Preferential low bone mineral density of the femoral neck in patients with a recent fracture of the proximal femur

1991 ◽  
Vol 1 (3) ◽  
pp. 147-154 ◽  
Author(s):  
T. Chevalley ◽  
R. Rizzoli ◽  
V. Nydegger ◽  
D. Slosman ◽  
L. Tkatch ◽  
...  
2013 ◽  
Vol 5 (2) ◽  
pp. 16 ◽  
Author(s):  
Stefan Grote ◽  
Tatjana Noeldeke ◽  
Michael Blauth ◽  
Wolf Mutschler ◽  
Dominik Bürklein

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 <em>ex situ </em>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&lt;0.001). The overall correlation of mechanical peak torque with T-score was r=0.60 (P&lt;0.001). A correlation was found between mechanical peak torque, load to failure of bone and BMD <em>in vitro</em>. 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.


2020 ◽  
Vol 33 (2) ◽  
pp. E58-E62
Author(s):  
Donald F. Colantonio ◽  
Sameer K. Saxena ◽  
Alan Vanier ◽  
Daniel Rodkey ◽  
Scott Tintle ◽  
...  

2015 ◽  
Vol 45 (8) ◽  
pp. 800-806 ◽  
Author(s):  
Amer N. Al-Ani ◽  
Tommy Cederholm ◽  
Maria Sääf ◽  
Gustaf Neander ◽  
Richard Blomfeldt ◽  
...  

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 980.2-981
Author(s):  
O. Dobrovolskaya ◽  
Z. Kolkhidova ◽  
A. Menshikova ◽  
N. Demin ◽  
N. Toroptsova

Background:The problem of sarcopenia (SP) in rheumatoid arthritis (RA) is particularly significant in terms of assessing the risk of fractures, since SP leads to falls, which are an independent risk factor for fractures along with RA and osteoporosis.Objectives:To evaluate the bone mineral density (BMD) and fracture risk in women with RA and SP.Methods:79 women with RA based on the 2010 ACR/EULAR classification criteria were included: 20 (25%) women with confirmed SP (age median 59 [53; 64]) according to EWGSOP2 criteria and 59 (75%) women without SP (age median 60 [55; 67]) (p>0.05). We assessed clinical data: age, body mass index (BMI), disease duration, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR), previous medication use including glucocorticoids and methotrexate, muscle strength and function. Dual-energy X-ray absorptiometry (DXA) to measure BMD of lumbar spine (LS), femoral neck (FN) and total hip (TH) was performed. The 10-year probability of major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture) and the 10-year probability hip fracture was calculated using the Russian version of the FRAX® tool. Statistical analysis was performed using non-parametric methods. All patients signed an informed consent to participate.Results:Median BMD in LS was 0.892 [0.772; 1.024] g/cm2in patients with SP and 0.910 [0.785; 1.028] g/cm2- without SP (p>0.05). There was significant difference between groups in the proximal femur BMD: 0.760 [0.731; 0.826] g/cm2in TH and 0.681 [0.607; 0.703] g/cm2in FN in patients with SP and 0.838 [0.735; 0.921] g/cm2in TH and 0.719 [0.622; 0.804] g/cm2in FN in patients without SP (p=0.009 and p=0.048, respectively). The frequency of osteoporosis was 35% and 22% in patients with and without SP (p>0,05). The 10-year probability of major osteoporotic fracture with / without femoral neck BMD data was 22,0% [17,0; 32,0] / 19,5% [18,5; 22,5 and 13,3% [9,8; 18,5] / 12,8% [9,3; 17,0] in patients with SP and without SP (р<0.05) and the 10-year probability of hip fracture with / without femoral neck BMD data - 3,1% [3,0; 7,5] / 3,1% [2,3; 3,3] and 1,4% [0,9; 2,78] / 0,65 [0,4; 1,7], respectively (р<0.05).Conclusion:There were no differences in the frequency of osteoporosis between patients with SP and without SP, however women with SP had proximal femur BMD less than women without SP. The probability of major osteoporotic fracture and hip fracture was significantly higher in patients with RA and SP compared with patients without SP.Disclosure of Interests:None declared


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