Relationship between Regular Green Tea Intake and Osteoporosis in Korean Postmenopausal Women: A Nationwide Study

Mixed results have been reported regarding whether habitual tea intake affects bone health. This study investigated the relationship between green tea intake and bone mineral density (BMD) in postmenopausal Korean women. We used data from the Korean National Health and Nutrition Examination Surveys from 2008 to 2011 and divided the participants into three groups according to their frequency of green tea intake over the past 12 months. BMD of the lumbar spine, total femur, and femur neck was measured using dual-energy X-ray absorptiometry. The odds ratios (ORs) and 95% confidence intervals (CIs) of osteoporosis and osteopenia according to green tea consumption were analyzed. Participants who did not consume green tea or consumed less than one cup per day were more likely to have osteopenia of the lumbar spine or femur than those who consumed it once to three times a day (OR 1.81 and 1.85, 95% CI, 1.20–2.71; and 1.23–2.77). Moreover, ORs for osteoporosis were 1.91 (95% CI 1.13–3.23) and 1.82 (95% CI 1.09–3.05) in non-consumers and consumers who drank less than one cup per day, respectively, compared with the reference group. These results support that green tea consumption may have benefits on bone health.

Multiple screw fixation versus cementless bipolar hemiarthroplasty for femur neck fracture using a nationwide hip fracture registry

Cementless bipolar hemiarthroplasty (BHA) recently gained popularity as a treatment for femur neck fracture (FNF), but there have been few studies comparing this with multiple screw fixation (MSF) in the elderly population. The purpose of this study is to compare (1) surgery-related parameters, (2) reoperation rate as a local complication, (3) in-hospital systemic complication rate, and (4) mortality rate at 1 year after MSF and cementless BHA in patients with FNF using nationwide data. Six-hundred sixty-six hips (aged ≥ 50 years) extracted from nationwide Hip Fracture Registry were included in this study (133 MSF and 533 cementless BHA). One hundred fifty-six hips were divided into nondisplaced FNF (Group A) and 510 into displaced FNF (Group B). We evaluated (1) surgery-related parameters (anesthesia type, time to surgery, operation time, estimated blood loss and volume of postoperative transfusion), (2) the rate of and reasons for reoperation, (3) the rate and type of in-hospital systemic complications and (4) one-year mortality rate after surgery. In Group A, MSF showed shorter operation time (p = 0.004) and lower incidence of in-hospital systemic complications (p = 0.003). In Group B, cementless BHA demonstrated lower reoperation rate than MSF (p < 0.001). In both Group A and B, cementless BHA was associated with higher estimated blood loss than MSF (p < 0.001). Based on findings in our study, MSF might be a more favorable option for nondisplaced FNF, whereas cementless BHA might be a better one for displaced FNF in patients older than fifty. Nevertheless, our nationwide study also showed that numbers of cementless BHAs were being performed for nondisplaced FNF even in teaching hospitals.

Assessment of total and regional bone mineral density using bioelectrical impedance vector analysis in elderly population

This study aimed to investigate the relationship between bone mineral density (BMD) and height-adjusted resistance (R/H), reactance (Xc/H) and phase angle (PhA). A total of 61 male and 64 female subjects aged over 60 years were recruited from middle Taiwan. The R and Xc were measured using Bodystat Quadscan 4000 at a frequency of 50 kHz. BMD at the whole body, L2–L4 spine, and dual femur neck (DFN), denoted as BMDTotal, BMDL2–L4, and BMDDFN, were calculated using a Hologic DXA scanner. The R-Xc graph was used to assess vector shift among different levels of BMD. BMD was positively correlated with Xc/H and negatively correlated with R/H (p < 0.001). The General Linear Model (GLM) regression results were as follows: BMDTotal = 1.473–0.002 R/H + 0.007 Xc/H, r = 0.684; BMDL2–L4 = 1.526–0.002 R/H + 0.012 Xc/H, r = 0.655; BMDDFN = 1.304–0.002 R/H + Xc/H, r = 0.680; p < 0.0001. Distribution of vector in the R-Xc graph was significantly different for different levels of BMDTotal, BMDL2–L4 and BMDDFN. R/H and Xc/H were correlated with BMD in the elderly. The linear combination of R/H and Xc/H can effectively predict the BMD of the whole body, spine and proximal femur, indicating that BIVA may be used in clinical and home-use monitoring tool for screening BMD in the elderly in the future.

Bone mineral density in postmenopausal women with osteoarthritis of knee joint

Objective. Study the state of mineral bone density (BMD) in postmenopausal women with osteoarthritis (OA) of the knee joint depending on the X-ray stage.Materials and methods. The study included 56 women between 44 and 75 years of age. The diagnosis of OA is established according to the diagnostic criteria of the American College of Rheumatology (ACR, 1991). For comparative analysis, patients were divided into two groups, taking into account the radiological stage: the 1st with 38 women with I–II radiology stage, the 2nd with 18 patients with III–IV radiology stage. The X-ray of the knee joint in the anterior projection is performed in a fixed bending position using a special frame (SynaFlexer TM Plexiglass positioning frame, Synarc Inc., USA). The BMD is estimated by a two-energy X-ray absorption technique in the femoral neck and lumbar spine.Results. Osteopenic syndrome is diagnosed in 52 (92.8%) of the total number of patients, 27 (48.2%) have osteopenia and 25 (44.6%) have osteoporosis. Four women (7.1%) have a normal BMD. There is no statistically significant difference in the frequency of detection of the osteopenic syndrome between the groups studied (p > 0.050). Statistically significant increases in BMD and T-criteria have been found as the OA progresses in both the femoral neck and the lumbar spine. The correlation analysis results show a significant positive correlation between the BMD femoral neck and the OA X-ray stage (r = 501; p < 0.001).Conclusions. The data show the presence of the osteopenic syndrome in the vast majority in postmenopausal women with OA of the knee joint. The high BMD values of the femur neck and lumbar spine are associated with the late X-ray stages of the OA of the knee joint.

Is bone health of young atopic dermatitis patients a significant healthcare problem?

Background Atopic dermatitis (AD) incidence has increased over the past decades, especially among young adults. However, their bone health has not been clearly elucidated with discordant results. Objective We aimed to investigate the bone mineral density (BMD) measured by double energy X-ray absorptiometry and Z-score at the lumbar spine, femur neck, and total femur to evaluate the risk of osteoporosis in men aged <50 years and premenopausal women with AD.Methods The Korea National Health and Nutrition Examination Survey 2007-2009 data were used in this case-control cohort study. We included young AD patients (aged 19≤ and <50 years) diagnosed by a doctor and compared these patients with 1:5 propensity score weighting controls by age, sex, body mass index (BMI), vitamin D level, and alcohol/smoking status. Results We analyzed 311 (weighted n=817,014) AD patients and 1,555 (weighted n=4,155,855) controls. BMD at the lumbar spine was significantly lower in the male AD group than in the male control group (mean ± SE, 0.989 ± 0.002 vs. 0.954 ± 0.016, P = 0.03) while BMDs at the femur neck and total femur were comparable. For women, BMDs at the three sites were not significantly different between the AD and control groups. Low bone mass (defined by a Z-score of ≤2.0) was not significantly different between the AD and control groups in both sexes. Conclusions Bone health, especially BMD and Z-score, in young AD patients were comparable with those without AD. AD was not a risk factor for low BMD.

Unusual Combination of Hip Dislocation with Ipsilateral Femoral Neck and Acetabulum Fracture: A Rare Case Report

Introduction: Traumatic dislocation of hip associated with ipsilateral femur neck and acetabulum fracture is a rare and devastating injury as a result of high-energy trauma, with potential complications of femur head aseptic necrosis and hip joint degenerative arthritis. Patients, postoperatively, may encounter decreased functional outcomes and serious challenge, during activities of daily living. Management guidelines lack clarity, with possible options including fracture fragments fixation or hip joint replacement. Case Report: A 45-year-old patient was diagnosed with posterior dislocation of hip with ipsilateral femur neck and acetabulum fracture. Plan for emergent hip reduction and primary surgical fixation of fracture fragments was made. Intraoperatively, posterior wall acetabulum fracture was found to be excessively comminuted and non-amenable for fixation and femoral head was found to be avascularized. Subsequently, plan was changed to total hip replacement with acetabular defect reconstruction. At 1-year follow-up, no aseptic loosening was observed on radiographic views of pelvis, with total Harris Hip Score of 91. Conclusion: Early operative management for such complex injuries is a necessity. Definitive management in the form of primary fracture fixation/arthroplasty should be decided intraoperatively. Keywords: Femur neck, hip dislocation, acetabulum fracture, ipsilateral, case report.