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1.
Aldinger PR Sabo D Pritsch M Thomsen M Mau H Ewerbeck V Breusch SJ 《Calcified tissue international》2003,73(2):115-121
Bone resorption in the proximal femur is commonly seen after total hip arthroplasty (THA). With dual energy X-ray absorptiometry (DXA), the amount of bone mass (BMD) after implantation of a total hip stem can be precisely determined. However, prospective evaluation of the change of bone mass around the stem is only available for selected stems and short-term follow-up (up to 36 months). We analyzed BMD in patients who had undergone uncemented THA by DXA. Only patients with good clinical outcome (Merle d Aubigné score > 12) were included to obtain normative data for regular bone response. Two separate studies were performed: a prospective longitudinal study over 84 months with baseline values acquired within the first postoperative week (group A) (n = 26 patients) and a separate cross-sectional study, median follow-up 156 (124-178) months (group B) (n = 35 patients). Regions of interest were defined according to Gruen (ROI 1-7) and as net average ROI (net avg) for the periprosthetic femoral bone. After the initial remodeling process (12 months), BMD was compared to the 84-month (longitudinal) and the 156-month (cross-sectional) follow-up values to determine long-term periprosthetic changes of bone mineral density. The longitudinal study (group A), after the initial bone remodeling, showed no relevant further bone loss for women and men with BMD values 1.19 ± 0.15 and 1.40 ± 0.19, respectively, 12 months (women 89.8%, men 93.6%), and 1.19 ± 0.13 and 1.36 ± 0.18, respectively, after 84 months (women 90.0%, men 91.3%) (P = 0.98, P = 0.08,) respectively. The distribution of the BMD around the stem changed during the first 12 months. The ROIs around the proximal stem (ROI 1 and 7) showed the lowest absolute values at the 12-month follow-up and BMD in ROI 7 decreased most during the further follow-up until 84 months. The cross-sectional study (group B) showed no significant difference in BMD (net avg) values at a median of 156 months follow-up compared to the 12-month values (group A) (women: P = 0.77, men: P = 0.44). Initial BMD, implant diameter, and body mass index did not influence BMD loss (net avg) in this study, whereas age showed a weak correlation with BMD loss. The results show that after the initial remodeling process, no relevant further bone loss (net avg) occurs up to 84 months postsurgery, and values after a median of 156 months are similar. Normative long-term changes in the periprosthetic bone can be demonstrated in defined ROIs after implantation of a tapered corundum-blasted titanium stem with a good clinical result. 相似文献
2.
Xiaoge D Eryuan L Xianping W Zhiguang Z Gan H Zaijing J Xiaoli P Hongzhuan T Hanwen W 《Calcified tissue international》2000,67(3):195-198
The incidence of hip fracture is lower in Chinese women compared with those from western countries, though they usually have
lower bone mineral density (BMD). In this study, reference data (from Caucasian women) supplied by the manufacturer of Hologic
Inc. was compared with data obtained from healthy women in Changsha, Hunan province, P.R.C. A total of 1488 Chinese women
aged 15–95 years were randomly chosen for the study. Measurements of BMD were taken at the hip by dual energy X-ray absorptiometry
(DXA) (QDR 4500A, Hologic Inc., USA). The BMD and the BMD decrease rate were somewhat lower than reference curves at all age
groups and all sites except for the femoral neck and Ward's triangle. Chinese women reached their peak BMD 5–10 years later
than their counterparts, and had a lower BMD decrease rate for about 35 years after peak BMD was attained. The fact that Chinese
women take longer time to reach peak BMD and have a lower BMD decrease rate at the neck and Ward's triangle after peak BMD
is attained protects them against hip fractures, and is a phenomenon that needs to be studied in the future.
Received: 11 May 1999 / Accepted: 29 February 2000 相似文献
3.
Th. Rand G. Seidl F. Kainberger A. Resch K. Hittmair B. Schneider C. C. Glüer H. Imhof 《Calcified tissue international》1997,60(5):430-433
The purpose of this study is to evaluate degenerative factors in a postmenopausal patient group and differentiate the influence
on bone mineral density (BMD) measurements by dual-energy X-ray absorptiometry (DXA). The patients and methods included an
investigation of 144 postmenopausal women (mean 63.3 years) with PA-DXA of the spine. Degenerative factors (osteophytes, osteochondrosis,
scoliosis, and vascular calcification) were evaluated from plain lumbar radiographs, their estimated probability was analyzed
as a function of age, and their influence on BMD measured by PA-DXA was determined. The results of the study revealed osteophytes
in 45.8%, vascular calcifications in 24.3%, scoliosis in 22.2%, osteochondrosis in 21.5%. The estimated probability for degenerative
factors increased from 35 to 80% in the 55- to 70- year age group. Osteophytes and osteochondrosis were associated with up
to a 14% increase in BMD values (P < 0.001). Vascular calcifications showed a positive trend, whereas scoliosis did not show a discernible influence.
We concluded that degenerative factors, except for scoliosis, showed an influence on BMD as measured by DXA. Their prevalence
increased rapidly between 55 and 70 years of age. Interpretation of PA-DXA spine data for subjects of or above this age range
should be complemented by plain film radiographs.
Received: 30 May 1996 / Accepted: 24 July 1996 相似文献
4.
Xiang Li Baiqi Pan Xiaoyu Wu Ming Fu Weiming Liao Chuheng Wu Puyi Sheng 《Orthopaedic Surgery》2022,14(5):902
ObjectiveTo investigate the application of impaction bone grafting (IBG) combined with Ti‐alloy mesh for acetabular bone defect reconstruction in total hip arthroplasty (THA) revision and follow up the clinical outcomes and imaging findings.MethodsThe clinical and imaging data of patients who were admitted to our hospital from January 2000 to December 2020 and underwent acetabular bone defects reconstruction using IBG combined with titanium mesh were retrospectively analyzed. Preoperative and post‐revision Oxford and Harris scores, and post‐revision complications were evaluated. Radiographs were used to determine center of rotation (COR) of the hip joint, transparency line, bone graft fusion, and bone mineral density (BMD) around the hip joint.ResultsSignificant improvement was observed in both Oxford and Harris scores (P < 0.05). The radiographs taken at the last follow‐up examination showed no significant differences in the acetabulum COR, offsets, inclination angle, mean ratio of vertical value, and BMD analysis between the post‐revision side and contralateral side (P > 0.05). The follow‐up data showed restoration of the mesh implant and graft bone fusion.ConclusionsThe application of IBG combined with titanium‐alloy mesh in revision THA patients with acetabular defects was found to provide satisfactory outcomes. However, large‐scale studies are still needed to further elucidate the long‐term outcomes. 相似文献
5.
Lehtonen-Veromaa M Möttönen T Nuotio I Heinonen OJ Viikari J 《Calcified tissue international》2000,66(4):248-254
The aim of this cross-sectional study was to investigate whether two types of physical exercise affect the growing skeleton
differently. We used calcaneal quantitative ultrasound measurements (QUS) and dual-energy X-ray absorptiometry (DXA) for measurement
of bone mineral density (BMD), and to test how QUS values reflect the axial DXA values in these various study groups. A total
of 184 peripubertal Caucasian girls aged 11–17 years (65 gymnasts, 63 runners, and 56 nonathletic controls) were studied.
Weight, height, stage of puberty, years of training, and the amount of leisure-time physical activity were recorded. Broadband
ultrasound attenuation (BUA) and sound of speed (SOS) through the calcaneus were measured. The BMD of the femoral neck and
the lumbar spine were measured by DXA. The differences in mean values of bone measurements among each exercise group were
more evident in pubertal than prepubertal girls. The mean BUA and SOS values of the pubertal gymnasts were 13.7% (77.8 dB/MHz
versus 68.4 dB/MHz, P < 0.05) and 2.2% (1607.7 m/s versus 1572.4 m/s, P < 0.001) higher than of the controls, respectively. The mean BMD of the femoral neck in the pubertal gymnasts and runners
was 20% (0.989 g/cm2 versus 0.824 g/cm2, P < 0.001) and 9.0% (0.901 g/cm2 versus 0.824 g/cm2, P < 0.05) higher than in the controls, respectively. The amount of physical activity correlated weakly but statistically significantly
with all measured BMD and ultrasonographic values in the pubertal group (r = 0.19–0.35). The correlation between ultrasonographic
parameters and BMD were weak, but significant among pubertal runners (r = 0.47–0.55) and controls (r = 0.39–0.42), whereas
the DXA values of the femoral neck and the ultrasonographic parameters of the calcaneus did not correlate among highly physically
active gymnasts. By stepwise regression analysis, physical activity accounted for much more of the variation in the DXA values
than the ultrasonographic values. We conclude that the beneficial influence of exercise on bone status as measured by ultrasound
and DXA was evident in these peripubertal girls. In highly active gymnasts the increase of the calcaneal ultrasonographic
values did not reflect statistically significantly the BMD values of the femoral neck.
Received: 28 June 1999 / Accepted: 2 November 1999 相似文献
6.
Bone mineral density (BMD) and soft tissue composition were measured by dual energy X-ray absorptiometry (DXA) 3–4 years
apart in 273 men and women aged 23–90. We found different rates of BMD loss in different skeletal regions. There were also
different rates of BMD loss in different regions within the hip. Average rates of loss for male subjects 50 years of age and
above for BMD total body were 0.1%/year and for femoral neck 1.5%/year, whereas lumbar spine (L2–L4) increased by 0.4%/year.
Average rates of loss for female subjects 50 years of age and above for BMD total body were 0.0%/year, femoral neck 0.9%/year,
and lumbar spine (L2–L4) 0.1%/year.
Received: 28 November 1997 / Accepted: 26 July 1999 相似文献
7.
M. Pedrazzoni F. S. Alfano G. Girasole N. Giuliani M. Fantuzzi C. Gatti C. Campanini M. Passeri 《Calcified tissue international》1996,59(5):334-338
The purpose of this study was to examine the serum levels of bone alkaline phosphatase (BALP) measured with a new assay in
normal and in osteoporotic women, and to evaluate prospectively its responsiveness to changes of bone metabolism. The following
groups of subjects were studied: (1) 95 healthy women (44–75 years) (22 pre- and 73 postmenopausal) and 35 osteoporotic women
[vertebral bone mineral density (BMD) more than 2.5 SD below the normal adult mean]; (2) 10 women (44–50 years) ovariectomized
(OVX) for benign uterine diseases, examined before and 12 months after surgery; (3) 16 OVX women (36–54 years), examined before
and after 12 months of transdermal estrogen replacement therapy (50 μg/day); (4) 12 previously untreated pagetic patients
(4 women and 8 men, 50–80 years), examined before and 3 months after the I.V. administration of clodronate (600 mg) or alendronate
(5 mg) for 2 consecutive days. The median BALP value was 11.6 U/liter (25–75th percentiles: 10.5–12.7; range 7.7–19.3) in
healthy premenopausal (PreMP) women and significantly higher (median: 16.8 U/liter; 25–75th percentile: 13.8–21.8; P < 0.01) in postmenopausal (PostMP) women. There was a clear age-related increase in normal subjects (r = 0.43; P < 0.001). In the osteoporotic group, BALP levels, as well as other biochemical parameters of bone turnover, were not significantly
different from those of normal women when adjusted for age. In OVX women, BALP levels showed a marked increase 12 months after
surgery (median: 113%; 25–75th percentile: 87–139%), significantly higher than the increase of total ALP (median: 43%; 25–75th
percentile: 25–66%; P < 0.001), and similar to the increases of serum osteocalcin and urinary hydroxyproline. Transdermal estrogen treatment prevented
the BALP increase, even if no reduction was observed; total ALP showed a similar behavior. The basal levels of BALP were significantly
elevated in pagetic patients (median: 91 U/liter; range 18–610 U/liter) and correlated to the scintigraphic extent of the
disease (r = 0.76; P < 0.01). Three months after the I.V. administration of bisphosphonates, the decrease of BALP was more marked than that of
total ALP (median: −54% versus −41%; P < 0.05). In conclusion, these results suggest that BALP measurement with this immunoassay may be clinically useful, and more
sensitive than total ALP, in the assessment of bone turnover during changes of the estrogen status as well as in monitoring
the effects of treatments that modify the metabolic activity of the skeleton.
Received: 25 January 1996 / Accepted: 3 May 1996 相似文献
8.
P. Masaryk M. Lunt L. Benevolenskaya J. Cannata J. Dequeker C. Dohenhof J. A. Falch D. Felsenberg H. A. P. Pols G. Poor D. M. Reid C. Scheidt-Nave K. Weber T. O'Neill A. J. Silman J. Reeve 《Calcified tissue international》1998,63(4):271-276
We have previously shown considerable between-center variation in bone mineral density (BMD) in the 13 EVOS centers that
performed bone densitometry on their sex- and age-stratified population samples, after adjusting for weight and age. We have
now investigated whether part of the between-center variability may be attributed to between-center variations in the use
of medications. Information was collected from 2088 women and 1908 men at baseline on whether the subjects had ever been prescribed
calcium, calcitonin, anabolic steroids, fluoride, vitamin D, or glucocorticoids and, for the women, whether they had ever
used the oral contraceptive pill (OCP) or hormone replacement therapy (HRT). Each of these variables was fitted into a regression
model adjusted for age, height, weight, and center. Only OCP and HRT significantly affected BMD. Those who had ever used OCPs
had spinal BMD 0.029 g/cm2 greater than those who had never used them. Users of HRT had higher BMD than nonusers: 0.037 g/cm2 at the spine, 0.018 g/cm2 at the trochanter, and 0.018 g/cm2 at the femoral neck. As expected, there was a great variation between centers in the use of OCP and HRT, but there were no
significant correlations between mean BMD at any site in a given center and the prevalence of OCP or HRT use in that center.
The between-center variance in BMD at all three sites remained highly significant after adjusting for treatment (P < 0.001). We conclude that HRT and OCP use are associated with moderate increases in BMD. The geographical variability of
BMD in Europe was not explained by treatment with pharmaceuticals.
Received: 27 July 1997 / Accepted: 23 March 1998 相似文献
9.
Leppälä J Kannus P Natri A Pasanen M Sievänen H Vuori I Järvinen M 《Calcified tissue international》1999,64(4):357-363
The objective of this 1-year prospective follow-up study was to assess, with dual-energy X-ray absorptiometry (DXA), the
effect of an anterior cruciate ligament (ACL) injury of the knee on areal bone mineral density (BMD) of the injured extremity
and lumbar spine in two separate patient groups: 21 surgically treated patients (group A) and 12 conservatively treated patients
(group B). Clinical and functional status of the patients and BMD of the spine (L2–L4), dominant distal radius, femoral neck,
trochanter area of the femur, distal femur, patella, proximal tibia, and calcaneus of both lower extremities were determined
at the time of the injury and after 4, 8, and 12 months. A surgically treated, complete ACL rupture (group A) resulted in
considerable and statistically significant bone loss to the affected knee (distal femur 21%, patella 17%, proximal tibia 14%;
P < 0.001 in each), whereas the other sites were clearly less affected. Patients with a conservatively treated, complete or
partial ACL injury (group B) had only a small but statistically significant bone loss at the patella (−3%; P= 0.005) and proximal tibia (−2%; P= 0.022) of the injured knee, and the other sites remained unchanged. The obvious differences between the groups A and B in
the severity of the injury itself (complete or partial tear), its treatment (surgical or conservative), and subsequent rehabilitation
(longer nonweight-bearing times in group A) explain these different BMD results, and the forthcoming years will show whether
the considerable posttraumatic osteoporosis in the affected knee of group A patients will finally recover, and if so, to what
extent.
Received: 16 June 1998 / Accepted: 6 October 1998 相似文献
10.
W. Yu M. Qin L. Xu C. van Kuijk X. Meng X. Xing J. Cao H. K. Genant 《Osteoporosis international》1999,9(2):179-187
This study was designed to determine age- and gender-based normative values for spinal bone mineral density (BMD) in a Chinese
population. In addition, we compared our data with those of other countries and populations. Four hundred and forty-three
healthy Chinese subjects, aged 10–79 years (189 males, mean age 46.9 years; 254 females, mean age 45.7 years) were recruited
for BMD assessment. BMD was measured by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA),
including postero-anterior DXA (PA-DXA), lateral DXA (L-DXA) and midlateral DXA (mL-DXA). For both genders, BMD values peaked
in the 10–19 year age group when measured by QCT, and in the 30–39 year age group when measured by PA-DXA. BMD values decreased
with age after reaching peak bone density in males and females for all measurements, except for PA-DXA in males. Male BMD
values by DXA tended to increase beginning with the 60–69 age group through the 70–79 age group whether by PA-DXA, or L-DXA
and mL-DXA. However, male QCT data showed stable BMD values among these two older groups. Comparative results showed female
QCT data were higher in the 20–39 age group and lower after the 40–49 age group compared with American females. The peak BMD
value by PA-DXA in Chinese females was reached in the same age group as American and European females and was similar in magnitude
(p > 0.05). However, the peak BMD value for Chinese females was reached earlier and was significantly higher than that observed
in Japanese females (p < 0.001). We conclude that the age group in which the peak BMD values are reached is different depending on the technique
used, as is the calculated age-related rate of bone loss. It can be speculated that such differences reflect different timing
for bone maturation in cancellous and cortical bone.
Received: 21 February 1998 / Accepted: 28 May 1998 相似文献
11.
S. S. Papiha L. C. Allcroft R. M. Kanan R. M. Francis H. K. Datta 《Calcified tissue international》1999,65(4):262-266
Vitamin D binding protein (DBP) is a major carrier protein for the vitamin D metabolites, but may also play an important
role in osteoclast differentiation. Polymorphisms of the DBP gene have been reported, including (TAAA)n-Alu repeat polymorphisms downstream of intron 8. We have examined the relationship between polymorphisms of the DBP gene
and bone mineral density (BMD) and vertebral fractures in a group of 26 men with vertebral fractures but no underlying secondary
cause of osteoporosis (median age 64, ages 27–72 years) and 21 male control subjects (median age 65, ages 40–77 years). There
was no apparent effect of DBP phenotype on BMD, but there was a relationship between certain genotypes of (TAAA)n-Alu repeats and reduced BMD and vertebral fracture. Lumbar spine and femoral neck BMD were significantly lower in men with
10/8 genotype than 10/10 genotype (P < 0.05). Furthermore, the predominant genotype in men with vertebral fractures was 10/8, whereas the most common genotype
in control subjects was 10/10 (odds ratio 56; 95% confidence interval 7–445). Plasma DBP was higher in men with 10/8 genotype
than those with 10/10 genotype (P < 0.05), and patients with vertebral fractures were found to have higher levels than control subjects (P < 0.0005). Although our study is small because of the relative rarity of idiopathic osteoporosis in men, the results suggest
that (TAAA)n-Alu polymorphism may have an important effect on plasma levels of DBP, bone density and fracture risk in men.
Received: 5 May 1998 / Accepted: 10 April 1999 相似文献
12.
M. C. Chapuy R. Pamphile E. Paris C. Kempf M. Schlichting S. Arnaud P. Garnero P. Garnero P. J. Meunier 《Osteoporosis international》2002,13(3):257-264
Vitamin D insufficiency and low calcium intake contribute to increase parathyroid function and bone fragility in elderly
people. Calcium and vitamin D supplements can reverse secondary hyperparathyroidism thus preventing hip fractures, as proved
by Decalyos I. Decalyos II is a 2-year, multicenter, randomized, double-masked, placebo-controlled confirmatory study. The
intention-to-treat population consisted of 583 ambulatory institutionalized women (mean age 85.2 years, SD = 7.1) randomized
to the calcium–vitamin D3 fixed combination group (n= 199); the calcium plus vitamin D3 separate combination group (n= 190) and the placebo group (n= 194). Fixed and separate combination groups received the same daily amount of calcium (1200 mg) and vitamin D3 (800 IU), which had similar pharmacodynamic effects. Both types of calcium-vitamin D3 regimens increased serum 25-hydroxyvitamin D and decreased serum intact parathyroid hormone to a similar extent, with levels
returning within the normal range after 6 months. In a subgroup of 114 patients, femoral neck bone mineral density (BMD) decreased
in the placebo group (mean =–2.36% per year, SD = 4.92), while remaining unchanged in women treated with calcium-vitamin D3 (mean = 0.29% per year, SD = 8.63). The difference between the two groups was 2.65% (95% CI =–0.44, 5.75%) with a trend in
favor of the active treatment group. No significant difference between groups was found for changes in distal radius BMD and
quantitative ultrasonic parameters at the os calcis. The relative risk (RR) of HF in the placebo group compared with the active
treatment group was 1.69 (95% CI = 0.96, 3.0), which is similar to that found in Decalyos I (RR = 1.7; 95% CI = 1.0, 2.8).
Thus, these data are in agreement with those of Decalyos I and indicate that calcium and vitamin D3 in combination reverse senile secondary hyperparathyroidism and reduce both hip bone loss and the risk of hip fracture in
elderly institutionalized women.
Received: 23 March 2001 / Accepted: 28 October 2001 相似文献