the test person does not belong to the high-risk hip fracture group. Finally, the estimated strains gathered from the walking simulation were compared to the strain values from the simulated fall-down scenario.

NELL-1 Injection Maintains Long-Bone Quantity and Quality in an Ovariectomy-Induced Osteoporotic Senile Rat Model

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Kwak, Jinny; Zara, Janette N.; Chiang, Michael; Ngo, Richard; Shen, Jia; James, Aaron W.; Le, Khoi M.; Moon, Crystal; Zhang, Xinli; Gou, Zhongru; Ting, Kang

2013-01-01

Over 10 million Americans have osteoporosis, and is the predominant cause of fractures in the elderly. Treatment of fractures in the setting of osteoporosis is complicated by a suboptimal bone regenerative response due to a decline in the number of osteoblasts, their function, and survival. Consequently, an osteogenic therapeutic to prevent and treat fractures in patients with osteoporosis is needed. Nel-like molecule-1 (NELL-1), a novel osteoinductive growth factor, has been shown to promote bone regeneration. In this study, we aim to demonstrate the capacity of recombinant NELL-1 to prevent ovariectomy (OVX)-induced osteoporosis in a senile rat model. Ten-month-old female Sprague-Dawley rats underwent either sham surgery or OVX. Subsequently, 50 μL of 600 μg/mL NELL-1 lyophilized onto a 0–50-μm tricalcium phosphate (TCP) carrier was injected into the femoral bone marrow cavity while phosphate-buffered saline (PBS) control was injected into the contralateral femur. Our microcomputed tomography results showed that OVX+PBS/TCP control femurs showed a continuous decrease in the bone volume (BV) and bone mineral density (BMD) from 2 to 8 weeks post-OVX. In contrast, OVX+NELL-1/TCP femurs showed resistance to OVX-induced bone resorption showing BV and BMD levels similar to that of SHAM femurs at 8 weeks post-OVX. Histology showed increased endosteal-woven bone, as well as decreased adipocytes in the bone marrow of NELL-1-treated femurs compared to control. NELL-1-treated femurs also showed increased immunostaining for bone differentiation markers osteopontin and osteocalcin. These findings were validated in vitro, in which addition of NELL-1 in OVX bone marrow stem cells resulted in increased osteogenic differentiation. Thus, NELL-1 effectively enhances in situ osteogenesis in the bone marrow, making it potentially useful in the prevention and treatment of osteoporotic fractures. PMID:23083222

Mathematical modeling of deformation of reinforced femur during prolonged static loads

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Vladimir P. Radchenko

2015-12-01

Full Text Available A two-layer mathematical model of a human femur neck reinforced implants of different design for modeling stress-strain state which occurs during a surgical procedure to prevent femur neck fractures by the forced introduction of metallic implants is proposed. Engineered implant designs are provided. Methods and software for geometric modeling of femur embedded with the implants are developed. New boundary value problems to evaluate kinetics in creep conditions of the stress-strain state of reinforced and non-reinforced femoral neck during prolonged static loads corresponding to human foot traffic are formulated. Effective elastic properties of cortical and cancellous bone, power and kinematic boundary value problems. A phenomenological creep model for compact bone tissue is constructed. The technique of identifying the parameters is developed. A check of its adequacy to experimental data is carried out. Based on the finite element method the numerical method for solving the provided boundary value problems at macro level of continuum mechanics is developed. A lot of variative calculations allowed developing recommendations for the rational positioning of the implant in order to minimize stress concentrations. The performed analysis showed that there is a significant relaxation of stresses in the most loaded areas due to creep. Relaxation is more intense in reinforced femoral neck than in the unreinforced. Thus the tension in the most loaded femoral neck area due to creep is reduced by 49 % with respect to the intensity of the initial time of loading for femur which is reinforced by the spoke-spoke-type implant when loading duration is 1 year under natural loads corresponding to human foot traffic. It was found that the time component (long-term fixed load does not impair the positive effect of reducing the stress concentration due to a femoral neck reinforcement which is a positive fact from the medical practice point of view.

Primary non-Hodgkin lymphoma of the right femur and subsequent metastasis to the left femur: A case report and literature review.

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Hu, Jing-Yu; Yu, Dan; Wu, Yao-Hui

2018-04-01

Non-Hodgkin lymphoma of the bone is rare and typically causes an extensive bone lesion. The present study describes a case of diffuse large B-cell primary non-Hodgkin lymphoma of the bone, which occurred in the right femur, and was initially treated with surgery and chemotherapy. Following a 7-year period of complete remission, a new, similar lesion was identified in the left femur. With both lesions, there was no accompanying destruction of any other bones or organ involvement. Metastasis of PLB to the contralateral side is extremely rare and, to the best of our knowledge, this is the first report of this particular presentation in China or worldwide. We hypothesized that the present situation arose due to mechanisms involving the tumor microenvironment, circulating tumor cells, lymphocyte homing and self-seeding. The present report describes the case in detail, and discusses the possible underlying mechanisms and their potential contribution to the treatment of non-Hodgkin lymphoma, as well as the prevention of metastasis and recurrence, which may be of considerable clinical significance.

Decreased bone mineral density in experimental myasthenia gravis in C57BL/6 mice.

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Oshima, Minako; Iida-Klein, Akiko; Maruta, Takahiro; Deitiker, Philip R; Atassi, M Zouhair

2017-09-01

Experimental autoimmune myasthenia gravis (EAMG), an animal model of myasthenia gravis (MG), can be induced in C57BL/6 (B6, H-2  b ) mice by 2-3 injections with Torpedo californica AChR (tAChR) in complete Freund's adjuvant. Some EAMG mice exhibit weight loss with muscle weakness. The loss in body weight, which is closely associated with bone structure, is particularly evident in EAMG mice with severe muscle weakness. However, the relationship between muscle weakness and bone loss in EAMG has not been studied before. Recent investigations on bone have shed light on association of bone health and immunological states. It is possible that muscle weakness in EAMG developed by anti-tAChR immune responses might accompany bone loss. We determined whether reduced muscle strength associates with decreased bone mineral density (BMD) in EAMG mice. EAMG was induced by two injections at 4-week interval of tAChR and adjuvants in two different age groups. The first tAChR injection was either at age 8 weeks or at 15 weeks. We measured BMD at three skeletal sites, including femur, tibia, and lumbar vertebrae, using dual energy X-ray absorptiometry. Among these bone areas, femur of EAMG mice in both age groups showed a significant decrease in BMD compared to control adjuvant-injected and to non-immunized mice. Reduction in BMD in induced EAMG at a later-age appears to parallel the severity of the disease. The results indicate that anti-tAChR autoimmune response alone can reduce bone density in EAMG mice. BMD reduction was also observed in adjuvant-injected mice in comparison to normal un-injected mice, suggesting that BMD decrease can occur even when muscle activity is normal. Decreased BMD observed in both tAChR-injected and adjuvant-injected mice groups were discussed in relation to innate immunity and bone-related immunology involving activated T cells and tumour necrosis factor-related cytokines that trigger osteoclastogenesis and bone loss.

Lower Serum Creatinine Is Associated with Low Bone Mineral Density in Subjects without Overt Nephropathy

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Huh, Ji Hye; Choi, Soo In; Lim, Jung Soo; Chung, Choon Hee; Shin, Jang Yel; Lee, Mi Young

2015-01-01

Background Low skeletal muscle mass is associated with deterioration of bone mineral density. Because serum creatinine can serve as a marker of muscle mass, we evaluated the relationship between serum creatinine and bone mineral density in an older population with normal renal function. Methods Data from a total of 8,648 participants (4,573 men and 4,075 postmenopausal women) aged 45–95 years with an estimated glomerular filtration rate >60 ml/min/1.73 m2 were analyzed from the Fourth Korea National Health and Nutrition Examination Survey (2008–2010). Bone mineral density (BMD) and appendicular muscle mass (ASM) were measured using dual-energy X-ray absorptiometry. Receiver operating characteristic curve analysis revealed that the cut points of serum creatinine for sarcopenia were below 0.88 mg/dl in men and 0.75 mg/dl in women. Subjects were divided into two groups: low creatinine and upper normal creatinine according to the cut point value of serum creatinine for sarcopenia. Results In partial correlation analysis adjusted for age, serum creatinine was positively associated with both BMD and ASM. Subjects with low serum creatinine were at a higher risk for low BMD (T-score ≤ –1.0) at the femur neck, total hip and lumbar spine in men, and at the total hip and lumbar spine in women after adjustment for confounding factors. Each standard deviation increase in serum creatinine was significantly associated with reduction in the likelihood of low BMD at the total hip and lumbar spine in both sexes (men: odds ratio (OR) = 0.84 [95% CI = 0.74−0.96] at the total hip, OR = 0.8 [95% CI = 0.68−0.96] at the lumbar spine; women: OR = 0.83 [95% CI = 0.73–0.95] at the total hip, OR=0.81 [95% CI = 0.67–0.99] at the lumbar spine). Conclusions Serum creatinine reflected muscle mass, and low serum creatinine was independently associated with low bone mineral density in subjects with normal kidney function. PMID:26207750

Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis.

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Erceg, M; Becic, K

2014-01-01

A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years).To the best of the author's knowledge, nobody has ever treated problem like this using this alternative, an unconventional method, with an Austin Moore endoprosthesis.

Femur-sparing pattern of abnormal fetal growth in pregnant women from New York City after maternal Zika virus infection.

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Walker, Christie L; Merriam, Audrey A; Ohuma, Eric O; Dighe, Manjiri K; Gale, Michael; Rajagopal, Lakshmi; Papageorghiou, Aris T; Gyamfi-Bannerman, Cynthia; Adams Waldorf, Kristina M

2018-05-05

analyze time-dependent effects of Zika virus infection on fetal size. Statistical analysis was performed using Wilcoxon signed-rank test on paired data, comparing either abdominal circumference or head circumference to femur length. A total of 56 pregnant women were included in the study with laboratory evidence of a confirmed or possible recent Zika virus infection. Based on the Centers for Disease Control and Prevention definition for microcephaly after congenital Zika virus exposure, microcephaly was diagnosed in 5% (3/56) by both the 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project and World Health Organization Fetal Growth Chart standards (head circumference Z-score ≤-2 or ≤2.3%). Using 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project, intrauterine fetal growth restriction was diagnosed in 18% of pregnancies (10/56; abdominal circumference Z-score ≤-1.3, Zika virus exposure. Fetal body ratios may represent a more sensitive ultrasound biomarker to detect viral injury in nonmicrocephalic fetuses that could impart long-term risk for complications of congenital Zika virus infection. Copyright © 2018 Elsevier Inc. All rights reserved.

The effect of feeding different sugar-sweetened beverages to growing female Sprague-Dawley rats on bone mass and strength.

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Tsanzi, Embedzayi; Light, Heather R; Tou, Janet C

2008-05-01

Consumption of sugar beverages has increased among adolescents. Additionally, the replacement of sucrose with high fructose corn syrup (HFCS) as the predominant sweetener has resulted in higher fructose intake. Few studies have investigated the effect of drinking different sugar-sweetened beverages on bone, despite suggestions that sugar consumption negatively impacts mineral balance. The objective of this study was to determine the effect of drinking different sugar-sweetened beverages on bone mass and strength. Adolescent (age 35d) female Sprague-Dawley rats were randomly assigned (n=8-9/group) to consume deionized distilled water (ddH2O, control) or ddH2O containing 13% w/v glucose, sucrose, fructose or high fructose corn syrup (HFCS-55) for 8weeks. Tibia and femur measurements included bone morphometry, bone turnover markers, determination of bone mineral density (BMD) and bone mineral content (BMC) by dual energy X-ray absorptiometry (DXA) and bone strength by three-point bending test. The effect of sugar-sweetened beverage consumption on mineral balance, urinary and fecal calcium (Ca) and phosphorus (P) was measured by inductively coupled plasma optical emission spectrometry. The results showed no difference in the bone mass or strength of rats drinking the glucose-sweetened beverage despite their having the lowest food intake, but the highest beverage and caloric consumption. Only in comparisons among the rats provided sugar-sweetened beverage were femur and tibia BMD lower in rats drinking the glucose-sweetened beverage. Differences in bone and mineral measurements appeared most pronounced between rats drinking glucose versus fructose-sweetened beverages. Rats provided the glucose-sweetened beverage had reduced femur and tibia total P, reduced P and Ca intake and increased urinary Ca excretion compared to the rats provided the fructose-sweetened beverage. The results suggested that glucose rather than fructose exerted more deleterious effects on mineral

Study on the relationship between serum IL-6, Sgp80, Sgp130 levels and bone metabolism in patients with Graves' disease

International Nuclear Information System (INIS)

Liu Chunyu; Mu Junqing; Zou Jianwen; Liu Songtao

2007-01-01

Objective: To investigate the relationship between serum IL-6, Sgp80, Sgpl30 levels and bone metabolism in patients with Graves' disease. Methods: Serum levels of IL-6 (with RIA), Sgp80, Sgpl30 (with ELISA) as well as BMD of proximal femur region were determined in 78 patients with Graves' disease (26 not treated yet, 26 partially remitted and 26 in remission) and 30 controls. Results: The serum IL-6 and Sgpl30 levels in all the patients with Graves' disease were significantly higher than those in controls (P 3 , FT 4 , phosphorous, BGP and urinary hydroxy proline levels. BMD of the proximal femur region in patients partially remitted were much lower than that in controls (P<0.05). Conclusion: Serum Sgp80 level might be taken as an important parameter in studying of Graves' disease. Bone loss, both cortical and trabecular, occurred in patients with Graves' disease. Increase of bone formation as well as bone resorption were primary, not secondary to each other. (authors)

Effect of short-term upper-body resistance training on muscular strength, bone metabolic markers, and BMD in premenopausal women

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Liang MT

2012-11-01

Full Text Available Michael TC Liang,1 Lorena Quezada,1 WY Jamie Lau,1 Bulent Sokmen,2 Thomas W Spalding11Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, USA; 2Department of Kinesiology, Sonoma State University, Rohnert Park, CA, USAAbstract: To examine the effect of a 10-week upper-body resistance training program on bone turnover markers and site-specific bone mineral density (BMD in the wrist and distal half of the ulna and radius in untrained and healthy young premenopausal women.Methods: Twenty-two subjects (aged 22.1 ± 1.8 years were randomly assigned to a resistance training (n = 12 or no training control (n = 10 group. The following outcome variables were measured before and after 10 weeks of resistance training: (1 bone formation biomarker osteocalcin, and bone resorption biomarker tartrate-resistant acid phosphatase isoform 5b; (2 BMD in the wrist and distal half of the ulna and radius; (3 isokinetic strength of the elbow and knee extensors and flexors; (4 dynamic strength of the arm extensors and flexors; and (5 maximum number of push-ups.Results: The 10-week upper body resistance training intervention resulted in improved strength performance in push-ups (resistance training versus control: P < 0.05, chest presses (P < 0.05, and pulldowns (P < 0.05. However, there was no improvement in the BMD of the wrist (P > 0.05, BMD of the distal half of the ulna and radius (P > 0.05, and metabolic biomarkers osteocalcin (P > 0.05 and tartrate-resistant acid phosphatase isoform 5b (P > 0.05, except for the osteocalcin/tartrate-resistant acid phosphatase isoform 5b ratio. Also, no improvement in the resistance training group was observed for isokinetic strength of the knee and elbow flexion/extension.Conclusion: Upper-body muscular strength performance, but not bone metabolic markers and BMD of the wrist, can be improved with a 10-week upper body resistance training program of the nonweight-bearing limbs in

Application of dual-energy X-ray absorptiometry to measure the changes of bone mineral density in 131 healthy women

International Nuclear Information System (INIS)

Sang Shibiao; Wang Dongliang; Wu Yiwei

2002-01-01

131 healthy women aged 31-72 years participated in the study, include 64 sexual maturity women aged 31-52 were enrolled in four groups based on age, and 67 postmenopausal women, the years of menopause from 1 month to 23 years, were also enrolled in four groups based on duration of menopause. The bone mineral density of the lumbar-spine and femur were measured using dual-energy X-rays absorptiometry. At the same time, the serum E 2 , FSH, BGP were detected by radioimmunoassay; the serum AKP, calcium, phosphate were detected using automatic biochemistry instrument. The results were: the BMD of lumbar-spine and right femur were decreased, and associated with increasing age and the duration of menopause, especially after menopause. Significant positive correlation was noted between BMD and E 2 . Serum AKP and BGP levels were higher in postmenopausal women than those of sexual maturity women. The serum calcium level was increased significantly soon after menopause, then decreased to normal level, and maintained in this level. The serum phosphate level had no difference in these groups. Therefore BMD, serum E 2 , BGP and AKP determination have some value for the early diagnosis of postmenopausal osteoporosis and prediction of bone fracture also

Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65-71 years: a 3-year randomized population-based trial (OSTPRE-FPS).

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Kärkkäinen, M; Tuppurainen, M; Salovaara, K; Sandini, L; Rikkonen, T; Sirola, J; Honkanen, R; Jurvelin, J; Alhava, E; Kröger, H

2010-12-01

The Osteoporosis Risk Factor and Prevention-Fracture Prevention Study (OSTPRE-FPS) was a randomized population-based open trial (n = 593). The supplementation group (n = 287) received daily cholecalciferol 800 IU + calcium 1,000 mg for 3 years while the control group (n = 306) received neither supplementation nor placebo. Daily vitamin D and calcium supplementation have a positive effect on the skeleton in ambulatory postmenopausal women. vitamin D deficiency is common in the elderly, and vitamin D levels are associated with low bone mineral density (BMD). The working hypothesis was that vitamin D and calcium supplementation could prevent bone loss in ambulatory postmenopausal women. the OSTPRE-FPS was a randomized population-based open trial with a 3-year follow-up in 3,432 women (aged 66 to 71 years). A randomly selected subsample of 593 subjects underwent BMD measurements. The supplementation group (n = 287) received daily cholecalciferol 800 IU + calcium 1,000 mg for 3 years while the control group (n = 306) received neither supplementation nor placebo. in the intention-to-treat analysis, total body BMD (n = 362) increased significantly more in the intervention group than in the control group (0.84% vs. 0.19%, p = 0.011). The BMD change differences at the lumbar spine (p = 0.372), femoral neck (p = 0.188), trochanter (p = 0.085), and total proximal femur (p = 0.070) were statistically nonsignificant. Analyses in compliant women (≥ 80% of use) resulted in stronger and statistically significant effects at the total body and femoral regions. daily vitamin D and calcium supplementation have a positive effect on the skeleton in ambulatory postmenopausal women with adequate nutritional calcium intake.

Insights into relationships between body mass, composition and bone: findings in elite rugby players.

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Hind, Karen; Gannon, Lisa; Brightmore, Amy; Beck, Belinda

2015-01-01

Recent reports indicate that bone strength is not proportional to body weight in obese populations. Elite rugby players have a similar body mass index (BMI) to obese individuals but differ markedly with low body fat, high lean mass, and frequent skeletal exposure to loading through weight-bearing exercise. The purpose of this study was to determine relationships between body weight, composition, and bone strength in male rugby players characterized by high BMI and high lean mass. Fifty-two elite male rugby players and 32 nonathletic, age-matched controls differing in BMI (30.2 ± 3.2 vs 24.1 ± 2.1 kg/m²; p = 0.02) received 1 total body and one total hip dual-energy X-ray absorptiometry scan. Hip structural analysis of the proximal femur was used to determine bone mineral density (BMD) and cross-sectional bone geometry. Multiple linear regression was computed to identify independent variables associated with total hip and femoral neck BMD and hip structural analysis-derived bone geometry parameters. Analysis of covariance was used to explore differences between groups. Further comparisons between groups were performed after normalizing parameters to body weight and to lean mass. There was a trend for a positive fat-bone relationship in rugby players, and a negative relationship in controls, although neither reached statistical significance. Correlations with lean mass were stronger for bone geometry (r(2): 0.408-0.520) than for BMD (r(2): 0.267-0.293). Relative to body weight, BMD was 6.7% lower in rugby players than controls (p Rugby players were heavier than controls, with greater lean mass and BMD (p rugby players (p rugby players was reduced in proportion to body weight and lean mass. However, their superior bone geometry suggests that overall bone strength may be adequate for loading demands. Fat-bone interactions in athletes engaged in high-impact sports require further exploration. Copyright © 2015. Published by Elsevier Inc.

Bone mineral density and trabecular bone tissue quality in obese men

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V.V. Povoroznyuk

2017-02-01

Full Text Available Obesity and osteoporosis are the two metabolic dise­ases with increased prevalence over last decades and a strong impact on the global morbidity and mortality have gained a status of major health threats worldwide. There is evidence that the higher body mass index (BMI values are associated with greater bone mineral density (BMD resulting in a site-specific protective effect for fragility fractures. On the other hand, higher BMI values increases incidence of falls and is associated with worse fractures consolidation. However, trabecular bone score (TBS indirectly explores bone quali­ty, independently of BMD. The aim of the study was to determine the connection between the BMD and TBS parameters in Ukrainian men suffering from obesity. Methods. We examined 396 men aged 40–89 years, by the BMI all the subjects were divided into 2 groups: Group A — with obesity and BMI ≥ 30 kg/m2 (n = 129 and Group B — without obesity and BMI < 30 kg/m2 (n = 267. The BMD of total body, lumbar spine at the site L1–L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA. The TBS of L1–L4 was assessed by means of TBS iNsight (Med-Imaps, Pessac, France. Results. In general, obese men had a significantly higher BMD of lumbar spine, femoral neck, total body and ultradistal forearm (p < 0.001 in comparison with men without obesity. The TBS of L1–L4 was significantly lower in obese men compared to non-obese men (p < 0.001. The significant positive correlation between the fat mass and the BMD at different sites was observed. The correlation between the fat mass and TBS of L1–L4 was also significant, but negative. Conclusions. Obesity negatively affects the quality of trabecular bone, while bone mineral density was significantly higher.

Contribution of Myostatin gene polymorphisms to normal variation in lean mass, fat mass and peak BMD in Chinese male offspring

Institute of Scientific and Technical Information of China (English)

Hua YUE; Miao LI; Yu-juan LIU; Song-hua WU; Zhen-lin ZHANG; Jin-wei HE; Hao ZHANG; Chun WANG; Wei-wei HU; Jie-mei GU; Yao-hua KE; Wen-zhen FU; Yun-qiu HU

2012-01-01

Myostatin gene is a member of the transforming growth factor-β (TGF-β) family that negatively regulates skeletal muscle growth.Genetic polymorphisms in Myostatin were found to be associated with the peak bone mineral density (BMD) in Chinese women.The purpose of this study was to investigate whether Myostatin played a role in the normal variation in peak BMD,lean mass (LM),and fat mass (FM) of Chinese men.Methods:Four hundred male-offspring nuclear families of Chinese Han ethnic group were recruited.Anthropometric measurements,includingthe peak BMD,body LM and FM were measured using dual-energy X-ray absorptiometry (DXA).The single nucleotide polymorphisms (SNPs) studied were tag-SNPs selected by sequencing.Both rs2293284 and +2278G＞A were genotyped using TaqMan assay,and rs3791783 was genotyped with PCR-restriction fragment length polymorphism (RFLP) analysis.The associations of the SNPs with anthropometfic variations were analyzed using the quantitative transmission disequilibrium test (QTDT).Results:Using QTDT to detect within-family associations,neither single SNP nor haplotype was found to be associated with peak BMD at any bone site.However,rs3791783 was found to be significantly associated with fat mass of the trunk (P＜0.001).Moreover,for within-family associations,haplotypes AGG,AAA,and TGG were found to be significantly associated with the trunk fat mass (all P＜0.001).Conclusion:Our results suggest that genetic variation within Myostatin may play a role in regulating the variation in fat mass in Chinese males.Additionally,the Myostatin gene may be a candidate that determines body fat mass in Chinese men.

A CLINICAL STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE (LCP - PF IN THE MANAGEMENT OF COMMUNITED INTERTROCHANTERIC AND SUBTROCHANTERIC FRACTURES OF THE FEMUR

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Hari Babu

2015-10-01

Full Text Available Fractures of proximal femur and hip are relatively common injuries in elderly individuals . The incidence of peritrochanteric and intertrochanteric fracture is also increasing among young population, who sustain high energy trauma Rigid Internal fixation and early mobilization has been the standard method of treatment. A combination of orthopaedic surgery and early postoperative physiotherapy and ambulation is the best approach. The overall goal in the treatment of hip fractures is to return the patient to pre - morbid level of function. AIMS & OBJECTIVE : To analyse the anatomical and f unctional outcome of the treatment with LCP - Proximal femur. METHODOLOGY : The present study consists of 12 adult patients of peritrochanteric factures of femur satisfying the inclusion criteria , treated with Proximal Femoral Locking Compression Plate at S. V. R. R . Govt . General Hospital, Tirupati during the period of nov 2013 to Oct 2015. INCLUSION CRITERIA : Age >18years , comminuted trochanteric and sub trochanteric fractures , Signed written informed consent . EXCLUSION CRITERIA: Inter trochanteric fractures involving piriformis fossa , Compound fractures . Pathological fractures . Any displacement of a femoral neck fracture . A ssociated malignancy. RESULTS : Average age incidence in the present study was 62.7 years. , Predominantly males (75% were affected. , Most cases occurred after a fall 10 (50% cases which was statistically significant , Right side involvement was more common. , Average post - operative stay was 13.5 days. , Out of the 12 cases, evaluated using Salvati - Wilson scoring : 3 cases (25% had good, 8 cases (66.67% fair, 1 case (8.33% had poor score , Average weight bearing time was14.5 weeks , Average union rate was 19.45 weeks.

Prevalence of osteoporosis and predictors of low BMD in a cohort of HIV-1-infected patients in Rome: features of a population at high risk.

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D'Avino, Alessandro; Lassandro, Annapia; Lamonica, Silvia; Piccoli, Benedetta; Fabbiani, Massimiliano; Mondi, Annalisa; Gagliardini, Roberta; Borghetti, Alberto; Fanti, Iuri; Pallavicini, Federico; Cauda, Roberto; Di Giambenedetto, Simona

2014-01-01

Ageing of HIV-infected patients led to an increasing rate of osteopenia and osteoporosis. The cause is multifactorial, including virus activity, drug toxicity and host factors. The aim of our analysis is to quantify this issue according to our department experience and to evaluate predictors of low BMD. HIV-1-infected patients, on stable HAART, were consecutively enrolled in this cross-sectional study and underwent DEXA. We analyzed the prevalence and evaluated predictors of low BMD in our population. We collected data from 208 patients, 148 of whom were male, with 49 years median age (IQR 24.1-68.3). About 39% of patients were heterosexuals, 33.7 MSM and 12.5% were IDU, 40.4% were smokers. Caucasians were 93.3%, and 13.9% were co-infected with HCV virus. Around 6.7% of patients were on their first HAART regimen and all of them started TDF. Their median time of HAART exposure was 1.17 years (IQR 0.8-1.6). Conversely, median time of HAART exposure of multi-experienced patients was 8.5 years (IQR 3.1-12.0). We stratified DEXA results for patients on first-line regimen versus multi-experienced one. We found that 42.9% of patients on first-line HAART had low BMD of lumbar spine and 7.1% had osteoporosis. Regarding the multi-experienced group of patients, lumbar spine osteopenia was observed in 36.6% of patients and 15.5% of them had osteoporosis. Median age of patients with low BMD of lumbar spine was 45.6 (IQR 24.1-68.3) for patients on first-line regimen and 49.8 years for multi-experienced (IQR 44.2-54.0) regimen. We found similar data for BMD of hip, but no patients in the first group had hip osteoporosis. We also analyzed predictors of low BMD in our population. MSM patients showed a 3.4-fold higher risk to have osteoporosis of lumbar spine (OR 3.41, CI 1,105-9,269, p=0.03). As expected, we found that non-Caucasian patients had 13.5-fold higher risk to have osteoporosis of the hip (OR 13.52, CI 1.5-122.7, p=0.02). Exposure to HAART was also evaluated, but no

Pre-hospital Management of the Fractured Femur Using the ...

African Journals Online (AJOL)

Two aspects of the early management of the fractured femur are discussed: firstly the immediate treatment in the pre-hospital phase and secondly the transportation of this injury case over a long distance where necessary. In both instances there is considerable room for improvement, and this is discussed, particularly with ...

Phantom-less bone mineral density (BMD) measurement using dual energy computed tomography-based 3-material decomposition

Science.gov (United States)

Hofmann, Philipp; Sedlmair, Martin; Krauss, Bernhard; Wichmann, Julian L.; Bauer, Ralf W.; Flohr, Thomas G.; Mahnken, Andreas H.

2016-03-01

Osteoporosis is a degenerative bone disease usually diagnosed at the manifestation of fragility fractures, which severely endanger the health of especially the elderly. To ensure timely therapeutic countermeasures, noninvasive and widely applicable diagnostic methods are required. Currently the primary quantifiable indicator for bone stability, bone mineral density (BMD), is obtained either by DEXA (Dual-energy X-ray absorptiometry) or qCT (quantitative CT). Both have respective advantages and disadvantages, with DEXA being considered as gold standard. For timely diagnosis of osteoporosis, another CT-based method is presented. A Dual Energy CT reconstruction workflow is being developed to evaluate BMD by evaluating lumbar spine (L1-L4) DE-CT images. The workflow is ROI-based and automated for practical use. A dual energy 3-material decomposition algorithm is used to differentiate bone from soft tissue and fat attenuation. The algorithm uses material attenuation coefficients on different beam energy levels. The bone fraction of the three different tissues is used to calculate the amount of hydroxylapatite in the trabecular bone of the corpus vertebrae inside a predefined ROI. Calibrations have been performed to obtain volumetric bone mineral density (vBMD) without having to add a calibration phantom or to use special scan protocols or hardware. Accuracy and precision are dependent on image noise and comparable to qCT images. Clinical indications are in accordance with the DEXA gold standard. The decomposition-based workflow shows bone degradation effects normally not visible on standard CT images which would induce errors in normal qCT results.

Gradually increasing ethinyl estradiol for Turner syndrome may produce good final height but not ideal BMD.

Science.gov (United States)

Hasegawa, Yukihiro; Ariyasu, Daisuke; Izawa, Masako; Igaki-Miyamoto, Junko; Fukuma, Mami; Hatano, Megumi; Yagi, Hiroko; Goto, Masahiro

2017-02-27

Estrogen replacement therapy in Turner syndrome should theoretically mimic the physiology of healthy girls. The objective of this study was to describe final height and bone mineral density (BMD) in a group of 17 Turner syndrome patients (group E) who started their ethinyl estradiol therapy with an ultra-low dosage (1-5 ng/kg/day) from 9.8-13.7 years. The subjects in group E had been treated with GH 0.35 mg/kg/week since the average age of 7.4 years. The 30 subjects in group L, one of the historical groups, were given comparable doses of GH, and conjugated estrogen 0.3125 mg/week ∼0.3125 mg/day was initiated at 12.2-18.7 years. The subjects in group S, the other historical group, were 21 patients who experienced breast development and menarche spontaneously. Final height (height gain Turner syndrome. The final height in group L was 148.5 ± 3.0 cm with a SD of 1.30 ± 0.55, which was significantly different from the values for group E. The volumetric BMD of group S (0.290 ± 0.026 g/cm 3 ) was significantly different from that of group L or E (0.262 or 0.262 g/cm 3 as a mean, respectively). This is the first study of patients with Turner syndrome where estrogen was administered initially in an ultra-low dose and then increased gradually. Our estrogen therapy in group E produced good final height but not ideal BMD.

Relationship of bony trabecular characteristics and age to bone mass

International Nuclear Information System (INIS)

Choi, Dong Hoon; Song, Young Han; Yoon, Young Nam; Lee, Wan; Lee, Byung Do

2006-01-01

Bony strength is dependent on bone mass and bony structure. So this study was designed to investigate the relationship between the bone mass and bony mass and bony trabecular characteristics. Study subjects were 51 females (average age 68.6 years) and 20 males (average age 66.4 years). Bony mineral density (BMD, grams/cm 2 ) of proximal femur was measured by a dual energy X-ray absorptiometry (DEXA). Regions of interest (ROIs) were selected from the digitized radiographs of proximal femur. A customized computer program processed morphologic operations (MO) of ROIs. 44 skeletal variables of MO were calculated from ROIs on the Ward's triangle and greater trochanter of femur. WHO BMD classes were predicted by MO variables of the same ROI. Classification and Regression Tree analysis was used for calculating weighted kappa values, sensitivity and specificity of MO. The discriminating factors of morphologic operation were branch point, branch point [per cm sq]. Age also played important role in distinguishing osteoporotic classes. The sensitivity of MO at Ward's triangle and Greater Trochanter was 91.8%, 65.6%, respectively. The specificity of MO was 100% at Ward's triangle and Greater Trochanter. Bony trabecular characteristics obtained using radiological bone morphometric analysis seem to be related to bone mass

Effects of chronic lead exposure on bone mineral properties in femurs of growing rats

International Nuclear Information System (INIS)

Álvarez-Lloret, Pedro; Lee, Ching Ming; Conti, María Inés; Terrizzi, Antonela Romina; González-López, Santiago; Martínez, María Pilar

2017-01-01

Lead exposure has been associated with several defective skeletal growth processes and bone mineral alterations. The aim of the present study is to make a more detailed description of the toxic effects of lead intoxication on bone intrinsic material properties as mineral composition, morphology and microstructural characteristics. For this purpose, Wistar rats were exposed (n = 12) to 1000 ppm lead acetate in drinking water for 90 days while control group (n = 8) were treated with sodium acetate. Femurs were examined using inductively coupled plasma optical emission spectrometry (ICP-OES), Attenuated Total Reflection Fourier transform infrared spectroscopy (ATR-FTIR), X-ray diffraction (XRD), and micro-Computed Tomography (μCT). Results showed that femur from the lead-exposed rats had higher carbonate content in bone mineral and (Ca 2+ + Mg 2+ + Na + )/P ratio values, although no variations were observed in crystal maturity and crystallite size. From morphological analyses, lead exposure rats showed a decreased in trabecular bone surface and distribution while trabecular thickness and cortical area increased. These overall effects indicate a similar mechanism of bone maturation normally associated to age-related processes. These responses are correlated with the adverse actions induced by lead on the processes regulating bone turnover mechanism. This information may explain the osteoporosis diseases associated to lead intoxication as well as the risk of fracture observed in populations exposed to this toxicant.

Relationship between total and segmental bone mineral density and different domains of physical activity among children and adolescents: cross-sectional study.

Science.gov (United States)

Diniz, Tiego Aparecido; Agostinete, Ricardo Ribeiro; Costa, Paulo; Saraiva, Bruna Thamyres Ciccotti; Sonvenso, Diego Kanashiro; Freitas, Ismael Forte; Fernandes, Rômulo Araujo; Christofaro, Diego Giulliano Destro

2017-01-01

This study aimed to investigate the relationship between total and segmental bone mineral density (BDM) and physical activity (PA) in different domains (school, leisure and sports) among adolescents and children. Cross-sectional study in the Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP). The study sample consisted of 173 children and adolescents (10.31 ± 1.87 years). The BMDs for the whole body (WB) and the regions of the trunk and legs were measured using dual energy X-ray absorptiometry (DXA). PA was measured using the Baecke questionnaire. A regression model was used to analyze the relationship between all the BMDs and the different domains of PA. 41.5% of the adolescents had high percentages of body fat. Regarding the comparison between physically active and insufficiently active adolescents, there were no statistically significant differences in any BMD variables (P > 0.05). The BMD of the legs showed positive relationships with the total PA (β = 0.009; P = 0.013) and sports PA (β = 0.010; P = 0.049) after insertion of the confounders. Similarly, the WB BMD showed the same relationships (total PA: β = 0.005; P = 0.045; and sports PA: β = 0.008; P = 0.049). No relationship was found between leisure and school PA and any of the BMDs (P > 0.05). The results indicated that practice of sport was related to higher BMD values, independent of sex, age and body fatness.

Anthropometric Measurements of the Human Distal Femur: A Study of the Adult Malay Population

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Fitdriyah Hussain

2013-01-01

Full Text Available The distal femurs of 100 subjects (50 men, 50 women from the Malay population aged between 19 and 38 years were scanned to measure the anterior-posterior (AP and medial-lateral (ML width. The mean AP values were 64.02 ± 3.38 mm and 57.33 ± 3.26 mm for men and women, respectively, and the mean ML values were 74.91 ± 3.52 mm and 64.53 ± 3.07 mm. We compared our data to that published previously for the Chinese and Indian populations. It was found that the Malay population had smaller distal femur than that of the Chinese but was larger than that of the Indian population (P < 0.05. In conclusion, although it is well established that Asians have a smaller distal femur size than that of the Western population, the variations in different Asian ethnicities may need to be considered when designing the appropriate knee implant.

Anthropometric measurements of the human distal femur: a study of the adult Malay population.

Science.gov (United States)

Hussain, Fitdriyah; Abdul Kadir, Mohammed Rafiq; Zulkifly, Ahmad Hafiz; Sa'at, Azlin; Aziz, Azian Abd; Hossain, Golam; Kamarul, T; Syahrom, Ardiyansyah

2013-01-01

The distal femurs of 100 subjects (50 men, 50 women) from the Malay population aged between 19 and 38 years were scanned to measure the anterior-posterior (AP) and medial-lateral (ML) width. The mean AP values were 64.02 ± 3.38 mm and 57.33 ± 3.26 mm for men and women, respectively, and the mean ML values were 74.91 ± 3.52 mm and 64.53 ± 3.07 mm. We compared our data to that published previously for the Chinese and Indian populations. It was found that the Malay population had smaller distal femur than that of the Chinese but was larger than that of the Indian population (P < 0.05). In conclusion, although it is well established that Asians have a smaller distal femur size than that of the Western population, the variations in different Asian ethnicities may need to be considered when designing the appropriate knee implant.

Osteoporosis or Low Bone Mass at the Femur Neck or Lumbar Spine in Older Adults: United States, 2005-2008

Science.gov (United States)

... Osteoporosis or Low Bone Mass at the Femur Neck or Lumbar Spine in Older Adults: United States, ... on bone mineral density at either the femur neck or lumbar spine? Nine percent of persons aged ...

Periosteal osteoblastoma of the distal femur

Energy Technology Data Exchange (ETDEWEB)

Nakatani, Tetsuya; Yamamoto, Tetsuji; Akisue, Toshihiro; Marui, Takashi; Hitora, Toshiaki; Kawamoto, Teruya; Nagira, Keiko; Yoshiya, Shinichi; Kurosaka, Masahiro [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe (Japan); Fujita, Ikuo; Matsumoto, Keiji [Department of Orthopaedic Surgery, Hyogo Medical Center for Adults, Akashi, Hyogo (Japan)

2004-02-01

Osteoblastomas located on the surface of the cortical bone, so-called periosteal osteoblastomas, are extremely rare. We report on a case of periosteal osteoblastoma arising from the posterior surface of the right distal femur in a 17-year-old man. Roentgenographic, computed tomographic, magnetic resonance imaging, and histologic features of the case are presented. Periosteal osteoblastoma should be radiologically and histologically differentiated from myositis ossificans, avulsive cortical irregularity syndrome, osteoid osteoma, parosteal osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. Although periosteal osteoblastoma is rare, this tumor should be included in the differential diagnosis of surface-type bone tumors. (orig.)

Biomechanical Evaluations of Hip Fracture Using Finite Element Model that Models Individual Differences of Femur

OpenAIRE

田中, 英一; TANAKA, Eiichi; 山本, 創太; YAMAMOTO, Sota; 坂本, 誠二; SAKAMOTO, Seiji; 中西, 孝文; NAKANISHI, Takafumi; 原田, 敦; HARADA, Atsushi; 水野, 雅士; MIZUNO, Masashi

2004-01-01

This paper is concerned with an individual finite element modeling system for femur and biomechanical evaluations of the influences of loading conditions, bone shape and bone density on risks of hip fracture. Firstly, a method to construct an individual finite element model by morphological parameters that represent femoral shapes was developed. Using the models with different shapes constructed by this method, the effects of fall direction, posture of upper body, femur shape and bone density...

Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis

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M Erceg

2014-01-01

Full Text Available A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years.To the best of the author′s knowledge, nobody has ever treated problem like this using this alternative, an unconventional method, with an Austin Moore endoprosthesis.

Initial years of recreational artistic gymnastics training improves lumbar spine bone mineral accrual in 4- to 8-year-old females.

Science.gov (United States)

Laing, Emma M; Wilson, Alissa R; Modlesky, Christopher M; O'Connor, Patrick J; Hall, Daniel B; Lewis, Richard D

2005-03-01

Gymnasts' bone mineral characteristics are generally not known before starting their sport. Prepubertal females who enrolled in beginning artistic gymnastics (n = 65) had lower bone mineral than controls (n = 78). However, 2 years of gymnastics participation versus no participation led to a significantly greater accrual of forearm bone area and lumbar spine areal BMD. The skeletal response to exercise in children compared with adults is heightened because of the high bone turnover rate and the ability of bone to change its size and shape. Whereas child gymnasts generally have greater rates of bone mineral accrual compared with nongymnasts, it is unknown if some of these skeletal advantages are present before the onset of training or are caused entirely by training. Changes in bone area (BA; cm2), BMC (g), and areal BMD (aBMD; g/cm2) over 24 months were examined in prepubertal females, 4-8 years of age, who selected to perform recreational gymnastics (GYM; n = 65), nongymnastic activities, or no organized activity (CON; n = 78). Participants had essentially no lifetime history of organized athletic participation (spine, total proximal femur, and forearm BA, BMC, and aBMD were measured every 6 months using DXA (Hologic QDR-1000W). Independent samples t-tests determined baseline group differences. Nonlinear mixed effects models were used to model 24-month changes in bone data. In subset analyses, high-level gymnasts advancing to competition (HLG; n = 9) were compared with low-level nonadvancing gymnasts (LLG; n = 56). At baseline, GYM were shorter, lighter, and had lower BA, BMC, and aBMD compared with CON (p 0.05). Controlling for differences in race, baseline measures of body mass, height, and calcium intake, and change in breast development beyond stage II at 24 months, GYM had greater long-term (asymptotic) mean responses for total body aBMD and forearm BMC (p spine aBMD and forearm BA compared with CON over 24 months. Over time, forearm BA increased to a greater

Robotic technique improves entry point alignment for intramedullary nailing of femur fractures compared to the conventional technique: a cadaveric study.

Science.gov (United States)

Suero, Eduardo M; Westphal, Ralf; Citak, Musa; Hawi, Nael; Liodakis, Emmanouil; Krettek, Christian; Stuebig, Timo

2017-08-11

We aimed to test whether a robotic technique would offer more accurate access to the proximal femoral medullary cavity for insertion of an intramedullary nail compared to the conventional manual technique. The medullary cavity of ten femur specimens was accessed in a conventional fashion using fluoroscopic control. In ten additional femur specimens, ISO-C 3D scans were obtained and a computer program calculated the ideal location of the cavity opening based on the trajectory of the medullary canal. In both techniques, the surgeon opened the cavity using a drill and inserted a radiopaque tube that matched the diameter of the cavity. The mean difference in angle between the proximal opening and the medullary canal in the shaft of the femur was calculated for both groups. Robotic cavity opening was more accurate than the manual technique, with a mean difference in trajectory between the proximal opening and the shaft canal of 2.0° (95% CI 0.6°-3.5°) compared to a mean difference of 4.3° (95% CI 2.11°-6.48°) using the manual technique (P = 0.0218). The robotic technique was more accurate than the manual procedure for identifying the optimal location for opening the medullary canal for insertion of an intramedullary nail. Additional advantages may include a reduction in total radiation exposure, as only one ISO-C 3D scan is needed, as opposed to multiple radiographs when using the manual technique.

[Finite element analysis of lumbar pelvic and proximal femur model with simulate lumbar rotatory manipulation].

Science.gov (United States)

Hu, Hua; Xiong, Chang-Yuan; Han, Guo-Wu

2012-07-01

To study the changes of displacement and stress in the model of lumbar pelvic and proximal femur during lumbar rotatory manipulation. The date of lumbar pelvic and proximal femur CT scan by Mimics 10.01 software was established a lumbar pelvic and proximal femur geometric model, then the model was modified with Geomagic 9, at last the modified model was imported into hypermesh 10 and meshed with tetrahedron, at the same time,add disc and ligaments. According to the principle of lumbar rotatory manipulation,the lumbar rotatory manipulation were decomposed. The mechanical parameters assigned into the three-dimensional finite element model. The changes of displacement and stress in the model of lunbar pelvic and proximal femur under the four conditions were calculated with Abaqus model of Hypermesh 10. 1) Under the same condition,the displacement order of lumbar was L1>L2>L3>L5 L5, anterior column > middle column > posterior column. 2) Under the different conditions, the displacement order of lumbar,case 3>case 1>case 4>case 2. 3) Under the same conditions, the displacement order of lumbar inter-vertebral disc from L1,2 to L5S1 was L1,2>L2,3>L3,4>L4,5>L5S1, as for the same inter-vertebral disc, the order was: second quadrant>third quadrant>first quadrant>fourth quadrant. 4) Under the different conditions,the displacement order of the inter-vertebral disc was L1,2>L2,3>L3,4>L4,5>L5S1, but to same inter-vertebral disc: case 3>case 4>case 1 >case 2. 5) There were apparent displacement and stress concentration in pelvis and hip during the manipulation. 1) The principles of lumbar rotation manipulation closely related to the relative displacement caused by rotation of various parts of lumbar pelvic and proximal femur model; 2) During the process of lumbar rotatory manipulation, the angle of lateral bending and flexion can not be randomly increased; 3) During the process of lumbar rotatory manipulation, all the conditions of lumbar pelvic and proximal femur must be

The difference between stretching and splitting muscle trauma during THA seems not to play a dominant role in influencing periprosthetic BMD changes.

Science.gov (United States)

Taylor, William R; Szwedowski, Tomasz D; Heller, Markus O; Perka, Carsten; Matziolis, Georg; Müller, Michael; Janshen, Lars; Duda, Georg N

2012-10-01

Periprosthetic bone adaptation in the proximal femur after total hip arthroplasty can result in reduced bone mineral density that may contribute to increased risk of aseptic loosening or fracture. Functional loading of the proximal femur postoperatively may depend upon the type of surgical muscle trauma - splitting or stretching - and is likely to influence the preservation of periprosthetic bone mineral. Since the maintenance of bone is known to be highly age and gender dependent, the aim of this study was to investigate the interplay between muscle trauma and age and gender influences on periprosthetic bone adaptation. Ninet y-three patients were consecutively recruited into either a transgluteal (splitting) or anterolateral (stretching) surgical approach and examined 7 days and 12 months after an elective primary hip arthroplasty (Zweymüller Alloclassic stem), using dual-energy X-ray absorptiometry measurements to quantify proximal femoral bone mineral density. The results indicate that neither gender, age nor surgical trauma type, but only the combination of age and gender, were significant predictors of postoperative remodelling rate, with younger men (role in influencing periprosthetic bone mineral changes. However, this data does suggest that certain patient populations may particularly benefit from muscle and bone preserving procedures. Copyright © 2012 Elsevier Ltd. All rights reserved.

Correlation between bone mineral density and oxidative stress in postmenopausal women

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Tripti Sharma

2015-01-01

Full Text Available Background: Postmenopausal osteoporosis affects large fraction of elderly women. Oxidative stress (OS appears to be involved in its pathogenesis. The scarcity of human studies focusing on the correlation between bone mineral density (BMD and OS in postmenopausal women has prompted us to study on this issue. Materials and Methods: We conducted a cross sectional study in 95 subjects, between 21-65 years of age, including postmenopausal osteoporotic females (n = 35, healthy postmenopausal females (n = 30 and healthy females in reproductive age group (n = 30. We measured serum antioxidant activity of superoxide dismutase (SOD, catalase, glutathione peroxidase (GPx, and total antioxidant power (TAP. BMD was obtained at lumbar spine and femur neck by dual-energy X-ray absorptiometry scan. Osteoporosis was considered when subjects had a BMD of 2.5 standard deviations or more below the mean value for young adults. Results: Serum GPx, SOD, catalase and TAP level were found significantly lower in osteoporotic postmenopausal group as compared to healthy postmenopausal women and women in healthy reproductive age group healthy reproductive women (P 0.005. Conclusion: These findings support that oxidative stress plays an important role in pathogenesis of postmenopausal osteoporosis. We did not find any significant association between BMD and serum level of antioxidants (P > 0.05. The failure to detect this association does not preclude the role of OS in osteoporosis because OS is complex and dynamic process.

A preclinical numerical assessment of a polyetheretherketone femoral component in total knee arthroplasty during gait

NARCIS (Netherlands)

Ruiter, L. de; Janssen, D.W.; Briscoe, A.; Verdonschot, N.J.

2017-01-01

BACKGROUND: Conventional total knee replacement designs show high success rates but in the long term, the stiff metal components may affect bone quality of the distal femur. In this study we introduce an all-polymer total knee replacement device containing a PEEK femoral component on an UHMWPE

Bone mineral content (bmc and bone mineral density (bmd in postmenopausal women formerly practising kayaking and fencing

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B Raczyńska

2003-06-01

Full Text Available The investigation was aimed at answering the following questions: 1 Can a prolonged career in sports associated with considerable training loads, in conjunction with other osteoporosis risk factors (both past and present, affect the bone mineral content (BMC and bone mineral density (BMD of the former female athletes in their postmenopausal period of life?, and 2 How does the present lifestyle of the tested women, including physical activity and diet (calcium intake, influence the preservation of the optimal bone mass in these subjects? The postmenopausal subjects recruited to the present study included 15 former athletes (ten kayakers and five fencers and 11 women who never actively engaged in sports (control group. BMC (g and BMD (g/cm2 were densitometrically determined in the lumbar segment (L2-L4 of the spine, and the bone stiffness coefficient was ultrasonically determined in calcaneus. The effects of the osteoporosis risk factors (both past and present were estimated from individual replies to the questionnaire inquiries about the past career in sports, present physical activity, gonadal dysfunctions (dysmenorrhoea during the career and the present need for hormonal supplementary treatment, and the current dietary patterns. The results indicate that mean BMC and BMD values detected in the former athletes did not differ significant from those obtained in the non-athlete, control women: the BMC values equalled to 54.5±10.5, 52.6±14.6, and 46.5±3.2 g in the kayakers, the fencers, and the control women, respectively, while the respective BMD values were 1.05±0.45, 0.96±0.66, and 1.08±0.58 g/cm2. The questionnaire-based studies showed that neither the former female athletes nor the non-athlete controls exhibited in the past longer (i.e., lasting more than three months periods of hormonal disorders (amenorrhoea. As assessed from the dietary intake, only in the former fencers the diet covered the demand for calcium in 100%. In conclusion

Bone mineral density changes after ovariectomy in rats as an osteopenic model : stepwise description of double dorso-lateral approach.

Science.gov (United States)

Park, Sung Bae; Lee, Yoon Jin; Chung, Chun Kee

2010-10-01

This study describes a method for inducing osteopenia using bilateral ovariectomy (OVX), which causes significant changes in bone mineral density (BMD) in rats. Twenty-five 10-week-old female Sprague Dawley rats were used. Five rats were euthanized after two weeks, and BMD was measured in their femora. The other 20 rats were assigned to one of two groups : a sham group (n = 10), which underwent a sham operation, and an OVX group (n = 10), which underwent bilateral OVX at 12 weeks of age. After six weeks, five rats from each group were euthanized, and BMD was measured in their femora. The same procedures were performed in the remaining rats form each group eight weeks later. The femur BMD was significantly lower in the six-week OVX group than in the six-week sham group, and in the eight-week OVX group than in the eight-week sham group. Bilateral OVX is a safe method for creating an osteopenic rat model. The significant decrease in BMD appears six weeks after bilateral OVX.

The bone mass density in men aged over 50 and its relation to the concentration of free and total testosterone in the blood serum

International Nuclear Information System (INIS)

Purzycka-Jazdon, A.; Lasek, W.; Serafin, Z.; Manysiak, S.

2003-01-01

As the mean length of life increases, osteoporosis affects a growing number of men and women, thus becoming an important medical and socioeconomic problem in many countries. Pathogenesis and the prevalence of the osteoporosis in women are well established, however, in men, they are still controversial. In this study, the bone mass density (BMD) of the lumbar spine was determined in 100 healthy men age 50-83, using quantitative computed tomography (QCT). Also, the total serum and free testosterone was measured. The mean BMD was 123.1I39.3 mg/cm 3 , and the values below a fracture threshold were noted in 39% of subjects. The mean concentration of total and free serum testosterone was 4.3I1.7 ng/ml and 6.2I3.7 pg/ml, respectively. There was a significant (p 3 , respectively). There was no correlation found between total testosterone and BMD. Results indicate that reduced bone mass density in males over 50 is as frequent as recently reported in females. Moreover, sex hormones seem to be related to osteoporosis development in men as well. (author)

A COMPARATIVE STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE VERSUS PROXIMAL FEMORAL NAILING IN THE MANAGEMENT OF COMMINUTED TROCHANTERIC AND SUBTROCHANTERIC FRACTURE

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Satish Koti

2016-11-01

Full Text Available BACKGROUND Fractures of proximal femur and hip are relatively common injuries in elderly individuals constituting 11.6% of total fractures. The latest implant for management of intertrochanteric fracture is Proximal Femoral Locking Compression Plate (PF-LCP. In this study, we compare the clinical outcome of fractures treated by proximal femoral nail with that of proximal femur locking compression plate. MATERIALS AND METHODS The present study consists of 24 elderly patients of peritrochanteric factures of femur satisfying the inclusion criteria who were treated with PF-LCP or PFN in Department of Orthopaedics, S.V.R.R.G.G.H, Tirupati, during a period between December 2013 to October 2015. RESULTS 24 cases were treated with PF-LCP or PFN in a randomised pattern who satisfied inclusion criteria. Intraoperative complication were found to be more with PF-LCP in contrast to PFN. Postoperative rehabilitation was easier with PFN though not statistically significant functional and anatomical outcomes were found to be better with PFN. CONCLUSION Both PFN and PF-LCP have good effectiveness in the treatment of intertrochanteric fractures with the lateral unsubstantial femoral wall in the elderly patients. Each has its own advantages and disadvantages. Further studies with large number of patients and long-term follow up is needed to determine the optimal implant for the internal fixation of comminuted pertrochanteric femoral fractures.

Trps1 differentially modulates the bone mineral density between male and female mice and its polymorphism associates with BMD differently between women and men.

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Lishi Wang

Full Text Available The objective of our study was to identify genetic factors that regulate bone mineral density (BMD in mice using well defined recombinant inbred strains. For this purpose we chose the BXD recombinant inbred (RI strains derived from progeny of the C57BL/6J (B6 and DBA/2J (D2 progenitor strains. We sampled both male and female mice (∼4 each of 46 strains at 3 months-of-age, measured their BMD, and conducted QTL mapping. The data were analyzed to identify candidates genes contained within the most significant quantitative trait locus (QTL. Evaluation of candidate genes included functional assessment, single nucleotide polymorphism (SNP genotyping and direct sequencing. We established that there was a QTL for BMD in males on chromosome 15 that has the impact larger than QTLs on all other chromosomes. The QTL on chromosome 15 was narrowed to a genomic region between 38 Mbp and 52 Mbp. By examining transcripts within this region, we found an important candidate gene: trichorhinophalangeal syndrome, type I (Trps1. SNP analysis identified a nonsynonymous SNP (rs32398060 in Trps1 that co-segregated with bone mineral density. Analysis of association between this SNP within TRPS1 and BMD in a human population confirmed its significance.

A preclinical numerical assessment of a polyetheretherketone femoral component in total knee arthroplasty during gait

NARCIS (Netherlands)

de Ruiter, Lennert; Janssen, Dennis W.; Briscoe, Adam; Verdonschot, Nico

2017-01-01

Background Conventional total knee replacement designs show high success rates but in the long term, the stiff metal components may affect bone quality of the distal femur. In this study we introduce an all-polymer total knee replacement device containing a PEEK femoral component on an UHMWPE tibial

Percutaneous Stabilization of Impending Pathological Fracture of the Proximal Femur

Energy Technology Data Exchange (ETDEWEB)

Deschamps, Frederic, E-mail: frederic.deschamps@igr.fr; Farouil, Geoffroy, E-mail: g.farouil@gmail.com; Hakime, Antoine, E-mail: thakime@yahoo.com; Teriitehau, Christophe, E-mail: cteriitehau@me.com; Barah, Ali, E-mail: ali.barah@gmail.com; Baere, Thierry de, E-mail: debaere@igr.fr [Institut Gustave Roussy, Interventional Radiology Department (France)

2012-12-15

Objective: Percutaneous osteosynthesis plus cementoplasty (POPC) is a minimally invasive technique that has never been reported before and that we have prospectively evaluated for patients with impending pathological fracture of the proximal femur. Methods: We performed POPC in 12 patients (3 males, 9 females) with metastasis of the proximal femur with a high risk of fracture (Mirels' score {>=}8) between February 2010 and July 2011. Patients were not candidates for standard surgical stabilization. We analyzed the feasibility, duration, and complication of the procedure, the risk of fracture, the decrease in pain (Visual Analog Scale, VAS), and length of stay in hospital. Data were prospectively collected in all patients. Results: The mean Mirels' score was 9.8 {+-} 1.2 (range, 8-11). The technical success was 100%. POPC was performed under general anesthesia (n = 6) or conscious sedation (n = 6). The mean duration was 110 {+-} 43 (range, 60-180) minutes. All patients stood up and walked the second day after the procedure. The average length of stay in the hospital was 4 {+-} 1.6 (range, 2-7) days. We experienced two hematomas in two patients and no thromboembolic complication. For symptomatic patients (n = 8), VAS decreased from 6.5/10 (range, 2-9) before treatment to 1/10 (range, 0-3) 1 month after. No fracture occurred after a median follow-up of 145 (range, 12-608) days. Conclusions: POPC for impending pathological fracture of the proximal femur seems to be a promising alternative for cancer patients who are not candidates for surgical stabilization. Further studies are required to confirm this preliminary experience.

Percutaneous Stabilization of Impending Pathological Fracture of the Proximal Femur

International Nuclear Information System (INIS)

Deschamps, Frederic; Farouil, Geoffroy; Hakime, Antoine; Teriitehau, Christophe; Barah, Ali; Baere, Thierry de

2012-01-01

Objective: Percutaneous osteosynthesis plus cementoplasty (POPC) is a minimally invasive technique that has never been reported before and that we have prospectively evaluated for patients with impending pathological fracture of the proximal femur. Methods: We performed POPC in 12 patients (3 males, 9 females) with metastasis of the proximal femur with a high risk of fracture (Mirels’ score ≥8) between February 2010 and July 2011. Patients were not candidates for standard surgical stabilization. We analyzed the feasibility, duration, and complication of the procedure, the risk of fracture, the decrease in pain (Visual Analog Scale, VAS), and length of stay in hospital. Data were prospectively collected in all patients. Results: The mean Mirels’ score was 9.8 ± 1.2 (range, 8–11). The technical success was 100%. POPC was performed under general anesthesia (n = 6) or conscious sedation (n = 6). The mean duration was 110 ± 43 (range, 60–180) minutes. All patients stood up and walked the second day after the procedure. The average length of stay in the hospital was 4 ± 1.6 (range, 2–7) days. We experienced two hematomas in two patients and no thromboembolic complication. For symptomatic patients (n = 8), VAS decreased from 6.5/10 (range, 2–9) before treatment to 1/10 (range, 0–3) 1 month after. No fracture occurred after a median follow-up of 145 (range, 12–608) days. Conclusions: POPC for impending pathological fracture of the proximal femur seems to be a promising alternative for cancer patients who are not candidates for surgical stabilization. Further studies are required to confirm this preliminary experience.

Rehabilitation after proximal femur surgery in the elderly

OpenAIRE

Holečková, Kristýna

2017-01-01

of thesis This thesis deals with physiotherapy after proximal femur surgery in elderly people. The aim of the thesis is to show the particularities of physiotherapy for elderly people and to determine the influence of nutritional status on the progress and outcome of physiotherapy. The thesis is divided into theoretical and practical part. The theoretical part is focused on old age period, and changes associated with aging, geriatric physiotherapy and its components, namely classical physioth...

Effects of chronic lead exposure on bone mineral properties in femurs of growing rats.

Science.gov (United States)

Álvarez-Lloret, Pedro; Lee, Ching Ming; Conti, María Inés; Terrizzi, Antonela Romina; González-López, Santiago; Martínez, María Pilar

2017-02-15

Lead exposure has been associated with several defective skeletal growth processes and bone mineral alterations. The aim of the present study is to make a more detailed description of the toxic effects of lead intoxication on bone intrinsic material properties as mineral composition, morphology and microstructural characteristics. For this purpose, Wistar rats were exposed (n=12) to 1000ppm lead acetate in drinking water for 90days while control group (n=8) were treated with sodium acetate. Femurs were examined using inductively coupled plasma optical emission spectrometry (ICP-OES), Attenuated Total Reflection Fourier transform infrared spectroscopy (ATR-FTIR), X-ray diffraction (XRD), and micro-Computed Tomography (μCT). Results showed that femur from the lead-exposed rats had higher carbonate content in bone mineral and (Ca 2+ +Mg 2+ + Na + )/P ratio values, although no variations were observed in crystal maturity and crystallite size. From morphological analyses, lead exposure rats showed a decreased in trabecular bone surface and distribution while trabecular thickness and cortical area increased. These overall effects indicate a similar mechanism of bone maturation normally associated to age-related processes. These responses are correlated with the adverse actions induced by lead on the processes regulating bone turnover mechanism. This information may explain the osteoporosis diseases associated to lead intoxication as well as the risk of fracture observed in populations exposed to this toxicant. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Evaluation of bone repair in the femur of rats submitted to laser therapy in different wavelengths: An image segmentation method of analysis

Science.gov (United States)

Queiroga, A. S.; Sousa, F. B.; Araújo, J. M. S.; Santos, S. D.; Sousa, C. D'f. S.; Quintans, T. C.; Almeida, T. P.; Nonaka, C. F. W.; Batista, L. V.; Limeira Junior, F. A.

2008-09-01

The aim of this study was to histologically assess the effect of laser therapy (LILT, 660 and 780 nm) on the repair of standardized bone defects on the femur of Wistar albinus rats. The sample was composed of 12 Wistar albinus young adult rats of both genders. Three randomized groups were studied: group I (control, n = 4), group II (LILT, 660 nm, n = 4), and group III (LILT, 780 nm, n = 4). Samples were prepared using a bone defect on the left-side femur surface of the animals, with a total dimension of approximately 3 mm3. Groups II and III were irradiated every 48 h from the second application, where the first dose was given immediately after surgery and the second application came 24 h after surgery. The irradiations were applied transcutaneously at four points around the wound for 14 days. At each point, a dose of 50 J/cm2 (2 J) was given ( s ˜ 0.04 cm2, 40 mW) and the total dose per session was 200 J/cm2 (8 J). The sacrifices were made 15 days after surgery and the specimens were routinely processed to wax, serially cut, stained with an H&E stain, and analyzed under light microscopy. The images were submitted to morphometric analysis using the image segmentation method using the K-means algorithm. The data obtained through the morphometric analysis were submitted to statistical analysis using the Tukey test. The results showed that the group treated with laser therapy in the infrared spectrum resulted in an increase in the repair of bone defects when compared with the group treated with the laser in the red spectrum and control group, which, in turn, had a very similar pattern of repair. A statistical significance ( p spectrum produced a positive biomodulation effect on the repair of bone defects in the femur of rats.

Subtrochanteric Femur Fractures in an Irish Trauma Centre over 9 years: How the Impact of Hospital Coding on Diagnosis of Subtrochanteric Femur Fractures Leads to Inaccurate Occurrence Rates

LENUS (Irish Health Repository)

Coveney, EI

2018-06-01

Our aim was to assess the occurrence rates of subtrochanteric femur fractures in an orthopaedic tertiary referral centre and to assess the correlation of patient’s actual diagnosis with national hospital inpatient enquiry data.

Bone mineral density and content during weight cycling in female rats: effects of dietary amylase-resistant starch

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Jagpal Sugeet

2008-11-01

Full Text Available Abstract Background Although there is considerable evidence for a loss of bone mass with weight loss, the few human studies on the relationship between weight cycling and bone mass or density have differing results. Further, very few studies assessed the role of dietary composition on bone mass during weight cycling. The primary objective of this study was to determine if a diet high in amylase-resistant starch (RS2, which has been shown to increase absorption and balance of dietary minerals, can prevent or reduce loss of bone mass during weight cycling. Methods Female Sprague-Dawley (SD rats (n = 84, age = 20 weeks were randomly assigned to one of 6 treatment groups with 14 rats per group using a 2 × 3 experimental design with 2 diets and 3 weight cycling protocols. Rats were fed calcium-deficient diets without RS2 (controls or diets high in RS2 (18% by weight throughout the 21-week study. The weight cycling protocols were weight maintenance/gain with no weight cycling, 1 round of weight cycling, or 2 rounds of weight cycling. After the rats were euthanized bone mineral density (BMD and bone mineral content (BMC of femur were measured by dual energy X-ray absorptiometry, and concentrations of calcium, copper, iron, magnesium, manganese, and zinc in femur and lumbar vertebrae were determined by atomic absorption spectrophotometry. Results Rats undergoing weight cycling had lower femur BMC (p 2 had higher femur BMD (p 2-fed rats also had higher femur calcium (p Conclusion Weight cycling reduces bone mass. A diet high in RS2 can minimize loss of bone mass during weight cycling and may increase bone mass in the absence of weight cycling.

Periacetabular Bone Mineral Density Changes After Resurfacing Hip Arthroplasty Versus Conventional Total Hip Arthroplasty. A Randomized Controlled DEXA Study

NARCIS (Netherlands)

Smolders, J.M.H.; Pakvis, D.F.; Hendrickx, B.W.; Verdonschot, Nicolaas Jacobus Joseph; van Susante, J.L.C.

2013-01-01

A randomized controlled trial was performed to evaluate acetabular bone mineral density (BMD) changes after hip resurfacing (RHA) versus an established conventional total hip arthroplasty (THA). A total of 71 patients were allocated randomly to receive either an RHA press-fit cobalt–chromium cup (n

Effect of zoledronic acid on bone density and markers of bone turnover in a community clinic.

Science.gov (United States)

Lim, Ria; Zailskas, Susan; Goldsby, Tashauna U; Lukens, Carrie; Muravev, Rostislav; Dulipsingh, Latha

2013-01-01

This study aims to document the efficacy of zoledronic acid by comparing bone densities and markers of bone turnover, in patients with osteoporosis. Bone mineral density (BMD) and urinary N-telopeptide, a marker of bone turnover, were compared before and after treatment with intravenous zoledronic acid. 52 participants had atleast two doses of zoledronic acid over 36 months. Significant increases in BMD were found in the spine (t=4.38, Pturnover marker N-telopeptide (t=3.30, P=0.002). Small but significant correlations were determined between prior steroid use and change in BMD in the spine (r=0.35, P<0.05), and family history of osteoporosis and change in BMD in the right femur (r=0.38, P<0.05). Annual infusions of zoledronic acid for at least two years, revealed a significant increase in bone density at the spine and a decrease in urinary N-telopeptide in patients treated at our center.

Patient Doses and Risk Evaluation in Bone Mineral Densitometry

International Nuclear Information System (INIS)

Angelucci, M.; Borio, R.; Chiocchini, S.; Degli Esposti, P.; Dipilato, A.C.; Policani, G.

1999-01-01

The aim of this work was to evaluate the equipment dose to the organs and tissues and the effective dose of patients undergoing the most frequent examinations carried out in bone mineral densitometry (BMD): lumbar spine and femur. Experimental measurements of absorbed doses on a Rando phantom, allow comparison of the performances of three different photon emitter facilities. The comparison of the entrance and exit doses measured on a Rando phantom and on 50 female non-obese patients show that entrance doses on Rando can be used as 'diagnostic reference levels' for patients. A quantitative estimate of the stochastic risk due to BMD procedures was made: the results obtained show that the stochastic risk is very low and that the BMD is, at present, the most confirmed procedure for osteoporosis diagnosis and management. (author)

Comparison of two interpolation methods for empirical mode decomposition based evaluation of radiographic femur bone images.

Science.gov (United States)

Udhayakumar, Ganesan; Sujatha, Chinnaswamy Manoharan; Ramakrishnan, Swaminathan

2013-01-01

Analysis of bone strength in radiographic images is an important component of estimation of bone quality in diseases such as osteoporosis. Conventional radiographic femur bone images are used to analyze its architecture using bi-dimensional empirical mode decomposition method. Surface interpolation of local maxima and minima points of an image is a crucial part of bi-dimensional empirical mode decomposition method and the choice of appropriate interpolation depends on specific structure of the problem. In this work, two interpolation methods of bi-dimensional empirical mode decomposition are analyzed to characterize the trabecular femur bone architecture of radiographic images. The trabecular bone regions of normal and osteoporotic femur bone images (N = 40) recorded under standard condition are used for this study. The compressive and tensile strength regions of the images are delineated using pre-processing procedures. The delineated images are decomposed into their corresponding intrinsic mode functions using interpolation methods such as Radial basis function multiquadratic and hierarchical b-spline techniques. Results show that bi-dimensional empirical mode decomposition analyses using both interpolations are able to represent architectural variations of femur bone radiographic images. As the strength of the bone depends on architectural variation in addition to bone mass, this study seems to be clinically useful.

Transplantation of human neonatal foreskin stromal cells in ex vivo organotypic cultures of embryonic chick femurs

DEFF Research Database (Denmark)

Aldahmash, Abdullah; Vishnubalaji, Radhakrishnan

2017-01-01

NSSCs in ex vivo organotypic cultures of embryonic chick femurs. Isolated embryonic chick femurs (E10 and E11) were cultured for 10 days together with micro-mass cell pellets of hNSSCs, human umbilical vein endothelial cells (HUVEC) or a combination of the two cell types. Changes in femurs gross morphology......We have previously reported that human neonatal foreskin stromal cells (hNSSCs) promote angiogenesis in vitro and in chick embryo chorioallantoic membrane (CAM) assay in vivo. To examine the in vivo relevance of this observation, we examined in the present study the differentiation potential of h......NSSC + HUVEC cultures. Our data suggest that organotypic cultures can be employed to test the differentiation potential of stem cells and demonstrate the importance of stem cell interaction with 3D-intact tissue microenvironment for their differentiation....

Locking plate and fibular strut-graft augmentation in the reconstruction of unicameral bone cyst of proximal femur in the paediatric population.

Science.gov (United States)

Jamshidi, Khodamorad; Mirkazemi, Masoud; Izanloo, Azra; Mirzaei, Alireza

2018-01-01

Several therapeutic strategies have been used for managing unicameral bone cyst (UBC) of the proximal femur. However, there is insufficient evidence to support one treatment over another, and the optimal treatment is controversial. This study aims at describing our experience with surgical reconstruction of paediatric UBCs of the proximal femur using a proximal locking plate and fibular strut allograft. In total, 14 consecutive paediatric patients with Dormans types IB (four cases) and IIB (10 cases) UBC were assessed. Mean patient age was 8.6 ± 2.3 years, and mean follow-up period was 41.7 ± 29.8 months. Six patients (42.8%) were referred with a pathologic fracture. Clinical/radiological outcome and complication rates were evaluated at the final follow-up session. No cysts were Capanna's class III (recurrence) or IV (no response). Complete healing (Capanna's class I) was seen in ten cysts, while four other cysts healed with residual radiolucent areas (Capanna's class II). Mean healing period was 14.1 ± 5.1 (9-24 months). One patient had superficial infection, one heterotopic ossification, and one mild coxa vara, and mean Musculoskeletal Tumor Society (MSTS) score was 99.5%. According to our results, locking plate and fibular strut graft in Dormans classification types IB and IIB results in a favorable outcome in managing UBC of the proximal femur in the paediatric population.

Indicators for the total duration of premenopausal endogenous estrogen exposure in relation to BMD

NARCIS (Netherlands)

Hagemans, M.L.C.; Schouw, van der Y.T.; Kleijn, de M.J.J.; Staveren, van W.A.; Pop, V.J.M.; Leusink, G.L.; Grobbee, D.E.

2004-01-01

BACKGROUND: Previous studies have shown that age at menopause is an important indicator of duration of endogenous estrogen exposure. The present study investigates whether combining more information on reproductive factors is useful in estimating individual total duration of exposure to endogenous

Adverse Effects of Caffeine on Development of Femur of BALB/c Mice and Protective Role of Vitamin D/sub 3/

International Nuclear Information System (INIS)

Khan, M.; Butt, S. A.

2017-01-01

Objective: To determine the effects of caffeine ingestion on the development of femur and role of vitamin D3 in preventing these effects in BALB/c mice. Study Design: Experimental study. Place and Duration of Study: Department of Anatomy, Army Medical College, Rawalpindi, in cooperation with NIH(National Institute of Health), Islamabad, from October 2014 to October 2015. Methodology: Thirty (100%) BALB/c mice, 50% male and female each, three weeks old, weighing 12-14 grams were taken and divided equally and randomly into three groups, each having 10 (33.3%) mice; 5 (16.6%) male and female. G1 (control group) was given normal diet with water ad libitum. G2 and G3 (experimental groups) were given 10 mg of caffeine per 100g body weight, three days a week, through oral gavage for 60 days on alternate days. However, experimental group G3 was additionally provided 0.1 micro g vitamin D3 daily, through oral gavage for 60 days. Experimental groups were compared with control group and data was analyzed statistically. Results: The mean weight of mice femur of G1(control group) was 0.387+-0.019 g; while mean weights of right femur of G2 and G3 (experimental groups) were 0.316+-0.020 g and 0.345+-0.020 g, respectively. Similarly, mean right femur length of group G1 was 20.70 +- 0.609 mm; while for groups G2 and G3, it was 24.382 +- 1.087 mm and 22.966 +- 0.822 mm, respectively. In comparison with group G1 for groups G2 and G3, femur weight decreased, however femur length increased. Conclusion: Caffeine intake caused femur length to increase and weight to decrease, but treatment with vitamin D3 ameliorated these effects of caffeine. (author)

Damage characterization on human femur bone by means of ultrasonics and acoustic emission

International Nuclear Information System (INIS)

Strantza, M; Boulpaep, F; Van Hemelrijck, D; Aggelis, D G; Polyzos, D; Louis, O

2015-01-01

Human bone tissue is characterized as a material with high brittleness. Due to this nature, visible signs of cracking are not easy to be detected before final failure. The main objective of this work is to investigate if the acoustic emission (AE) technique can offer valuable insight to the fracture process of human femur specimens as in other engineering materials characterization. This study describes the AE activity during fracture of whole femur bones under flexural load. Before fracture, broadband AE sensors were used in order to measure parameters like wave velocity dispersion and attenuation. Waveform parameters like the duration, rise time and average frequency, were also examined relatively to the propagation distance as a preparation for the AE monitoring during fracture. After the ultrasonic study, the samples were partly cast in concrete and fixed as cantilevers. A point load was applied on the femur head, which due to the test geometry resulted in a combination of two different patterns of fracture, bending and torsion. Two AE broadband sensors were placed in different points of the sample, one near the fixing end and the other near the femur head. Preliminary analysis shows that parameters like the number of acquired AE signals and their amplitude are well correlated with the load history. Furthermore, the parameters of rise time and frequency can differentiate the two fracture patterns. Additionally, AE allows the detection of the load at the onset of fracture from the micro-cracking events that occur at the early loading stages, allowing monitoring of the whole fracture process. Parameters that have been used extensively for monitoring and characterization of fracture modes of engineering materials seem to poses characterization power in the case of bone tissue monitoring as well. (paper)

Metallographic examination of a failed Jewett nail-plate from a human femur

International Nuclear Information System (INIS)

Gray, R.J.; Zirkel, L.G. Jr.

1976-01-01

A type 316L wrought stainless steel Jewett nail-plate is one of several implant designs for bridging fractures in the proximal end of the femur. A soldier received a high velocity projectile in the trochanteric region of the femur. He was treated for a subtrochanteric fracture and greater trochanteric bone loss. After 9 months, hip varus angulation was progressively increasing. A Jewett nail-plate was inserted after valgus osteotomy and bone grafting of the unhealed fracture. The nail-plate fractured three weeks after surgery. Optical and scanning electron microscopy related the origin of failure to an impactor failure and subsequent microscopic scoring of the nail-plate during insertion into the abnormally hard femoral head. Photomicrographs showing the implant failure and evidences of corrosion after the short time in the body are presented. 12 figs

operative treatment of primary bone tumours of the femur and the tibia

African Journals Online (AJOL)

can cause infection, pseudoarthrosis and pathological fracture. Objective: The purpose of ... after several re-surgeries. Key words: Bone tumour, Femur, Tibia, Resection, Allograft .... stress, the length of the graft, the realization of an arthrodesis ...

Delayed bone regeneration and low bone mass in a rat model of insulin-resistant type 2 diabetes mellitus is due to impaired osteoblast function.

Science.gov (United States)

Hamann, Christine; Goettsch, Claudia; Mettelsiefen, Jan; Henkenjohann, Veit; Rauner, Martina; Hempel, Ute; Bernhardt, Ricardo; Fratzl-Zelman, Nadja; Roschger, Paul; Rammelt, Stefan; Günther, Klaus-Peter; Hofbauer, Lorenz C

2011-12-01

Patients with diabetes mellitus have an impaired bone metabolism; however, the underlying mechanisms are poorly understood. Here, we analyzed the impact of type 2 diabetes mellitus on bone physiology and regeneration using Zucker diabetic fatty (ZDF) rats, an established rat model of insulin-resistant type 2 diabetes mellitus. ZDF rats develop diabetes with vascular complications when fed a Western diet. In 21-wk-old diabetic rats, bone mineral density (BMD) was 22.5% (total) and 54.6% (trabecular) lower at the distal femur and 17.2% (total) and 20.4% (trabecular) lower at the lumbar spine, respectively, compared with nondiabetic animals. BMD distribution measured by backscattered electron imaging postmortem was not different between diabetic and nondiabetic rats, but evaluation of histomorphometric indexes revealed lower mineralized bone volume/tissue volume, trabecular thickness, and trabecular number. Osteoblast differentiation of diabetic rats was impaired based on lower alkaline phosphatase activity (-20%) and mineralized matrix formation (-55%). In addition, the expression of the osteoblast-specific genes bone morphogenetic protein-2, RUNX2, osteocalcin, and osteopontin was reduced by 40-80%. Osteoclast biology was not affected based on tartrate-resistant acidic phosphatase staining, pit formation assay, and gene profiling. To validate the implications of these molecular and cellular findings in a clinically relevant model, a subcritical bone defect of 3 mm was created at the left femur after stabilization with a four-hole plate, and bone regeneration was monitored by X-ray and microcomputed tomography analyses over 12 wk. While nondiabetic rats filled the defects by 57%, diabetic rats showed delayed bone regeneration with only 21% defect filling. In conclusion, we identified suppressed osteoblastogenesis as a cause and mechanism for low bone mass and impaired bone regeneration in a rat model of type 2 diabetes mellitus.

Association between serum 25-hydroxyvitamin D levels and bone mineral density in normal postmenopausal women

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Vasundhara Kamineni

2016-01-01

Full Text Available Aim: This study was conducted with the objective of assessing serum 25-hydroxyvitamin D (25(OHD in postmenopausal women (PMW, to detect osteopenia or osteoporosis in PMW and to establish a correlation between serum 25(OHD levels and bone mineral density (BMD. Materials and Methods: A total of 100 healthy PMW were selected, and a prospective observational study was conducted to correlate the BMD with serum 25(OHD levels. Their laboratory investigations along with serum 25(OHD levels were done. Their BMD was assessed with dual-energy X-ray absorptiometry at lumbar spine and neck of femur; T-scores were derived. Correlation analysis was done to investigate the relationship between serum 25(OHD levels and BMD. Results: The proportion of osteoporosis at the hip was 31.9% in deficient group, 16.1% in insufficient, and 18.2% in sufficient group and at lumbar spine, it was 27.7%, 16.1%, and 22.7%, respectively. Forty-seven percent of PMW had deficient (<20 ng/ml serum 25(OHD levels and 31% had insufficiency. T-score at hip in deficient group was −2.05 ± 0.25, and in an insufficient group, it was −1.79 ± 0.13; T-score at lumbar spine was −1.92 ± 0.12 and −1.79 ± 0.12, respectively, but both were not statistically significant. Osteoporosis was seen in 24%, osteopenia in 55% at hip level and 23% and 59% respectively at lumbar spine. There was no association between serum 25(OHD levels and BMD neither at hip nor at lumbar spine ( P = 0.51 and P = 0.79 respectively. Conclusion: In this study, among our cohort of patients there was no correlation between serum 25(OHD levels and BMD. However, Vitamin D deficiency coexists with low BMD. Vitamin D insufficiency is a common risk factor for osteoporosis associated with increased bone remodeling and low bone mass.

EE.UU. y el debate del sistema de defensa estratégica BMD

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David García

2008-05-01

Full Text Available Este artículo analiza el desarrollo por parte de EE.UU. de un sistema de defensa estratégica contra misiles balísticos (BMD, en el contexto de la crítica al concepto de disuasión nuclear tras la Guerra Fría y de la política de seguridad y defensa de la Administración Bush. En las conclusiones, se relacionan estas capacidades con la política espacial estadounidense y la creación de sistemas de defensa basados en el espacio.

Evaluation of osteoporosis using conventional radiographic methods and dual energy x-ray absorptiometry

International Nuclear Information System (INIS)

Anburajan, M.

2001-01-01

In India, conventional radiographs play a major part in evaluating osteoporosis since advanced bone densitometers are expensive and not widely available. Our aim in this study was to investigate the usefulness of conventional radiographic methods, viz., clavicle and metacarpal radiogrammetry, quantitative vertebral morphometry, Singh's index, hip geometry compared to a sophisticated method, viz., DXA for studying osteoporosis in south Indian men (n=663) and women (n=741). This study provides data on BMD of the proximal femur in normal south Indian females. In women, aged above 65 years, BMD of femoral neck, trochanter, and Ward's triangle decreased by 0.90%, 0.84%, and 1.66% per annum, respectively. In 45 pre- and post-menopausal women without fractures, total hip BMD correlated significantly ( p 2 =0.47), medial cortical thickness of the femoral shaft (r 2 =0.38) and neck (r 2 =0.29), combined cortical thickness (CCT) and %CCT of the clavicle (r 2 =0.54 each), and the second metacarpal (r 2 =0.51 and r 2 =0.53, respectively). On comparing variables studied for osteoporotic women with corresponding values in the premenopausal group, the average difference in SD from the mean was greatest for clavicle radiogrammetry (-3.7 SD for %CCT of the clavicle). An empirical formula for predicting total hip BMD with good sensitivity was derived from a multiple linear regression equation involving three independent variables, viz., CCT, %CCT of the clavicle (measured from the chest radiograph) and the patient's age. This author's equation, with modified weightings, has 82% sensitivity and 94% specificity and a positive and negative predictive value of 88% and 91% respectively. A chest radiograph in combination with the formula would serve as a readily available, inexpensive tool for assessing post-menopausal osteoporosis, especially in developing countries

Association between childhood atopic dermatitis, malnutrition, and low bone mineral density: a US population-based study.

Science.gov (United States)

Silverberg, Jonathan I

2015-02-01

Children with atopic dermatitis (AD) have multiple risk factors for low bone mineral density (BMD). We analyzed data from 3049 children and adolescents aged 8-19 yrs from the 2005-2006 National Health and Nutrition Examination Survey, including a cross-sectional questionnaire, dual energy X-ray absorptiometry, and blood samples. In multivariate models that controlled for age, sex, race/ethnicity, level of education and household income, body mass index (BMI), and smoking in the household, AD was associated with lower BMD z-score for the total femur (survey linear regression; adjusted β [95% CI]: -0.42 [0.68, -0.16]), including trochanter (-0.29 [-0.54, -0.05]) and femoral neck (-0.29 [-0.53, -0.05]) and total lumbar spine (-0.31 [-0.52, -0.11]). Children with AD had higher median levels of serum IgE (110.0 vs. 53.0 kU/l), peripheral lymphocyte (2.9 vs. 2.5 × 10(3) cells/μl), and eosinophil counts (0.3 vs. 0.2 × 10(3) cells/μl) (Mann-Whitney U-test, p ≤ 0.003 for all), but not CRP levels (0.03 vs. 0.04 mg/dl) and higher odds of 25-OH vitamin D deficiency (survey logistic regression; odds ratio [OR] [95% CI]: 4.81 [1.21, 20.81]), low calcium (2.56 [1.24, 5.28]), low alkaline phosphatase (2.56 [1.20, 5.44]), and higher tertiles of LDH (tertile 2: 6.36 [1.75, 23.18]; tertile-3: 4.57 [1.32, 15.85]), but not parathyroid hormone (PTH) or albumin. Finally, children with AD had higher rates of low BMD, that is, BMD z-score malnutrition and Hispanic ethnicity. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Simultaneous existence of unicameral bone cysts involving the femur and ischium].

Science.gov (United States)

Makris, Vassilios; Papavasiliou, Kyriakos A; Bobos, Mattheos; Hytiroglou, Prodromos; Kirkos, John M; Kapetanos, George A

2009-01-01

We report a 30-year-old male patient with two unicameral bone cysts (UBC) simultaneously located in the proximal third of the right femur and ipsilateral ischium ramus, respectively. Fine needle biopsies were attempted for both lesions. Biopsy of the femoral lesion under local anesthesia was unsuccessful, so an open biopsy was performed which confirmed the diagnosis of UBC. Biopsy of the ischial lesion was not sufficient for diagnosis. Cytological examination of both specimens showed no other benign or malignant pathology. The femoral lesion was treated with intralesional (due to its large size) excision-curettage, bone grafting, and the introduction of a long gamma locking intramedullary nail to prevent the occurrence of a pathological fracture. The ischial lesion was left untreated and followed conservatively. The patient was free of any symptoms and complications three years postoperatively. This is the first report of an adult patient with UBCs simultaneously located both in a long tubular bone (femur) and a flat bone (ischium ramus).

Morphometric Evaluation of Korean Femurs by Geometric Computation: Comparisons of the Sex and the Population

Directory of Open Access Journals (Sweden)

Ho-Jung Cho

2015-01-01

Full Text Available We measured 28 parameters of 202 femurs from Koreans by an automated geometric computation program using 3D models generated from computed tomography images. The measurement parameters were selected with reference to physical and forensic anthropology studies as well as orthopedic implant design studies. All measurements were calculated using 3D reconstructions on a computer using scientific computation language. We also analyzed sex and population differences by comparison with data from previous studies. Most parameters were larger in males than in females. The height, head diameter, head center offset, and chord length of the diaphysis, most parameters in the distal femur, and the isthmic width of the medullary canal were smaller in Koreans than in other populations. However, the neck-shaft angle, subtense, and width of the intercondylar notch in the distal femur were larger than those in other populations. The results of this study will be useful as a reference for physical and forensic anthropology as well as the design of medical devices suitable for Koreans.

A seasonal variation of calcitropic hormones, bone turnover and bone mineral density in early and mid-puberty girls - a cross-sectional study

DEFF Research Database (Denmark)

Viljakainen, H.T.; Palssa, A.; Karkkainen, M.

2006-01-01

-six girls, mean age 11 center dot 4 (sd 0 center dot 4) years, in Tanner stage 2 (early puberty) and 3 (mid-puberty) were studied during September to March. The BMD was measured from the lumbar vertebrae and the left femur by dual-energy X-ray absoptiometry. Their serum 25-hydroxyvitamin D (S-25-OHD), serum...

Mortality and morbidity in elderly patients with fracture neck of femur treated by hemi arthroplasty

International Nuclear Information System (INIS)

Ahmad, I.

2006-01-01

To determine mortality and morbidity in elderly patients with fracture neck of femur treated by hemiarthroplasty (Austin Moore Prosthesis) during one year postoperatively. During the study period, all patients with fracture neck of femur, who were 65 years of age or above and treated by Austin Moore Prosthesis (AMP), were included. The patients were followed for one year at intervals of 2 weeks, 4 weeks, 6 months, and one year. All surviving patients were assessed for complications, both general and mechanical, related to the implant. The mortality and morbidity were compared for various age subgroups, and in patients with and without systemic co-morbidities.Chi square test was applied to see the significance of results. The total number of patients was 46 with average age of 70 years. Male to female ratio was 1:2. There were 70% patients who had one or more associated systemic disease. The mortality at 2 weeks was 4.3%, 17.4% at 6 months and 26% at one year. The overall dislocation rate was 4.3%. Two patients had infection and 17.4% patients had thigh pain at one year. The mortality and morbidity was high in patients with systemic comorbidities, and those above 70 years of age, but this was statistically not significant (p value >0.05). The functional assessment of surviving patients at one year was graded as excellent or good in 76.4% of patients. (author)

[Remodeling simulation of human femur under bed rest and spaceflight circumstances based on three dimensional finite element analysis].

Science.gov (United States)

Yang, Wenting; Wang, Dongmei; Lei, Zhoujixin; Wang, Chunhui; Chen, Shanguang

2017-12-01

Astronauts who are exposed to weightless environment in long-term spaceflight might encounter bone density and mass loss for the mechanical stimulus is smaller than normal value. This study built a three dimensional model of human femur to simulate the remodeling process of human femur during bed rest experiment based on finite element analysis (FEA). The remodeling parameters of this finite element model was validated after comparing experimental and numerical results. Then, the remodeling process of human femur in weightless environment was simulated, and the remodeling function of time was derived. The loading magnitude and loading cycle on human femur during weightless environment were increased to simulate the exercise against bone loss. Simulation results showed that increasing loading magnitude is more effective in diminishing bone loss than increasing loading cycles, which demonstrated that exercise of certain intensity could help resist bone loss during long-term spaceflight. At the end, this study simulated the bone recovery process after spaceflight. It was found that the bone absorption rate is larger than bone formation rate. We advise that astronauts should take exercise during spaceflight to resist bone loss.

A case of monostotic fibrous dysplasia of proximal femur managed with curettage and cortical bone grafting

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A D Sud

2013-01-01

Full Text Available We present a case report of a young military personnel with monostotic fibrous dysplasia of proximal femur with painful, dysplasticlesion of the femoral neck and fatigue fracture who underwent cortical bone grafting using autogenous fibular strut graft and iliac crest bone graft. The fibular cortical grafts was used to bridge the lesion in the femoral neck and were securely anchored to the normal bone of the lateral femoral cortex and a head of the femur. No supplemental internal fixation was required.

Indomethacin induced avascular necrosis of head of femur

Science.gov (United States)

Prathapkumar, K; Smith, I; Attara, G

2000-01-01

Chemically induced avascular necrosis of bone is a well documented entity. Indomethacin is one of the causes of this condition but is often difficult to recognise. Review of the literature shows that only one case of indomethacin induced avascular necrosis has been reported in the English language between 1966 and the present.
The case of a young healthy man, who developed avascular necrosis of head of femur after prolonged administration of indomethacin, is reported here.


Keywords: indomethacin; avascular necrosis PMID:10964124

Adaptive Bone Remodeling of the Femoral Bone After Tumor Resection Arthroplasty With an Uncemented Proximally Hydroxyapatite-Coated Stem

DEFF Research Database (Denmark)

Andersen, Mikkel R.; Petersen, Michael M.

2016-01-01

-fluted 125-mm uncemented press-fit titanium alloy stem with hydroxyapatite coating of the proximal part of the stem. Measurements of bone mineral density (BMD; g/cm2) were done postoperatively and after 3, 6, and 12 mo in the part of the femur bone containing the Global Modular Replacement System stem using...... of 8%-9% during the first postoperative year was seen along the femoral stem, but in the bone containing the hydroxyapatite-coated part of the stem, the decrease in BMD was 14%, thus indicating that stress shielding of this part of the bone may play a role for the adaptive bone remodeling....

Bone mineral density, muscle strength and physical activity. A population-based study of 332 subjects aged 15-42 years.

Science.gov (United States)

Düppe, H; Gärdsell, P; Johnell, O; Nilsson, B E; Ringsberg, K

1997-04-01

The aim of this population-based study was to find out whether differences in levels of physical activity have an influence on bone mass quantity and whether quadriceps muscle strength is a reliable determinant of bone mass. Included were 175 men and 157 women, aged 15-42 years. Bone mineral density (BMD) was measured at various sites by dual X-ray absorptiometry (DXA) and single photon absorptiometry (SPA). Muscle strength was assessed using an isokinetic muscle force meter. A questionnaire was used to estimate the level of physical activity. We found a positive correlation between physical activity and BMD for boys at the distal forearm and for girls at the trochanter (age group 15-16 years). Active men (age group 21-42 years) had up to 9% higher BMD levels at the hip than those who were less active. Quadriceps muscle torque was not an independent predictor of BMD. Our data suggest that a higher level of physical activity-within the limits of a "normal life style"-may have a positive effect on BMD in the proximal femur of young adults, which in turn may lessen the subsequent risk of fracture.

[Different strength intermittent treadmill training of growth period rats and related bone metabolism of the hormone influence].

Science.gov (United States)

Xie, Shun-cheng; Ma, Xue-jun; Guo, Cheng-ji; Liu, Hong-zhen

2012-05-01

To explore the influence of different strength intermittent treadmill training of growth period rats on the bone metabolism, so as to provide the training intensity of teenagers to set theory support. Select 70 male four weeks Wistar rats according to body weight randomly divided into seven groups (n = 10): the control group and the exercise group. According to the VO2max the exercise group was divided into 6 groups: 65%, 70%, 75%, 80%, 85% and 90% group. Nine weeks treadmill training, training six days a week, each group of training three times, each time not less than 10min, the interval was 30 min. The last movement after 24 h, took the femur and blood to measured the bone mineral density (BMD), bone mass (BMC) and alkaline phosphatase (AKP), resist tartaric acid acidic phosphatase (Str-ACP). 1. The femoral BMD (0.1393 +/- 0.0031), BMC (0.4525 +/- 0.0335) of 70% group were significantly higher than those in the control group (BMD: 0.1200 +/- 0.0095, BMC: 0.3238 +/- 0.0485) and the other sports group (65% BMD:0.1339 +/- 0.0062, BMC: 0.4058 +/- 0.0492, 75% BMD: 0.1296 +/- 0.0015, BMC: 0.3869 +/- 0.0254, 80% BMD: 0.1223 +/- 0.0082, BMC: 0.3454 +/- 0.0483, 85% BMD: 0.1250 +/- 0.0044, BMC: 0.3731 +/- 0.0381, 90% BMD: 0.1171 +/- 0.0047, BMC: 0.3051 +/- 0.0286) (P growth period rat bone mass and bone mineral density to increase obviously.

Assessment of association of smoking with bone mineral density (BMD) and fragility fractures in a cohort of pakistani males ages <= 50 years and postmenopausal females

International Nuclear Information System (INIS)

Akhlaq, U.; Ayaz, S.B.

2015-01-01

Objectives: The study aimed to determine the association between smoking, bone mineral density (BMD), and fragility fractures in a cohort of Pakistani males aged > 50 years and postmenopausal females. Methodology: This was a cross-sectional survey carried out at Armed Forces Institute of Rehabilitation Medicine (AFIRM), Rawalpindi from Jan 2010 to Jan 2011. Through non-probability purposive sampling, we included male patients of age > 50 years and postmenopausal women. All subjects were submitted to dual energy X-Ray absorptiometery at lumbar spine (L2 > L4) and at both femoral by Hologic Discovery-A machine . The lowest BMD was noted and expressed in the form of T-score.Using SPSS V 20, descriptive statistics were calculated for the various variables. Independent samples t-test was used to determine the significance of difference between mean T-score in between smokers and non-smokers. Association between smoking and the risk of fracture was carried out using Fisher exact test. A p-value < 0.05 was considered significant. Results: Out of a total of 328 patients, 142 (43.3%) were male (mean age 64 ± 8, range: 50 - 82 years) and 186 (56.7%) were female (mean age 61 ± 8, range: 43 - 92 years). Sixteen (8.6%) females and 52 (36.6%) males were smokers. In males, the mean T-score was -1.6 ± 1.3 in non-smokers and -1.9 ± 1.2 in smokers (p=0.17). Two of the non-smokers and nine of the smokers had a fracture. (p=0.002). In females, the mean T-score was -2.9 ± 1.9 in smokers and -2.3 ± 1.4 in non-smokers (p=0.23). Twelve of the non-smokers and 15 smokers had a fracture. (p<0.001) Conclusion: Smoking was significantly associated with increased percentage of fragility fractures but not with a reduction in BMD in our sample of postmenopausal women and men of age > 50 years. (author)

Fractal analysis of bone architecture at distal radius

International Nuclear Information System (INIS)

Tomomitsu, Tatsushi; Mimura, Hiroaki; Murase, Kenya; Sone, Teruki; Fukunaga, Masao

2005-01-01

Bone strength depends on bone quality (architecture, turnover, damage accumulation, and mineralization) as well as bone mass. In this study, human bone architecture was analyzed using fractal image analysis, and the clinical relevance of this method was evaluated. The subjects were 12 healthy female controls and 16 female patients suspected of having osteoporosis (age range, 22-70 years; mean age, 49.1 years). High-resolution CT images of the distal radius were acquired and analyzed using a peripheral quantitative computed tomography (pQCT) system. On the same day, bone mineral densities of the lumbar spine (L-BMD), proximal femur (F-BMD), and distal radius (R-BMD) were measured by dual-energy X-ray absorptiometry (DXA). We examined the correlation between the fractal dimension and six bone mass indices. Subjects diagnosed with osteopenia or osteoporosis were divided into two groups (with and without vertebral fracture), and we compared measured values between these two groups. The fractal dimension correlated most closely with L-BMD (r=0.744). The coefficient of correlation between the fractal dimension and L-BMD was very similar to the coefficient of correlation between L-BMD and F-BMD (r=0.783) and the coefficient of correlation between L-BMD and R-BMD (r=0.742). The fractal dimension was the only measured value that differed significantly between both the osteopenic and the osteoporotic subjects with and without vertebral fracture. The present results suggest that the fractal dimension of the distal radius can be reliably used as a bone strength index that reflects bone architecture as well as bone mass. (author)

Combined spinal epidural anesthesia in achondroplastic dwarf for femur surgery

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Rochana Girish Bakhshi

2011-11-01

Full Text Available Achondroplasia is the commonest form of short-limbed dwarfism and occurs in 1:26,000- 40,000 live births. This is an autosomal dominant disorder with abnormal endochondral ossification whereas periosteal and intramembranous ossification are normal. The basic abnormality is a disturbance of cartilage formation mainly at the epiphyseal growth plates and at the base of the skull. The anesthetic management of achondroplastic dwarfs is a challenge to the anesthesiologist. Both regional as well as general anesthesia have their individual risks and consequences. We report a case of an achondroplastic dwarf in whom combined spinal epidural anesthesia was used for fixation of a fractured femur. The patient had undergone previous femur surgery under general anesthesia since he had been informed that spinal anesthesia could be very problematic. There was no technical difficulty encountered during the procedure and an adequate level was achieved with low-dose local anesthetics without any problem. Postoperative pain relief was offered for three consecutive postoperative days using epidural tramadol. We discuss the anesthetic issues and highlight the role of combined spinal epidural anesthesia with low-dose local anesthetics in this patient. This approach also helped in early ambulation and postoperative pain relief.

Magnetic resonance perfusion and diffusion imaging characteristics of transient bone marrow edema, avascular necrosis and subchondral insufficiency fractures of the proximal femur

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Mueller, Dirk, E-mail: d.mueller@uk-koeln.de [Department of Radiology, University of Cologne (Germany); Department of Radiology, Technische Universität München (Germany); Schaeffeler, Christoph, E-mail: schaeffeler@me.com [Department of Radiology, Cantonal Hospital Graubuenden, Chur (Switzerland); Department of Radiology, Cantonal Hospital Graubuenden, Chur (Switzerland); Baum, Thomas, E-mail: thomas-baum@gmx.de [Department of Radiology, Technische Universität München (Germany); Walter, Flavia, E-mail: flavia_walter2000@yahoo.de [Department of Radiology, Technische Universität München (Germany); Rechl, Hans, E-mail: rechl@tum.de [Department of Orthopaedics, Technische Universität München (Germany); Rummeny, Ernst J., E-mail: rummeny@tum.de [Department of Radiology, Technische Universität München (Germany); Woertler, Klaus, E-mail: klaus.woertler@tum.de [Department of Radiology, Technische Universität München (Germany)

2014-10-15

Highlights: • DCE-MRI may add information to the pathophysiology of bone marrow edema (BME) of the proximal femur. • Patients with transient bone marrow edema (TBME) or subchondral insufficiency fractures (SIF) and avascular osteonecrosis (AVN) showed different MR perfusion patterns. • Perfusion characteristics suggest different pathophysiology for AVN compared with TBME or SIF. • Diffusion weighted imaging (DWI) was not able to discriminate necrotic from edematous bone marrow. • DWI is of limited value to evaluate BME of the proximal femur. - Abstract: Purpose: To evaluate magnetic resonance (MR) perfusion and diffusion imaging characteristics in patients with transient bone marrow edema (TBME), avascular necrosis (AVN), or subchondral insufficiency fractures (SIF) of the proximal femur. Materials and methods: 29 patients with painful hip and bone marrow edema pattern of the proximal femur on non-contrast MR imaging were examined using diffusion-weighted and dynamic gadolinium-enhanced sequences. Apparent diffusion coefficients (ADCs) and perfusion parameters were calculated for different regions of the proximal femur. Regional distribution and differences in ADC values and perfusion parameters were evaluated. Results: Seven patients presented with TBME, 15 with AVN and seven with SIF of the proximal femur. Perfusion imaging showed significant differences for maximum enhancement values (E{sub max}), slope (E{sub slope}) and time to peak (TTP) between the three patient groups (p < 0.05). In contrast, no significant differences for ADC values were calculated when comparing TBME, AVN, and SIF patients. Conclusion: Diffusion weighted imaging of bone marrow of the proximal femur did not show significant differences between patients with TBME, AVN or SIF. In contrast, MR perfusion imaging demonstrated significant differences for the different patient groups and may as a complementary imaging technique add information to the understanding of the pathophysiology

Magnetic resonance perfusion and diffusion imaging characteristics of transient bone marrow edema, avascular necrosis and subchondral insufficiency fractures of the proximal femur

International Nuclear Information System (INIS)

Mueller, Dirk; Schaeffeler, Christoph; Baum, Thomas; Walter, Flavia; Rechl, Hans; Rummeny, Ernst J.; Woertler, Klaus

2014-01-01

Highlights: • DCE-MRI may add information to the pathophysiology of bone marrow edema (BME) of the proximal femur. • Patients with transient bone marrow edema (TBME) or subchondral insufficiency fractures (SIF) and avascular osteonecrosis (AVN) showed different MR perfusion patterns. • Perfusion characteristics suggest different pathophysiology for AVN compared with TBME or SIF. • Diffusion weighted imaging (DWI) was not able to discriminate necrotic from edematous bone marrow. • DWI is of limited value to evaluate BME of the proximal femur. - Abstract: Purpose: To evaluate magnetic resonance (MR) perfusion and diffusion imaging characteristics in patients with transient bone marrow edema (TBME), avascular necrosis (AVN), or subchondral insufficiency fractures (SIF) of the proximal femur. Materials and methods: 29 patients with painful hip and bone marrow edema pattern of the proximal femur on non-contrast MR imaging were examined using diffusion-weighted and dynamic gadolinium-enhanced sequences. Apparent diffusion coefficients (ADCs) and perfusion parameters were calculated for different regions of the proximal femur. Regional distribution and differences in ADC values and perfusion parameters were evaluated. Results: Seven patients presented with TBME, 15 with AVN and seven with SIF of the proximal femur. Perfusion imaging showed significant differences for maximum enhancement values (E max ), slope (E slope ) and time to peak (TTP) between the three patient groups (p < 0.05). In contrast, no significant differences for ADC values were calculated when comparing TBME, AVN, and SIF patients. Conclusion: Diffusion weighted imaging of bone marrow of the proximal femur did not show significant differences between patients with TBME, AVN or SIF. In contrast, MR perfusion imaging demonstrated significant differences for the different patient groups and may as a complementary imaging technique add information to the understanding of the pathophysiology of

Bone health in patients with epilepsy: A community-based pilot nested case–control study

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Shweta Singla

2017-01-01

Full Text Available Background: Antiepileptic drugs (AEDs adversely affect bone health and there are reports describing association of alternations of bone and mineral metabolism in epileptic patients. Objectives: This study was undertaken to evaluate the bone profile (bone mineral parameters and bone mineral density [BMD] of patients with epilepsy and compare them to their age-, gender-, and socioeconomic status-matched healthy controls in a community. Materials and Methods: This was a nested case–control study conducted in fifty individuals, which included 25 cases (age above 18 years and on AEDs for at least 3 years for which 25 controls were selected from the same community. Bone mineral parameters (serum calcium, proteins, phosphorous, alkaline phosphate, parathyroid hormone, and Vitamin D and BMD were measured. Results: There was significant hypocalcemia (P = 0.003, hypoproteinemia (P = 0.014, hyperparathyroidism (P = 0.048, and increased levels of serum alkaline phosphatase (P = 0.019 in cases as compared to controls. The difference was insignificant in the serum levels of Vitamin D and phosphorous among both the groups. Vitamin D was significantly low in female patients as compared to males (P = 0.043. There was no significant difference in BMD at the lumbar spine and femur neck among both the groups. Mean duration of epilepsy was longest in patients with osteoporosis (23.6 years, and increasing duration of epilepsy was associated with reduction in age- and sex-corrected total BMD mean Z-score anteroposterior spine. There was negative correlation between cumulative drug load and T-score of patients with epilepsy. Conclusion: Patients on long-term AED treatment have altered bone profile as evident from biochemical parameters and reduced BMD. There is a need for more extensive research and that too on a larger sample size.

Prevalence of low trauma fractures in long-term kidney transplant patients with preserved renal function

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J.W.R. Braga Júnior

2006-01-01

Full Text Available We evaluated the prevalence of low bone mineral density (BMD and osteoporotic fractures in kidney transplantation (KT patients and determined risk factors associated with osteoporotic fractures. The study was conducted on 191 patients (94 men and 97 women with first KT for 3 years or more presenting stable and preserved renal function (serum creatinine levels lower than 2.5 mg/dl. KT patients were on immunosuppressive therapy and the cumulative doses of these drugs were also evaluated. BMD was determined by dual-energy X-ray absorptiometry at multiple sites (spine, femur and total body. Quantitative ultrasound of the calcaneus (broadband ultrasound attenuation, speed of sound, and stiffness index, SI was also performed. Twenty-four percent (46 of all patients had either vertebral (29/46 or appendicular (17/46 fractures. We found osteoporosis and osteopenia in 8.5-13.4 and 30.9-35.1% of KT patients, respectively. Women had more fractures than men. In women, prevalent fractures were associated with diabetes mellitus [OR = 11.5, 95% CI (2.4-55.7], time since menopause [OR = 3.7, 95% CI (1.2-11.9], femoral neck BMD [OR = 1.99, 95% CI (1.4-2.8], cumulative dose of steroids [OR = 1.1, 95% CI (1.02-1.12] and low SI [OR = 1.1, 95% CI (1.0-1.2]. In men, fractures were associated with lower lumbar spine BMD [OR = 1.75, 95% CI (1.1-2.7], lower SI [OR = 1.1, 95% CI (1.03-1.13], duration of dialysis [OR = 1.3, 95% CI (1.13-2.7], and lower body mass index [OR = 1.24, 95% CI (1.1-1.4. Our results demonstrate high prevalence of low BMD and osteoporotic fractures in patients receiving a successful kidney transplant and indicate the need for specific intervention to prevent osteoporosis in this population.

Relationship between Bone-Specific Physical Activity Scores and Measures for Body Composition and Bone Mineral Density in Healthy Young College Women.

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SoJung Kim

Full Text Available The purpose of this cross-sectional study was to investigate the relationship between bone-specific physical activity (BPAQ scores, body composition, and bone mineral density (BMD in healthy young college women.Seventy-three college women (21.7 ± 1.8 years; 162.1 ± 4.6 cm; 53.9 ± 5.8 kg between the ages of 19 and 26 years were recruited from the universities in Seoul and Gyeonggi province, South Korea. We used dual energy X-ray absorptiometry to measure the lumbar spine (L2-L4 and proximal femur BMD (left side; total hip, femoral neck. The BPAQ scores (past, pBPAQ; current, cBPAQ; total, tBPAQ were used to obtain a comprehensive account of lifetime physical activity related to bone health. We used X-scan plus II instrumentation to measure height (cm, weight (kg, fat free mass (FFM, kg, percent body fat (%, and body mass index (BMI. Participants were asked to record their 24-hour food intake in a questionnaire.There were positive correlations between BPAQ scores and total hip (pBPAQ r = 0.308, p = 0.008; tBPAQ, r = 0.286, p = 0.014 and FN BMD (pBPAQ r = 0.309, p = 0.008; tBPAQ, r = 0.311, p = 0.007, while no significant relationships were found in cBPAQ (p > 0.05. When FFM, Vitamin D intake, cBPAQ, pBPAQ, and tBPAQ were included in a stepwise multiple linear regression analysis, FFM and pBPAQ were predictors of total hip, accounting for 16% (p = 0.024, while FFM and tBPAQ predicted 14% of the variance in FN (p = 0.015. Only FFM predicted 15% of the variance in L2-L4 (p = 0.004. There was a positive correlation between Vitamin D intake and L2-L4 (p = 0.025, but other dietary intakes variables were not significant (p > 0.05.BPAQ-derived physical activity scores and FFM were positively associated with total hip and FN BMD in healthy young college women. Our study suggests that osteoporosis awareness and effective bone healthy behaviors for college women are required to prevent serious bone diseases later in life.

Prediction on fracture risk of femur with Osteogenesis Imperfecta using finite element models: Preliminary study

Science.gov (United States)

Wanna, S. B. C.; Basaruddin, K. S.; Mat Som, M. H.; Mohamad Hashim, M. S.; Daud, R.; Majid, M. S. Abdul; Sulaiman, A. R.

2017-10-01

Osteogenesis imperfecta (OI) is a genetic disease which affecting the bone geometry. In a severe case, this disease can cause death to patients. The main issue of this disease is the prediction on bone fracture by the orthopaedic surgeons. The resistance of the bone to withstand the force before the bones fracture often become the main concern. Therefore, the objective of the present preliminary study was to investigate the fracture risk associated with OI bone, particularly in femur, when subjected to the self-weight. Finite element (FEA) was employed to reconstruct the OI bone model and analyse the mechanical stress response of femur before it fractures. Ten deformed models with different severity of OI bones were developed and the force that represents patient self-weight was applied to the reconstructed models in static analysis. Stress and fracture risk were observed and analysed throughout the simulation. None of the deformed model were observed experienced fracture. The fracture risk increased with increased severity of the deformed bone. The results showed that all deformed femur models were able to bear the force without experienced fracture when subjected to only the self-weight.

Implant failure caused by non-union of bisphosphonate-associated subtrochanteric femur fracture.

LENUS (Irish Health Repository)

O'Neill, Barry James

2014-04-03

Bisphosphonate use has been identified as a contributory factor in atypical subtrochanteric fracture of the femur. These fractures are commonly treated with an intramedullary device. We present a case of implant failure of an intrameduallary device caused by non-union of an atypical subtrochanteric fracture.

Trabecular bone analysis in CT and X-ray images of the proximal femur for the assessment of local bone quality.

Science.gov (United States)

Fritscher, Karl; Grunerbl, Agnes; Hanni, Markus; Suhm, Norbert; Hengg, Clemens; Schubert, Rainer

2009-10-01

Currently, conventional X-ray and CT images as well as invasive methods performed during the surgical intervention are used to judge the local quality of a fractured proximal femur. However, these approaches are either dependent on the surgeon's experience or cannot assist diagnostic and planning tasks preoperatively. Therefore, in this work a method for the individual analysis of local bone quality in the proximal femur based on model-based analysis of CT- and X-ray images of femur specimen will be proposed. A combined representation of shape and spatial intensity distribution of an object and different statistical approaches for dimensionality reduction are used to create a statistical appearance model in order to assess the local bone quality in CT and X-ray images. The developed algorithms are tested and evaluated on 28 femur specimen. It will be shown that the tools and algorithms presented herein are highly adequate to automatically and objectively predict bone mineral density values as well as a biomechanical parameter of the bone that can be measured intraoperatively.

The effect of rapid decompression on femur blood flow of rabbits

International Nuclear Information System (INIS)

Yu Shaoning; Tian Wuxun; Zhu Xiangqi

1997-01-01

PURPOSE: To study the influence of regional blood flow in femur trochanter (FT) of rabbits' under rapid decompression after exposure to hyperbaric air. METHODS: Rabbits were placed in a hyperbaric chamber and exposed to the pressure of 0.5 MPa for 1.5 h, and the pressure was reduced to the atmosphere pressure at a uniform rate of 0.03 mPa/min. The regional blood flow of FT in rabbits were measured with 133 Xe washout methods. RESULTS: The normal average regional blood flow in left and right FT were 14.5 +- 1.7 and 14.1 +- 1.9 ml/(min·100g) respectively. After exposure to hyperbaric air with rapid decompression, the average regional blood flow of left and right FT were 11.1 +- 1.2 and 10.5 +- 1.6 ml/(min·100g) respectively. But the symptoms of dysbarism in these rabbits were various each other. CONCLUSIONS: After being exposed to hyperbaric air with rapid decompression, the blood flow of rabbits' femur trochanter were noticeably reduced

Swine cortical and cancellous bone: histomorphometric and densitometric characterisation

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Maria Elena Andreis

2017-06-01

Full Text Available Introduction: Swine bone morphology, composition and remodelling are similar to humans’, therefore they are considered good models in bone-related research. They have been used for several studies involving bone growth, bone and cartilage fractures and femoral head osteonecrosis. Nevertheless, the literature about pig normal bone features is incomplete. This work aims to fill the literature gaps on the microarchitecture and Bone Mineral Density (BMD of swine femoral diaphysis and distal epiphysis and tibial plateau and diaphysis. Materials and methods: Five hind limbs were collected from slaughtered 80-100 kg pigs. Microscopic analysis of cortical and cancellous bone from middle/distal femur and proximal/middle tibia was performed to determine basic histomorphometric parameters at different sites. Dual-energy X-Rays Absorptiometry was also employed to evaluate BMD. ANOVA and correlation between BMD, bone area (BA and cortical thickness were performed. Results and discussion: Diaphyseal cortical bone was mostly plexiform both in the tibia and the femur; primary/secondary osteons without clear organization were also found. Mean values for bone area, bone perimeter, trabecular width, number and separation and BMD at different anatomical sites were defined. No significant difference was found for these values at different anatomical sites. BMD proved to be positively correlated with cortical thickness (r=0,80; p<0,01. Despite the small sample size, these results seem homogeneous. They could therefore represent reference values for normal bone parameters in pigs. Applied anatomy and regenerative medicine, in fact, demand very precise information about bone micromorphology, composition and density to provide reliable indication in bone substitutes building. Moreover, since the interpretation of bone abnormalities is based on mastering normal bone characteristics, the definition of reference parameters is mandatory to avoid misinterpretation and

In-vivo assessment of femoral bone strength using Finite Element Analysis (FEA based on routine MDCT imaging: a preliminary study on patients with vertebral fractures.

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Hans Liebl

Full Text Available To experimentally validate a non-linear finite element analysis (FEA modeling approach assessing in-vitro fracture risk at the proximal femur and to transfer the method to standard in-vivo multi-detector computed tomography (MDCT data of the hip aiming to predict additional hip fracture risk in subjects with and without osteoporosis associated vertebral fractures using bone mineral density (BMD measurements as gold standard.One fresh-frozen human femur specimen was mechanically tested and fractured simulating stance and clinically relevant fall loading configurations to the hip. After experimental in-vitro validation, the FEA simulation protocol was transferred to standard contrast-enhanced in-vivo MDCT images to calculate individual hip fracture risk each for 4 subjects with and without a history of osteoporotic vertebral fractures matched by age and gender. In addition, FEA based risk factor calculations were compared to manual femoral BMD measurements of all subjects.In-vitro simulations showed good correlation with the experimentally measured strains both in stance (R2 = 0.963 and fall configuration (R2 = 0.976. The simulated maximum stress overestimated the experimental failure load (4743 N by 14.7% (5440 N while the simulated maximum strain overestimated by 4.7% (4968 N. The simulated failed elements coincided precisely with the experimentally determined fracture locations. BMD measurements in subjects with a history of osteoporotic vertebral fractures did not differ significantly from subjects without fragility fractures (femoral head: p = 0.989; femoral neck: p = 0.366, but showed higher FEA based risk factors for additional incident hip fractures (p = 0.028.FEA simulations were successfully validated by elastic and destructive in-vitro experiments. In the subsequent in-vivo analyses, MDCT based FEA based risk factor differences for additional hip fractures were not mirrored by according BMD measurements. Our data suggests, that MDCT

Successful reconstruction for complex malunions and nonunions of the tibia and femur

NARCIS (Netherlands)

Buijze, Geert A.; Richardson, Shawn; Jupiter, Jesse B.

2011-01-01

Information regarding the long-term outcomes of the treatment of lower-extremity fracture malunion and nonunion is lacking. Twenty-nine secondarily referred patients with complex malunion or nonunion of the tibia or femur, treated by a single surgeon, were followed for a median of twenty years

Decrease in local volumetric bone mineral density (vBMD) in osteoarthritic joints is associated with the increase in cartilage damage: a pQCT study

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Tamaddon, Maryam; Chen, Shen Mao; Vanaclocha, Leyre; Hart, Alister; El-Husseiny, Moataz; Henckel, Johann; Liu, Chaozong

2017-11-01

Osteoarthritis (OA) is the most common type of arthritis and a major cause of disability in the adult population. It affects both cartilage and subchondral bone in the joints. There has been some progress in understanding the changes in subchondral bone with progression of osteoarthritis. However, local changes in subchondral bone such as microstructure or volumetric bone mineral density in connection with the defect in cartilage are relatively unexplored. To develop an effective treatment for progression of OA, it is important to understand how the physical environment provided by the subchondral bone affects the overlying cartilage. In this study we examined the volumetric bone mineral density (vBMD) distribution in the osteoarthritic joint tissues obtained from total hip replacement surgeries due to osteoarthritis, using peripheral quantitative CT (pQCT). It was found that there is a significant decrease in volumetric bone mineral density, which co-localises with the damage in the overlying cartilage. This was not limited to the subchondral bone immediately adjacent to the cartilage defect but continued in the layers below. Bone resorption and cyst formation in the OA tissues were also detected. We observed that the bone surrounding subchondral bone cysts exhibited much higher volumetric bone mineral density than that of the surrounding bones. PQCT was able to detect significant changes in vBMD between OA and non-OA samples, as well as between areas of different cartilage degeneration, which points to its potential as a technique for detection of early OA.

A comparative approach to computer aided design model of a dog femur.

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Turamanlar, O; Verim, O; Karabulut, A

2016-01-01

Computer assisted technologies offer new opportunities in medical imaging and rapid prototyping in biomechanical engineering. Three dimensional (3D) modelling of soft tissues and bones are becoming more important. The accuracy of the analysis in modelling processes depends on the outline of the tissues derived from medical images. The aim of this study is the evaluation of the accuracy of 3D models of a dog femur derived from computed tomography data by using point cloud method and boundary line method on several modelling software. Solidworks, Rapidform and 3DSMax software were used to create 3D models and outcomes were evaluated statistically. The most accurate 3D prototype of the dog femur was created with stereolithography method using rapid prototype device. Furthermore, the linearity of the volumes of models was investigated between software and the constructed models. The difference between the software and real models manifests the sensitivity of the software and the devices used in this manner.

Prevalência do hipotiroidismo subclínico e repercussões sobre o perfil lipídico e massa óssea em mulheres na pós-menopausa Prevalence of subclinical hypothyroidism and its effects on lipidic profile and bone mineral density in postmenopausal women

Directory of Open Access Journals (Sweden)

Eliana Aguiar Petri Nahas

2005-08-01

-stimulating hormone (TSH and free thyroxin (T4-L. Exclusion criteria: hyperthyroidism and thyroid cancer. Values of TSH >5.0 mIU/ml and normal T4-L were considered to be subclinical hypothyroidism. The 329 selected women (55.2±6.4 years were divided into three groups: normal thyroid function (control (n=208, subclinical hypothyroidism (n=53 and clinical hypothyroidism under treatment (n=59. Clinical data, hormonal therapy use, body mass index (BMI=kg/m², lipid profile (total cholesterol, HDL, LDL, triglycerides and BMD of lumbar column and femur were obtained. RESULTS: subclinical hypothyroidism was diagnosed in 16.1% of the cases. The groups were homogeneous regarding clinical features, BMI or lipidic profile. BMD in lumbar column and femur was lower in subclinical and clinical hypothyroidism than in euthyroidism (p<0.001. There was a negative correlation between values of TSH and BMD of lumbar column and femur (p<0.001. There was no correlation between TSH values and age, menopause time, BMI, and lipid profile. The total of hormonal therapy users was 65.1%, mean duration of 3.43±2.42 years, not differing between the groups. CONCLUSION: subclinical hypothyroidism with prevalence of 16.1% in postmenopausal women was associated with lower BMD, with no effects on lipid profile.

Are effects of MTHFR (C677T) genotype on BMD confined to women with low folate and riboflavin intake?

DEFF Research Database (Denmark)

Abrahamsen, B.; Madsen, Jonna Skov; Tofteng, Charlotte L.

2005-01-01

by vitamin B supplementation. We have, therefore, reviewed baseline food record data from our original study to determine if BMD and fracture associations with the MTHFR genotype depended on the intake of folate, riboflavin, or other members of the vitamin B complex, associated with homocysteine metabolism...

Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density. A 2-year RSA and 8-year radiographic follow-up study of 34 patients.

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Finnilä, Sami; Moritz, Niko; SvedströM, Erkki; Alm, Jessica J; Aro, Hannu T

2016-02-01

Low bone mineral density (BMD) may jeopardize the initial component stability and delay osseointegration of uncemented acetabular cups in total hip arthroplasty (THA). We measured the migration of uncemented cups in women with low or normal BMD. We used radiostereometric analysis (RSA) to measure the migration of hydroxyapatite-coated titanium alloy cups with alumina-on-alumina bearings in THA of 34 female patients with a median age of 64 (41-78) years. 10 patients had normal BMD and 24 patients had low systemic BMD (T-score ≤ -1) based on dual-energy X-ray absorptiometry (DXA). Cup migration was followed with RSA for 2 years. Radiographic follow-up was done at a median of 8 (2-10) years. Patients with normal BMD did not show a statistically significant cup migration after the settling period of 3 months, while patients with low BMD had a continuous proximal migration between 3 and 12 months (p = 0.03). These differences in cup migration persisted at 24 months. Based on the perceived risk of cup revision, 14 of the 24 cases were "at risk" (proximal translation of 0.2 to 1.0 mm) in the low-BMD group and 2 of the 10 cases were "at risk" in the normal-BMD group (odds ratio (OR) = 8.0, 95% CI: 1.3-48). The radiographic follow-up showed no radiolucent lines or osteolysis. 2 cups have been revised for fractures of the ceramic bearings, but none for loosening. Low BMD contributed to cup migration beyond the settling period of 3 months, but the migrating cups appeared to osseointegrate eventually.

Reconstruction of juxta-articular huge defects of distal femur with vascularized fibular bone graft and Ilizarov's distraction osteogenesis.

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Lai, Davy; Chen, Chuan-Mu; Chiu, Fang-Yao; Chang, Ming-Chau; Chen, Tain-Hsiung

2007-01-01

We evaluate the effect of reconstructing huge defects (mean, 15.8 cm) of the distal femur with Ilizarov's distraction osteogenesis and free twin-barreled vascularized fibular bone graft (TVFG). We retrospectively reviewed a consecutive series of five patients who had cases of distal femoral fractures with huge defects and infection that were treated by the Ilizarov's distraction osteogenesis. After radical debridement, two of the five cases had free TVFG and monolocal distraction osteogenesis, and another two cases had multilocal distraction osteogenesis with knee fusion because of loss of the joint congruity. The other case with floating knee injury had bilocal distraction osteogenesis and a preserved knee joint. The mean defect of distal femur was 15.8 cm (range, 14-18 cm) in length. The mean length of distraction osteogenesis by Ilizarov's apparatus was 8.2 cm. The mean length of TVFG was 8 cm. The average duration from application of Ilizarov's apparatus to achievement of bony union was 10.2 months (range, 8-13 months). At the end of the follow-up, ranges of motion of three knees were 0 to 45 degrees, 0 to 60 degrees, and 0 to 90 degrees. Two cases had knee arthrodesis with bony fusion because of loss of the joint congruity. There were no leg length discrepancies in all five patients. In addition, three patients had pin tract infections and one case had a 10 degree varus deformity of the femur. Juxta-articular huge defect (>10 cm) of distal femur remains a challenge to orthopedic surgeons. Ilizarov's technique provides the capability to maintain stability, eradicate infection, restore leg length, and to perform adjuvant reconstructive procedure easily. In this study, we found that combining Ilizarov's distraction osteogenesis with TVFG results in improved patient outcome for patients with injuries such as supracondylar or intercondylar infected fractures or nonunion of distal femur with huge bone defect.

Short-term muscle atrophy caused by botulinum toxin-A local injection impairs fracture healing in the rat femur.

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Hao, Yongqiang; Ma, Yongcheng; Wang, Xuepeng; Jin, Fangchun; Ge, Shengfang

2012-04-01

Damaged bone is sensitive to mechanical stimulation throughout the remodeling phase of bone healing. Muscle damage and muscular atrophy associated with open fractures and subsequent fixation are not beneficial to maintaining optimum conditions for mechanical stability. The aim of this study was to investigate whether local muscle atrophy and dysfunction affect fracture healing in a rat femur fracture model. We combined the rat model of a short period atrophy of the quadriceps with femur fracture. Forty-four-month-old male Wistar rats were adopted for this study. Two units of botulinum toxin-A (BXTA) were administered locally into the right side of the quadriceps of each rat, while the same dose of saline was injected into the contralateral quadriceps. After BXTA had been fully absorbed by the quadriceps, osteotomy was performed in both femurs with intramedullary fixation. Gross observation and weighing of muscle tissue, X-ray analysis, callus histology, and bone biomechanical testing were performed at different time points up to 8 weeks post-surgery. Local injection of BXTA led to a significant decrease in the volume and weight of the quadriceps compared to the control side. At the eighth week, the left side femurs of the saline-injected quadriceps almost reached bony union, and fibrous calluses were completely calcified into woven bone. However, a gap was still visible in the BXTA-treated side on X-ray images. As showed by bone histology, there were no mature osseous calluses or woven bone on the BXTA-treated side, but a resorption pattern was evident. Biomechanical testing indicated that the femurs of the BXTA-treated side exhibited inferior mechanical properties compared with the control side. The inferior outcome following BXTA injection, compared with saline injection, in terms of callus resistance may be the consequence of unexpected load and mechanical unsteadiness caused by muscle atrophy and dysfunction. Copyright © 2011 Orthopaedic Research Society.

Assessment of Bone Quality in Osteoporosis Treatment with Bone Anabolic Agents: Really Something New?

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