The objective of this study was to study the age-related adaptation of lumbar vertebral trabecular bone at the apparent level, as well as the tissue level in three orthogonal directions. Ninety trabecular specimens we...The objective of this study was to study the age-related adaptation of lumbar vertebral trabecular bone at the apparent level, as well as the tissue level in three orthogonal directions. Ninety trabecular specimens were obtained from six normal L4 vertebral bodies of six male cadavers in two age groups, three aged 62 years and three aged 69 years, and were scanned using a high-resolution micro-computed tomography （micro-CT） system, then converted to micro- finite element models to do micro-finite element analyses. The relationship between apparent stiffness and bone volume fraction, and the tissue level yon Mises stress distribution for each trabecular specimen when compressed separately in the longitudinal direction, medial-lateral and anterior-posterior directions （transverse directions） were derived and compared between two age groups. The results showed that at the apparent level, trabecular bones from 69-year group had stiffer bone structure relative to their volume fractions in all three directions, and in both age groups, changes in bone volume fraction could explain more variations in apparent stiffness in the longitudinal direction than the transverse directions; at the tissue level, aging had little effect on the tissue von Mises stress distributions for the compressions in all the three directions. The novelty of the present study was that it provided quantitative assessments on the age and direction- related adaptation of Chinese male lumbar vertebral trabecular bone from two different levels： stiffness at the apparent level and stress distribution at the tissue level. It may help to understand the failure mechanisms and fracture risks of vertebral body associated with aging and direction for the prevention of fracture risks in elder individuals.展开更多
The mechanical properties of the pelvic trabecular bone have been studied at the continuum level. However, nothing is known about the tissue-level damage in the trabecular bone of the healthy human acetabulum at appar...The mechanical properties of the pelvic trabecular bone have been studied at the continuum level. However, nothing is known about the tissue-level damage in the trabecular bone of the healthy human acetabulum at apparent small strains characteristic of habitual. By a DAWING 4000 A supercomputer, nonlinear micro-finite element (μFE) analysis was performed to quantify tissue-level damage accumulation in trabecular bone at small strains. The data indicate that damage in trabecular bone commence at 0.2% apparent strain. The findings imply that tissue yielding can initiate at very low strains in the trabecular bone of the healthy acetabulum and that this local failure has negative consequences on the apparent mechanical properties of trabecular bone.展开更多
BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk...BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk of low-energy fractures as bone quality is reduced.It was hypothesized that a decrease in the trabecular bone score(TBS),a parameter assessing bone microarchitecture,may be an early marker of impaired bone health in women with T2D.AIM To identify clinical and body composition parameters that affect TBS in postmenopausal women with T2D and normal BMD.METHODS A non-interventional cross-sectional comparative study was conducted.Potentially eligible subjects were screened at tertiary referral center.Postmenopausal women with T2D,aged 50-75 years,with no established risk factors for secondary osteoporosis,were included.BMD,TBS and body composition parameters were assessed by dual-energy X-ray absorptiometry.In women with normal BMD,a wide range of anthropometric,general and diabetes-related clinical and laboratory parameters were evaluated as risk factors for TBS decrease using univariate and multivariate regression analysis and analysis of receiver operating characteristic(ROC)curves.RESULTS Three hundred twelve women were initially screened,176 of them met the inclusion criteria and underwent dual X-ray absorptiometry.Those with reduced BMD were subsequently excluded;96 women with normal BMD were included in final analysis.Among them,43 women(44.8%)showed decreased TBS values(≤1.31).Women with TBS≤1.31 were taller and had a lower body mass index(BMI)when compared to those with normal TBS(Р=0.008 and P=0.007 respectively).No significant differences in HbA1c,renal function,calcium,phosphorus,alkaline phosphatase,PTH and 25(ОН)D levels were found.In a model of multivariate linear regression analysis,TBS was positively associated with gynoid fat mass,whereas the height and androgen fat mass were associated negatively(all P<0.001).In a multiple logistic regression,TBS≤1.31 was associated with lower gynoid fat mass(adjusted odd ratio[OR],0.9,95%confidence interval[CI],0.85-0.94,P<0.001),higher android fat mass(adjusted OR,1.13,95%CI,1.03-1.24,P=0.008)and height(adjusted OR,1.13,95%CI,1.05-1.20,P<0.001).In ROC-curve analysis,height≥162.5 cm(P=0.04),body mass index≤33.85 kg/m2(P=0.002),gynoid fat mass≤5.41 kg(P=0.03)and android/gynoid fat mass ratio≥1.145(P<0.001)were identified as the risk factors for TBS reduction.CONCLUSION In postmenopausal women with T2D and normal BMD,greater height and central adiposity are associated with impaired bone microarchitecture.展开更多
To evaluate the long-term consequence of repetitive mild traumatic brain injury （mTBI） on bone, mTBI was induced in 10-week-old female C57BL/6J mice using a weight drop model, once per day for 4 consecutive days at ...To evaluate the long-term consequence of repetitive mild traumatic brain injury （mTBI） on bone, mTBI was induced in 10-week-old female C57BL/6J mice using a weight drop model, once per day for 4 consecutive days at different drop heights （0.5, 1 and 1.5 m） and the skeletal phenotype was evaluated at different time points after the impact. In vivo micro-CT （μ-CT） analysis of the tibial metaphysis at 2, 8 and 12 weeks after the impact revealed a 5%-32% reduction in trabecular bone mass. Histomorphometric analyses showed a reduced bone formation rate in the secondary spongiosa ofl.5 m impacted mice at 12 weeks post impact. Apparent modulus （bone strength）, was reduced by 30% （P 〈 0.05） at the proximal tibial metaphysis in the 1.5 m drop height group at 2 and 8 weeks post impact. Ex vivo μ-CT analysis of the fifth lumbar vertebra revealed a significant reduction in trabecular bone mass at 12 weeks of age in all three drop height groups. Serum levels of osteocalcin were decreased by 22%, 15%, and 19% in the 0.5, 1.0 and 1.5 m drop height groups, respectively, at 2 weeks post impact. Serum IGF-I levels were reduced by 18%-32% in mTBI mice compared to control mice at 2 weeks post impact. Serum osteocalcin and IGF-I levels correlated with trabecular BV/TV （r2 = 0.14 and 0.16, P 〈 0.05）. In conclusion, repetitive mTBI exerts significant negative effects on the trabecular bone microarchitecture and bone mechanical properties by influencing osteoblast function via reduced endocrine IGF-I actions.展开更多
Trabecular bone holds the utmost importance due to its significance regarding early bone loss.Diseases like osteoporosis greatly affect the structure of the Trabecular bone which results in different outcomes like hig...Trabecular bone holds the utmost importance due to its significance regarding early bone loss.Diseases like osteoporosis greatly affect the structure of the Trabecular bone which results in different outcomes like high risk of fracture.The objective of this paper is to inspect the characteristics of the Trabecular Bone by using the Magnetic Resonance Imaging(MRI)technique.These characteristics prove to be quite helpful in studying different studies related to Trabecular bone such as osteoporosis.The things that were considered before the selection of the articles for the systematic review were language,research field,and electronic sources.Only those articles written in the English language were selected as it is the most prominent language used in scientific,engineering,computer science,and biomedical researches.This literature review was conducted on the articles published between 2006 and 2020.A total of 62 research papers out of 1050 papers were extracted which were according to our topic of review after screening abstract and article content for the title and abstract screening.The findings from those researches were compiled at the end of the result section.This systematic literature review presents a comprehensive report on scientific researches and studies that have been done in the medical area concerning trabecular bone.展开更多
The objective of this paper is to identify the effects of mechanical disuse and basic multi-cellular unit （BMU） activation threshold on the form of trabecular bone during menopause. A bone adaptation model with mech...The objective of this paper is to identify the effects of mechanical disuse and basic multi-cellular unit （BMU） activation threshold on the form of trabecular bone during menopause. A bone adaptation model with mechanical- biological factors at BMU level was integrated with finite element analysis to simulate the changes of trabecular bone structure during menopause. Mechanical disuse and changes in the BMU activation threshold were applied to the model for the period from 4 years before to 4 years after menopause. The changes in bone volume fraction, trabecular thickness and fractal dimension of the trabecular structures were used to quantify the changes of trabecular bone in three different cases associated with mechanical disuse and BMU activation threshold. It was found that the changes in the simulated bone volume fraction were highly correlated and consistent with clinical data, and that the trabecular thickness reduced signi-ficantly during menopause and was highly linearly correlated with the bone volume fraction, and that the change trend of fractal dimension of the simulated trabecular structure was in correspondence with clinical observations. The numerical simulation in this paper may help to better understand the relationship between the bone morphology and the mecha-nical, as well as biological environment; and can provide a quantitative computational model and methodology for the numerical simulation of the bone structural morphological changes caused by the mechanical environment, and/or the biological environment.展开更多
The mechanical behaviour of trabecular bone is dependent on both the properties of individual trabeculae as well as their three-dimensional arrangement in space. In this study, nanoindentation was used to determine tr...The mechanical behaviour of trabecular bone is dependent on both the properties of individual trabeculae as well as their three-dimensional arrangement in space. In this study, nanoindentation was used to determine trabecular stiffness of bovine bone, both dehydrated and rehydrated. Values of 18.3 GPa and 14.3 GPa were obtained for dehydrated and rehydrated trabeculae respectively. These values were then used for finite element analysis where the mesh was generated directly from an X-ray microtomography dataset. The relationship between intrinsic tissue properties and apparent stiffness was explored. Moreover, the important role of collagen in bone micromechanics was demonstrated by complementing the study with Raman spectroscopy.展开更多
Objective. To evaluate the effects of alendronate on the structural properties of trabecular bone.Methods. Alendronate was administered at a daily p. o. dose of 0. 5 mg/kg over a 12-week period in hound dogs (n = 8 fo...Objective. To evaluate the effects of alendronate on the structural properties of trabecular bone.Methods. Alendronate was administered at a daily p. o. dose of 0. 5 mg/kg over a 12-week period in hound dogs (n = 8 for both the control and treated group), and the structural indices of the lumbar vertebral (LI and L2) trabecular bone were assessed directly from 3-D images.Results. Treatment with alendronate increased bone volume fraction by 9. 5% and 7. 7% in L1 and L2 respectively. Trabecular thickness significantly increased after alendronate treatment, whereas trabecular separation remained constant. The degree of anisotropy for the alendronate - treated group was decreased compared with that of the control group. Bone surface to volume ratio declined significantly in the alendronate-reated group, whereas alendronate induced a higher bone surface density.Conclusion. Alendronate increased the structural properties of canine trabecular bone after short-term treatment at a dose of 0. 5 mg · kg-1·day-1.展开更多
The study aimed to examine changes in trabecular bone microstructure （TBMS） during the period of 5 weeks after the injury in a rat model of spinal cord injury （SCI）. Eight-week-old male Wistar rats underwent surgi...The study aimed to examine changes in trabecular bone microstructure （TBMS） during the period of 5 weeks after the injury in a rat model of spinal cord injury （SCI）. Eight-week-old male Wistar rats underwent surgical transection of the lower thoracic spinal cord （SCI, n = 16） or sham operation （SHAM, n = 14）. TBMS （tissue volume, bone volume, bone volume fraction, trabecular thickness, width, number, separation, connectivity density, and trabecular bone pattern factor）, assessed using a micro-computed tomography, was deteriorated 1, 3 and 5 weeks after SCI. In addition, both bone mass and serum biochemical parameters were determined. Dry bone weight, ash weight, bone mineral content （BMC）, and BMC/tissue-volume were significantly lower in the SCI group than in the SHAM group throughout the experimental period. Serum inorganic phosphate and alkaline phosphatase levels were significantly lower in the SCI group than in the SHAM group 1 week after the surgery. SCI resulted in rapid deterioration of both bone mass and microstructure. These changes appeared as early as 1 week after SCI. Based on the authors＇ results, it should be noted that in SCI patients, interventions for preventing bone loss should start as soon as possible after the injury.展开更多
Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions...Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions parallel and perpendicular to the forearm. Methodology: Data from more than two hundred subjects were studied retrospectively. A DXA (GE Lunar Prodigy) scan of the forearm was performed on each subject to measure the bone mineral density (BMD) value at the location of ultra-distal radius, and an X-ray digital image of the same forearm was taken on the same day. The values of trabecular bone score along the direction perpendicular to the forearm, TBS<sub>x</sub>, and along the direction parallel to the forearm, TBS<sub>y</sub>, were calculated respectively. The statistics of TBS<sub>x</sub> and TBS<sub>y</sub> were calculated, and the anisotropy of the trabecular bone, which was defined as the ratio of TBS<sub>y</sub> to TBS<sub>x</sub> and changed with subjects’ BMD and age, was reported and analyzed. Results: The results show that the correlation coefficient between TBS<sub>x</sub> and TBS<sub>y</sub> was 0.72 (p BMD and age was reported. The results showed that decreased trabecular bone anisotropy was associated with deceased BMD and increased age in the subject group. Conclusions: This study shows that decreased trabecular bone anisotropy was associated with decreased BMD and increased age.展开更多
Background: When applied to trabecular bone X-ray images, a method for analyzing trabecular bone texture based on the initial slope of variogram (ISV) was used to assess the trabecular bone health. Methodology: Data f...Background: When applied to trabecular bone X-ray images, a method for analyzing trabecular bone texture based on the initial slope of variogram (ISV) was used to assess the trabecular bone health. Methodology: Data from more than two hundred subjects were retrospectively studied. For each subject, a DXA (GE Lunar Prodigy) scan of the forearm was performed, and bone mineral density (BMD) value was measured at the location of ultra-distal radius, X-ray digital image of the same forearm was taken on the same day, and ISV value over the same location of ultra-distal radius was calculated. Pearson’s correlation coefficients were calculated to examine the correlation between BMD and ISV of the trabecular bones located at the same ultra-distal radius. ISV values changed with subjects’ age were also reported. Results: The results show that ISV value was highly correlated with the DXA-measured BMD of the same trabecular bone located at the ultra-distal radius. The correlation coefficient between ISV and BMD with the 95% confident was 0.79 ± 0.09. They also demonstrated that the age-related changes in trabecular bone health and differentiated age patterns in males and females, respectively. The results showed that the decrease in BMD was accompanied by a decrease in the initial slope of variogram (ISV). Conclusions: This study suggests that ISV might be used to quantitatively evaluate trabecular health for osteoporosis and bone disease diagnosis.展开更多
The aim of this study was to identify three-dimensional microstructural changes of trabecular bone with age and gender, using micro-computed tomography. Human trabecular bone from two disease groups, osteoporosis and ...The aim of this study was to identify three-dimensional microstructural changes of trabecular bone with age and gender, using micro-computed tomography. Human trabecular bone from two disease groups, osteoporosis and osteoarthritis was analyzed. A prior analysis of the effects of some procedure variables on the micro-CT results was performed. Preliminary micro-CT scans were performed with three voxel resolutions and two acquisition conditions. On the reconstruction step, the image segmentation was performed with three different threshold values. Samples were collected from patients, with coxarthrosis (osteoarthritis) or fragility fracture (osteoporosis). The specimens of the coxarthrosis group include twenty females and fifteen males, while the fragility fracture group was composed by twenty three females and seven males. The mean age of the population was 69 ± 11 (females) and 67 ± 10 years (males), in the coxarthrosis group, while in the fragility fracture group was 81 ± 6 (females) and 78 ± 6 (males) years. The 30 μm voxel size provided lower percentage difference for the microarchitecture parameters. Acquisition conditions with 160 μA and 60 kV permit the evaluation of all the volume’s sample, with low average values of the coefficients of variation of the microstructural parameters. No statistically significant differences were found between the two diseases groups, neither between genders. However, with aging, there is a decrease of bone volume fraction, trabecular number and fractal dimension, and an increase of structural model index and trabecular separation, for both disease groups and genders. The parameters bone specific surface, trabecular thickness and degree of anisotropy have different behaviors with age, depending on the type of disease. While in coxarthrosis patients, trabecular thickness increases with age, in the fragility fracture group, there is a decrease of trabecular thickness with increasing age. Our findings indicate that disease, age and gender do not provide significant differences in trabecular microstructure. With aging, some parameters exhibit different trends which are possibly related to different mechanisms for different diseases.展开更多
In order to study the microstructure characteristics of normal lunate bones, eight fresh cadaver normal lunates were scanned with micro-computed tomography. High-resolution images of the micro-structure of normal luna...In order to study the microstructure characteristics of normal lunate bones, eight fresh cadaver normal lunates were scanned with micro-computed tomography. High-resolution images of the micro-structure of normal lunates were obtained and we analyzed the nutrient foramina. Then nine regions of interest(ROI) were chosen in the central sagittal plane so that we could obtain the parameters of trabecular bones of ROIs. The distal lamellar-like compact structure had statistically significant differences when it was compared with the ROIs in the volar and dorsal ends of the distal cortex. The difference of diameter between the volar and dorsal foramina was significant(P<0.05). However, there was no significant difference regarding the number. The trabecular bones of the volar and dorsal distal ends had lower intensity than those of the distal central subchondral bone plate. The diameters of the nutrient foramina on the volar cortex were larger than those on the dorsal. This research provided more detailed information about microstructure of normal lunate and the nutrient foramina on cortex, and a reference for further study about diseased lunate.展开更多
The authors revise the latest evidence in the literature regarding managing of osteoporosis in ulcerative colitis (UC), paying particular attention to the latest tendency of the research concerning the management of b...The authors revise the latest evidence in the literature regarding managing of osteoporosis in ulcerative colitis (UC), paying particular attention to the latest tendency of the research concerning the management of bone damage in the patient affected by UC. It is wise to assess vitamin D status in ulcerative colitis patients to recognize who is predisposed to low levels of vitamin D, whose deficiency has to be treated with oral or parenteral vitamin D supplementation. An adequate dietary calcium intake or supplementation and physical activity, if possible, should be guaranteed. Osteoporotic risk factors, such as smoking and excessive alcohol intake, must be avoided. Steroid has to be prescribed at the lowest possible dosage and for the shortest possible time. Moreover, conditions favoring falling have to been minimized, like carpets, low illumination, sedatives assumption, vitamin D deficiency. It is advisable to assess the fracture risk in all UC patient by the fracture assessment risk tool (FRAX<sup>®</sup> tool), that calculates the ten years risk of fracture for the population aged from 40 to 90 years in many countries of the world. A high risk value could indicate the necessity of treatment, whereas a low risk value suggests a follow-up only. An intermediate risk supports the decision to prescribe bone mineral density (BMD) assessment and a subsequent patient revaluation for treatment. Dual energy X-ray absorptiometry bone densitometry can be used not only for BMD measurement, but also to collect data about bone quality by the means of trabecular bone score and hip structural analysis assessment. These two indices could represent a method of interesting perspectives in evaluating bone status in patients affected by diseases like UC, which may present an impairment of bone quality as well as of bone quantity. In literature there is no strong evidence for instituting pharmacological therapy of bone impairment in UC patients for clinical indications other than those that are also applied to the patients with osteoporosis. Therefore, a reasonable advice is to consider pharmacological treatment for osteoporosis in those UC patients who already present fragility fractures, which bring a high risk of subsequent fractures. Therapy has also to be considered in patients with a high risk of fracture even if it did not yet happen, and particularly when they had long periods of corticosteroid therapy or cumulative high dosages. In patients without fragility fractures or steroid treatment, a medical decision about treatment could be guided by the FRAX tool to determine the intervention threshold. Among drugs for osteoporosis treatment, the bisphosphonates are the most studied ones, with the best and longest evidence of efficacy and safety. Despite this, several questions are still open, such as the duration of treatment, the necessity to discontinue it, the indication of therapy in young patients, particularly in those without previous fractures. Further, it has to be mentioned that a long-term bisphosphonates use in primary osteoporosis has been associated with an increased incidence of dramatic side-effects, even if uncommon, like osteonecrosis of the jaw and atypical sub-trochanteric and diaphyseal femoral fractures. UC is a long-lasting disease and the majority of patients is relatively young. In this scenario primary prevention of fragility fracture is the best cost-effective strategy. Vitamin D supplementation, adequate calcium intake, suitable physical activity (when possible), removing of risk factors for osteoporosis like smoking, and avoiding falling are the best medical acts.展开更多
Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related ost...Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline bone mineral density （BMD） characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography. Results Para-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery. Conclusion The approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.展开更多
Objective To study the effects of electromagnetic pulse （EMP） on bone metabolism of mice in vivo. Methods Twenty-four male BALB/c mice were divided into a control group and 2 experimental groups （n=8）. The whole-b...Objective To study the effects of electromagnetic pulse （EMP） on bone metabolism of mice in vivo. Methods Twenty-four male BALB/c mice were divided into a control group and 2 experimental groups （n=8）. The whole-body of mice in experimental groups were exposed to 50 kV/m and 400kV/m EMP, 400 pulses daily for 7 consecutive days at 2 seconds intervals. Alkaline phosphotase （ALP） activity, serum calcium concentration and osteocalcin level and trabecular bone volume （BV/TV, %） were measured immediately after EMP exposure by biochemical, ELISA and morphological methods. Results The ALP activity, serum calcium concentration and osteocalcin level and BV/TV in experimental groups remained unchanged after EMP exposure. Conelusion Under our experimental conditions, EMP exposure cannot affect bone metabolism of mice in vivo.展开更多
This study aims to investigate the regional variations of trabecular morphological parameters and mechanical parameters of the femoral head,as well as to determine the relationship between trabecular morphological and...This study aims to investigate the regional variations of trabecular morphological parameters and mechanical parameters of the femoral head,as well as to determine the relationship between trabecular morphological and mechanical parameters.Seven femoral heads from patients with fractured proximal femur were scanned using a micro-CT system.Each femoral head was divided into 12 sub-regions according to the trabecular orientation.One 125 mm^3 trabecular cubic model was reconstructed from each sub-region.A total of 81 trabecular models were reconstructed,except three destroyed sub-regions from two femoral heads during the surgery.Trabecular morphological parameters,i.e.trabecular separation（Tb.Sp）,trabecular thickness（Tb.Th）,specific bone surface（BS/B V）,bone volume fraction（BV/TV）,structural model index（SMI）,and degree of anisotropy（DA） were measured.Micro-finite element analyses were performed for each cube to obtain the apparent Young＇s modulus and tissue level von Mises stress distribution under 1%compressive strain along three orthogonal directions,respectively.Results revealed significant regional variations in the morphological parameters（P〈0.05）.Young＇s moduli along the trabecular orientation were significantly higher than those along the other two directions.In general,trabecular mechanical properties in the medial region were lower than those in the lateral region.Trabecular mechanical parameters along the trabecular orientation were significantly correlated with BS/BV,BV/TV,Tb.Th,and DA.In this study,regional variations of microstructural features and mechanical properties in the femoral head of patients with proximal femur fracture were thoroughly investigated at the tissue level.The results of this study will help to elucidate the mechanism of femoral head fracture for reducing fracture risk and developing treatment strategies for the elderly.展开更多
Detection of prevalence and development of osteopenia or osteoporosis in patients with inflammatory bowel disease using only bone mineral density could be inappropriate to detect all individuals at risk for osteoporos...Detection of prevalence and development of osteopenia or osteoporosis in patients with inflammatory bowel disease using only bone mineral density could be inappropriate to detect all individuals at risk for osteoporosis.Numerous patients could remain undetected by using only bone mineral density as a screening method,especially in patients with ulcerative colitis.Therefore,trabecular bone score should be used as a complementary method.展开更多
BACKGROUND In the past decade,the evolution of themes in the field of osteoporotic fractures has changed from epidemiology and prediction of long-term morbidity,risk assessment of osteoporotic fractures,and zoledronic...BACKGROUND In the past decade,the evolution of themes in the field of osteoporotic fractures has changed from epidemiology and prediction of long-term morbidity,risk assessment of osteoporotic fractures,and zoledronic acid and denosumab in the treatment of osteoporosis to treatment guidelines for osteoporosis and the side effects caused by anti-osteoporotic drugs.AIM To understand the trends and hotspots in osteoporotic fracture research.METHODS Original articles were retrieved between January 1,2010,and December 31,2019,from the Web of Science Core Collection database.CiteSpace software facilitated the analysis and visualization of scientific productivity and emerging trends.RESULTS Nine studies were identified using bibliometric indices,including citation,centrality,and sigma value,which might indicate a growing trend.Through clustering,we identified six major hot subtopics.Using burst analysis,top-5 references with the strongest bursting strength after 2017 were identified,indicating a future hotspot in this field.CONCLUSION Current hot subtopics in osteoporotic fracture research include atypical femoral fractures,androgen deprivation therapy,denosumab discontinuation,hip fractures,trabecular bone score(TBS),and bone phenotype.Management and prevention of secondary fractures in patients with osteoporotic fractures,TBSs,and long-term administration strategy for zoledronic acid are expected to become research hotspots.展开更多
Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fra...Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.展开更多
基金The project supported by the Hong Kong Polytechnic University Research Grants(G-U273) the National Natural Science Foundation of China(10502021 and 10529202)
文摘The objective of this study was to study the age-related adaptation of lumbar vertebral trabecular bone at the apparent level, as well as the tissue level in three orthogonal directions. Ninety trabecular specimens were obtained from six normal L4 vertebral bodies of six male cadavers in two age groups, three aged 62 years and three aged 69 years, and were scanned using a high-resolution micro-computed tomography （micro-CT） system, then converted to micro- finite element models to do micro-finite element analyses. The relationship between apparent stiffness and bone volume fraction, and the tissue level yon Mises stress distribution for each trabecular specimen when compressed separately in the longitudinal direction, medial-lateral and anterior-posterior directions （transverse directions） were derived and compared between two age groups. The results showed that at the apparent level, trabecular bones from 69-year group had stiffer bone structure relative to their volume fractions in all three directions, and in both age groups, changes in bone volume fraction could explain more variations in apparent stiffness in the longitudinal direction than the transverse directions; at the tissue level, aging had little effect on the tissue von Mises stress distributions for the compressions in all the three directions. The novelty of the present study was that it provided quantitative assessments on the age and direction- related adaptation of Chinese male lumbar vertebral trabecular bone from two different levels： stiffness at the apparent level and stress distribution at the tissue level. It may help to understand the failure mechanisms and fracture risks of vertebral body associated with aging and direction for the prevention of fracture risks in elder individuals.
基金the National High Technology Research and Development Program (863) of China(No. 2006AA02A137the Postgraduate Creativity Foundation of Shanghai Jiaotong University (No. BXJ0730)
文摘The mechanical properties of the pelvic trabecular bone have been studied at the continuum level. However, nothing is known about the tissue-level damage in the trabecular bone of the healthy human acetabulum at apparent small strains characteristic of habitual. By a DAWING 4000 A supercomputer, nonlinear micro-finite element (μFE) analysis was performed to quantify tissue-level damage accumulation in trabecular bone at small strains. The data indicate that damage in trabecular bone commence at 0.2% apparent strain. The findings imply that tissue yielding can initiate at very low strains in the trabecular bone of the healthy acetabulum and that this local failure has negative consequences on the apparent mechanical properties of trabecular bone.
文摘BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk of low-energy fractures as bone quality is reduced.It was hypothesized that a decrease in the trabecular bone score(TBS),a parameter assessing bone microarchitecture,may be an early marker of impaired bone health in women with T2D.AIM To identify clinical and body composition parameters that affect TBS in postmenopausal women with T2D and normal BMD.METHODS A non-interventional cross-sectional comparative study was conducted.Potentially eligible subjects were screened at tertiary referral center.Postmenopausal women with T2D,aged 50-75 years,with no established risk factors for secondary osteoporosis,were included.BMD,TBS and body composition parameters were assessed by dual-energy X-ray absorptiometry.In women with normal BMD,a wide range of anthropometric,general and diabetes-related clinical and laboratory parameters were evaluated as risk factors for TBS decrease using univariate and multivariate regression analysis and analysis of receiver operating characteristic(ROC)curves.RESULTS Three hundred twelve women were initially screened,176 of them met the inclusion criteria and underwent dual X-ray absorptiometry.Those with reduced BMD were subsequently excluded;96 women with normal BMD were included in final analysis.Among them,43 women(44.8%)showed decreased TBS values(≤1.31).Women with TBS≤1.31 were taller and had a lower body mass index(BMI)when compared to those with normal TBS(Р=0.008 and P=0.007 respectively).No significant differences in HbA1c,renal function,calcium,phosphorus,alkaline phosphatase,PTH and 25(ОН)D levels were found.In a model of multivariate linear regression analysis,TBS was positively associated with gynoid fat mass,whereas the height and androgen fat mass were associated negatively(all P<0.001).In a multiple logistic regression,TBS≤1.31 was associated with lower gynoid fat mass(adjusted odd ratio[OR],0.9,95%confidence interval[CI],0.85-0.94,P<0.001),higher android fat mass(adjusted OR,1.13,95%CI,1.03-1.24,P=0.008)and height(adjusted OR,1.13,95%CI,1.05-1.20,P<0.001).In ROC-curve analysis,height≥162.5 cm(P=0.04),body mass index≤33.85 kg/m2(P=0.002),gynoid fat mass≤5.41 kg(P=0.03)and android/gynoid fat mass ratio≥1.145(P<0.001)were identified as the risk factors for TBS reduction.CONCLUSION In postmenopausal women with T2D and normal BMD,greater height and central adiposity are associated with impaired bone microarchitecture.
基金supported by funding from a Veterans Administration BLR&D merit review grant 1–101-BX-002717 to Dr Subburaman Mohan
文摘To evaluate the long-term consequence of repetitive mild traumatic brain injury （mTBI） on bone, mTBI was induced in 10-week-old female C57BL/6J mice using a weight drop model, once per day for 4 consecutive days at different drop heights （0.5, 1 and 1.5 m） and the skeletal phenotype was evaluated at different time points after the impact. In vivo micro-CT （μ-CT） analysis of the tibial metaphysis at 2, 8 and 12 weeks after the impact revealed a 5%-32% reduction in trabecular bone mass. Histomorphometric analyses showed a reduced bone formation rate in the secondary spongiosa ofl.5 m impacted mice at 12 weeks post impact. Apparent modulus （bone strength）, was reduced by 30% （P 〈 0.05） at the proximal tibial metaphysis in the 1.5 m drop height group at 2 and 8 weeks post impact. Ex vivo μ-CT analysis of the fifth lumbar vertebra revealed a significant reduction in trabecular bone mass at 12 weeks of age in all three drop height groups. Serum levels of osteocalcin were decreased by 22%, 15%, and 19% in the 0.5, 1.0 and 1.5 m drop height groups, respectively, at 2 weeks post impact. Serum IGF-I levels were reduced by 18%-32% in mTBI mice compared to control mice at 2 weeks post impact. Serum osteocalcin and IGF-I levels correlated with trabecular BV/TV （r2 = 0.14 and 0.16, P 〈 0.05）. In conclusion, repetitive mTBI exerts significant negative effects on the trabecular bone microarchitecture and bone mechanical properties by influencing osteoblast function via reduced endocrine IGF-I actions.
文摘Trabecular bone holds the utmost importance due to its significance regarding early bone loss.Diseases like osteoporosis greatly affect the structure of the Trabecular bone which results in different outcomes like high risk of fracture.The objective of this paper is to inspect the characteristics of the Trabecular Bone by using the Magnetic Resonance Imaging(MRI)technique.These characteristics prove to be quite helpful in studying different studies related to Trabecular bone such as osteoporosis.The things that were considered before the selection of the articles for the systematic review were language,research field,and electronic sources.Only those articles written in the English language were selected as it is the most prominent language used in scientific,engineering,computer science,and biomedical researches.This literature review was conducted on the articles published between 2006 and 2020.A total of 62 research papers out of 1050 papers were extracted which were according to our topic of review after screening abstract and article content for the title and abstract screening.The findings from those researches were compiled at the end of the result section.This systematic literature review presents a comprehensive report on scientific researches and studies that have been done in the medical area concerning trabecular bone.
基金The Hong Kong Polytechnic University Research Grants (1-BB 81 and G-YX64)the National Natural Science Foundation of China (10502021 and 10529202)
文摘The objective of this paper is to identify the effects of mechanical disuse and basic multi-cellular unit （BMU） activation threshold on the form of trabecular bone during menopause. A bone adaptation model with mechanical- biological factors at BMU level was integrated with finite element analysis to simulate the changes of trabecular bone structure during menopause. Mechanical disuse and changes in the BMU activation threshold were applied to the model for the period from 4 years before to 4 years after menopause. The changes in bone volume fraction, trabecular thickness and fractal dimension of the trabecular structures were used to quantify the changes of trabecular bone in three different cases associated with mechanical disuse and BMU activation threshold. It was found that the changes in the simulated bone volume fraction were highly correlated and consistent with clinical data, and that the trabecular thickness reduced signi-ficantly during menopause and was highly linearly correlated with the bone volume fraction, and that the change trend of fractal dimension of the simulated trabecular structure was in correspondence with clinical observations. The numerical simulation in this paper may help to better understand the relationship between the bone morphology and the mecha-nical, as well as biological environment; and can provide a quantitative computational model and methodology for the numerical simulation of the bone structural morphological changes caused by the mechanical environment, and/or the biological environment.
文摘The mechanical behaviour of trabecular bone is dependent on both the properties of individual trabeculae as well as their three-dimensional arrangement in space. In this study, nanoindentation was used to determine trabecular stiffness of bovine bone, both dehydrated and rehydrated. Values of 18.3 GPa and 14.3 GPa were obtained for dehydrated and rehydrated trabeculae respectively. These values were then used for finite element analysis where the mesh was generated directly from an X-ray microtomography dataset. The relationship between intrinsic tissue properties and apparent stiffness was explored. Moreover, the important role of collagen in bone micromechanics was demonstrated by complementing the study with Raman spectroscopy.
文摘Objective. To evaluate the effects of alendronate on the structural properties of trabecular bone.Methods. Alendronate was administered at a daily p. o. dose of 0. 5 mg/kg over a 12-week period in hound dogs (n = 8 for both the control and treated group), and the structural indices of the lumbar vertebral (LI and L2) trabecular bone were assessed directly from 3-D images.Results. Treatment with alendronate increased bone volume fraction by 9. 5% and 7. 7% in L1 and L2 respectively. Trabecular thickness significantly increased after alendronate treatment, whereas trabecular separation remained constant. The degree of anisotropy for the alendronate - treated group was decreased compared with that of the control group. Bone surface to volume ratio declined significantly in the alendronate-reated group, whereas alendronate induced a higher bone surface density.Conclusion. Alendronate increased the structural properties of canine trabecular bone after short-term treatment at a dose of 0. 5 mg · kg-1·day-1.
文摘The study aimed to examine changes in trabecular bone microstructure （TBMS） during the period of 5 weeks after the injury in a rat model of spinal cord injury （SCI）. Eight-week-old male Wistar rats underwent surgical transection of the lower thoracic spinal cord （SCI, n = 16） or sham operation （SHAM, n = 14）. TBMS （tissue volume, bone volume, bone volume fraction, trabecular thickness, width, number, separation, connectivity density, and trabecular bone pattern factor）, assessed using a micro-computed tomography, was deteriorated 1, 3 and 5 weeks after SCI. In addition, both bone mass and serum biochemical parameters were determined. Dry bone weight, ash weight, bone mineral content （BMC）, and BMC/tissue-volume were significantly lower in the SCI group than in the SHAM group throughout the experimental period. Serum inorganic phosphate and alkaline phosphatase levels were significantly lower in the SCI group than in the SHAM group 1 week after the surgery. SCI resulted in rapid deterioration of both bone mass and microstructure. These changes appeared as early as 1 week after SCI. Based on the authors＇ results, it should be noted that in SCI patients, interventions for preventing bone loss should start as soon as possible after the injury.
文摘Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions parallel and perpendicular to the forearm. Methodology: Data from more than two hundred subjects were studied retrospectively. A DXA (GE Lunar Prodigy) scan of the forearm was performed on each subject to measure the bone mineral density (BMD) value at the location of ultra-distal radius, and an X-ray digital image of the same forearm was taken on the same day. The values of trabecular bone score along the direction perpendicular to the forearm, TBS<sub>x</sub>, and along the direction parallel to the forearm, TBS<sub>y</sub>, were calculated respectively. The statistics of TBS<sub>x</sub> and TBS<sub>y</sub> were calculated, and the anisotropy of the trabecular bone, which was defined as the ratio of TBS<sub>y</sub> to TBS<sub>x</sub> and changed with subjects’ BMD and age, was reported and analyzed. Results: The results show that the correlation coefficient between TBS<sub>x</sub> and TBS<sub>y</sub> was 0.72 (p BMD and age was reported. The results showed that decreased trabecular bone anisotropy was associated with deceased BMD and increased age in the subject group. Conclusions: This study shows that decreased trabecular bone anisotropy was associated with decreased BMD and increased age.
文摘Background: When applied to trabecular bone X-ray images, a method for analyzing trabecular bone texture based on the initial slope of variogram (ISV) was used to assess the trabecular bone health. Methodology: Data from more than two hundred subjects were retrospectively studied. For each subject, a DXA (GE Lunar Prodigy) scan of the forearm was performed, and bone mineral density (BMD) value was measured at the location of ultra-distal radius, X-ray digital image of the same forearm was taken on the same day, and ISV value over the same location of ultra-distal radius was calculated. Pearson’s correlation coefficients were calculated to examine the correlation between BMD and ISV of the trabecular bones located at the same ultra-distal radius. ISV values changed with subjects’ age were also reported. Results: The results show that ISV value was highly correlated with the DXA-measured BMD of the same trabecular bone located at the ultra-distal radius. The correlation coefficient between ISV and BMD with the 95% confident was 0.79 ± 0.09. They also demonstrated that the age-related changes in trabecular bone health and differentiated age patterns in males and females, respectively. The results showed that the decrease in BMD was accompanied by a decrease in the initial slope of variogram (ISV). Conclusions: This study suggests that ISV might be used to quantitatively evaluate trabecular health for osteoporosis and bone disease diagnosis.
基金the Portuguese research foundation FCT(Fundacao para a Ciencia e Tecnologia)for providing financial support(SFRH/BD/48100/2008)MFC Pereira and A Mauricio acknowledge FEDER Funds through Programa Operacional Factores de Com-petitividade-COMPETE,and FCT Project PEst-OE/CTE/UI0098/2011
文摘The aim of this study was to identify three-dimensional microstructural changes of trabecular bone with age and gender, using micro-computed tomography. Human trabecular bone from two disease groups, osteoporosis and osteoarthritis was analyzed. A prior analysis of the effects of some procedure variables on the micro-CT results was performed. Preliminary micro-CT scans were performed with three voxel resolutions and two acquisition conditions. On the reconstruction step, the image segmentation was performed with three different threshold values. Samples were collected from patients, with coxarthrosis (osteoarthritis) or fragility fracture (osteoporosis). The specimens of the coxarthrosis group include twenty females and fifteen males, while the fragility fracture group was composed by twenty three females and seven males. The mean age of the population was 69 ± 11 (females) and 67 ± 10 years (males), in the coxarthrosis group, while in the fragility fracture group was 81 ± 6 (females) and 78 ± 6 (males) years. The 30 μm voxel size provided lower percentage difference for the microarchitecture parameters. Acquisition conditions with 160 μA and 60 kV permit the evaluation of all the volume’s sample, with low average values of the coefficients of variation of the microstructural parameters. No statistically significant differences were found between the two diseases groups, neither between genders. However, with aging, there is a decrease of bone volume fraction, trabecular number and fractal dimension, and an increase of structural model index and trabecular separation, for both disease groups and genders. The parameters bone specific surface, trabecular thickness and degree of anisotropy have different behaviors with age, depending on the type of disease. While in coxarthrosis patients, trabecular thickness increases with age, in the fragility fracture group, there is a decrease of trabecular thickness with increasing age. Our findings indicate that disease, age and gender do not provide significant differences in trabecular microstructure. With aging, some parameters exhibit different trends which are possibly related to different mechanisms for different diseases.
文摘In order to study the microstructure characteristics of normal lunate bones, eight fresh cadaver normal lunates were scanned with micro-computed tomography. High-resolution images of the micro-structure of normal lunates were obtained and we analyzed the nutrient foramina. Then nine regions of interest(ROI) were chosen in the central sagittal plane so that we could obtain the parameters of trabecular bones of ROIs. The distal lamellar-like compact structure had statistically significant differences when it was compared with the ROIs in the volar and dorsal ends of the distal cortex. The difference of diameter between the volar and dorsal foramina was significant(P<0.05). However, there was no significant difference regarding the number. The trabecular bones of the volar and dorsal distal ends had lower intensity than those of the distal central subchondral bone plate. The diameters of the nutrient foramina on the volar cortex were larger than those on the dorsal. This research provided more detailed information about microstructure of normal lunate and the nutrient foramina on cortex, and a reference for further study about diseased lunate.
文摘The authors revise the latest evidence in the literature regarding managing of osteoporosis in ulcerative colitis (UC), paying particular attention to the latest tendency of the research concerning the management of bone damage in the patient affected by UC. It is wise to assess vitamin D status in ulcerative colitis patients to recognize who is predisposed to low levels of vitamin D, whose deficiency has to be treated with oral or parenteral vitamin D supplementation. An adequate dietary calcium intake or supplementation and physical activity, if possible, should be guaranteed. Osteoporotic risk factors, such as smoking and excessive alcohol intake, must be avoided. Steroid has to be prescribed at the lowest possible dosage and for the shortest possible time. Moreover, conditions favoring falling have to been minimized, like carpets, low illumination, sedatives assumption, vitamin D deficiency. It is advisable to assess the fracture risk in all UC patient by the fracture assessment risk tool (FRAX<sup>®</sup> tool), that calculates the ten years risk of fracture for the population aged from 40 to 90 years in many countries of the world. A high risk value could indicate the necessity of treatment, whereas a low risk value suggests a follow-up only. An intermediate risk supports the decision to prescribe bone mineral density (BMD) assessment and a subsequent patient revaluation for treatment. Dual energy X-ray absorptiometry bone densitometry can be used not only for BMD measurement, but also to collect data about bone quality by the means of trabecular bone score and hip structural analysis assessment. These two indices could represent a method of interesting perspectives in evaluating bone status in patients affected by diseases like UC, which may present an impairment of bone quality as well as of bone quantity. In literature there is no strong evidence for instituting pharmacological therapy of bone impairment in UC patients for clinical indications other than those that are also applied to the patients with osteoporosis. Therefore, a reasonable advice is to consider pharmacological treatment for osteoporosis in those UC patients who already present fragility fractures, which bring a high risk of subsequent fractures. Therapy has also to be considered in patients with a high risk of fracture even if it did not yet happen, and particularly when they had long periods of corticosteroid therapy or cumulative high dosages. In patients without fragility fractures or steroid treatment, a medical decision about treatment could be guided by the FRAX tool to determine the intervention threshold. Among drugs for osteoporosis treatment, the bisphosphonates are the most studied ones, with the best and longest evidence of efficacy and safety. Despite this, several questions are still open, such as the duration of treatment, the necessity to discontinue it, the indication of therapy in young patients, particularly in those without previous fractures. Further, it has to be mentioned that a long-term bisphosphonates use in primary osteoporosis has been associated with an increased incidence of dramatic side-effects, even if uncommon, like osteonecrosis of the jaw and atypical sub-trochanteric and diaphyseal femoral fractures. UC is a long-lasting disease and the majority of patients is relatively young. In this scenario primary prevention of fragility fracture is the best cost-effective strategy. Vitamin D supplementation, adequate calcium intake, suitable physical activity (when possible), removing of risk factors for osteoporosis like smoking, and avoiding falling are the best medical acts.
基金Supported by GRF of Hong Kong SAR (project no. 464508)a direct grant for research from the Chinese University of Hong Kong (project no.2041501)
文摘Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline bone mineral density （BMD） characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography. Results Para-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery. Conclusion The approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.
基金supported by the Research Fund of National Natural Science Foundation of China (No.30800928,No.30670492)the National 863 Project (No.2006 AA02Z4C3)
文摘Objective To study the effects of electromagnetic pulse （EMP） on bone metabolism of mice in vivo. Methods Twenty-four male BALB/c mice were divided into a control group and 2 experimental groups （n=8）. The whole-body of mice in experimental groups were exposed to 50 kV/m and 400kV/m EMP, 400 pulses daily for 7 consecutive days at 2 seconds intervals. Alkaline phosphotase （ALP） activity, serum calcium concentration and osteocalcin level and trabecular bone volume （BV/TV, %） were measured immediately after EMP exposure by biochemical, ELISA and morphological methods. Results The ALP activity, serum calcium concentration and osteocalcin level and BV/TV in experimental groups remained unchanged after EMP exposure. Conelusion Under our experimental conditions, EMP exposure cannot affect bone metabolism of mice in vivo.
基金supported by the National Natural Science Foundation of China(Nos.11322223,11432016,81471753 and 11272134)the 973 Program(No.2012CB821202)
文摘This study aims to investigate the regional variations of trabecular morphological parameters and mechanical parameters of the femoral head,as well as to determine the relationship between trabecular morphological and mechanical parameters.Seven femoral heads from patients with fractured proximal femur were scanned using a micro-CT system.Each femoral head was divided into 12 sub-regions according to the trabecular orientation.One 125 mm^3 trabecular cubic model was reconstructed from each sub-region.A total of 81 trabecular models were reconstructed,except three destroyed sub-regions from two femoral heads during the surgery.Trabecular morphological parameters,i.e.trabecular separation（Tb.Sp）,trabecular thickness（Tb.Th）,specific bone surface（BS/B V）,bone volume fraction（BV/TV）,structural model index（SMI）,and degree of anisotropy（DA） were measured.Micro-finite element analyses were performed for each cube to obtain the apparent Young＇s modulus and tissue level von Mises stress distribution under 1%compressive strain along three orthogonal directions,respectively.Results revealed significant regional variations in the morphological parameters（P〈0.05）.Young＇s moduli along the trabecular orientation were significantly higher than those along the other two directions.In general,trabecular mechanical properties in the medial region were lower than those in the lateral region.Trabecular mechanical parameters along the trabecular orientation were significantly correlated with BS/BV,BV/TV,Tb.Th,and DA.In this study,regional variations of microstructural features and mechanical properties in the femoral head of patients with proximal femur fracture were thoroughly investigated at the tissue level.The results of this study will help to elucidate the mechanism of femoral head fracture for reducing fracture risk and developing treatment strategies for the elderly.
文摘Detection of prevalence and development of osteopenia or osteoporosis in patients with inflammatory bowel disease using only bone mineral density could be inappropriate to detect all individuals at risk for osteoporosis.Numerous patients could remain undetected by using only bone mineral density as a screening method,especially in patients with ulcerative colitis.Therefore,trabecular bone score should be used as a complementary method.
文摘BACKGROUND In the past decade,the evolution of themes in the field of osteoporotic fractures has changed from epidemiology and prediction of long-term morbidity,risk assessment of osteoporotic fractures,and zoledronic acid and denosumab in the treatment of osteoporosis to treatment guidelines for osteoporosis and the side effects caused by anti-osteoporotic drugs.AIM To understand the trends and hotspots in osteoporotic fracture research.METHODS Original articles were retrieved between January 1,2010,and December 31,2019,from the Web of Science Core Collection database.CiteSpace software facilitated the analysis and visualization of scientific productivity and emerging trends.RESULTS Nine studies were identified using bibliometric indices,including citation,centrality,and sigma value,which might indicate a growing trend.Through clustering,we identified six major hot subtopics.Using burst analysis,top-5 references with the strongest bursting strength after 2017 were identified,indicating a future hotspot in this field.CONCLUSION Current hot subtopics in osteoporotic fracture research include atypical femoral fractures,androgen deprivation therapy,denosumab discontinuation,hip fractures,trabecular bone score(TBS),and bone phenotype.Management and prevention of secondary fractures in patients with osteoporotic fractures,TBSs,and long-term administration strategy for zoledronic acid are expected to become research hotspots.
文摘Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.
