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Abdul-Al O, Zunquin G, El Hage R. Effects of two types of resistance training modalities (hypertrophy vs. contrast training) on bone parameters in a group of healthy elderly women. J Clin Densitom 2024; 27:101521. [PMID: 39181062 DOI: 10.1016/j.jocd.2024.101521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/22/2024] [Accepted: 08/08/2024] [Indexed: 08/27/2024]
Abstract
The aim of the present study was to explore the effects of two types of resistance training modalities (hypertrophy training vs. contrast training) on bone health parameters in a group of healthy elderly women. Forty-nine healthy elderly women whose ages range between 60 and 70 years were included in this study. The study population was randomly divided into three groups: hypertrophy training group (HTG; n=16), contrast training group (CTG; n=16) and control group (CG; n=17). Bone mineral density (BMD) values at the whole body (WB), lumbar spine (L1-L4), total hip (TH) and femoral neck (FN) were measured by DXA before and after 12 months of resistance training. Composite indices of femoral neck strength were calculated. WB BMD, L1-L4 BMD, TH BMD and FN BMD increased in the contrast training group. WB BMD and L1-L4 BMD increased in the hypertrophy training group, while TH BMD and FN BMD remained unchanged. Significant decreases in WB BMD, L1-L4 BMD, TH BMD and FN BMD were observed in the control group. The contrast training group showed the highest improvements in BMD values compared to the two other groups. Both experimental groups (HTG and CTG) showed similar significant improvements in composite indices of femoral neck strength and muscular strength. In conclusion, contrast training and hypertrophy training can stimulate bone gain at clinically important sites of osteoporotic fractures in elderly women.
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Affiliation(s)
- Obaida Abdul-Al
- Laboratoire Mouvement, Equilibre, Performance, Santé (MEPS), Université de Pau et des Pays de l'Adour, Campus Montaury, 64600 Anglet, France; Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100 Tripoli, Lebanon
| | - Gautier Zunquin
- Laboratoire Mouvement, Equilibre, Performance, Santé (MEPS), Université de Pau et des Pays de l'Adour, Campus Montaury, 64600 Anglet, France
| | - Rawad El Hage
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100 Tripoli, Lebanon.
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Zouhal H, Berro AJ, Maliha E, Khalil N, El Khoury G, Jayavel A, Laziri F, Saeidi A, Laher I, El Hage R. Team sports practice and bone health: A systematic review and meta- analysis. J Clin Densitom 2024; 27:101508. [PMID: 39068702 DOI: 10.1016/j.jocd.2024.101508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/27/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024]
Abstract
The primary aim of this study was to explore the effects of team sports practice on bone health indices in adults engaged in team sports. The secondary aim was to investigate the osteogenic effects of each type of team sport. This systematic literature search was conducted using common electronic databases from inception in June 2023, using key terms (and synonyms searched for by the MeSH database) that were combined using the operators "AND", "OR", "NOT": (``men'' OR ``man'' OR ``women'' OR ``woman'') AND (``bone mineral density'' OR ``BMD'' OR ``bone mineral content'' OR ``BMC'' OR ``peak bone mass'' OR ``mechanical loading'' OR ``osteoporosis'' OR ``bone geometry'' OR ``bone resistance'') AND (``team sport'' OR ``sport'' OR rugby OR basketball OR volleyball OR handball OR soccer OR football OR ``players''). After screening, 16 studies were included in the final analysis (5 continents, 2740 participants). The training duration lasted 1 to 13 years. Team sport training had a moderate impact on whole body bone mineral density (WB BMD) (1.07 SMD; 95 % [0.77, 1.37], p < 0.00) but a more significant impact on whole body bone mineral content (WB BMC) (1.3 SMD; 95 % [0.81, 1.79], p < 0.00). Subgroup analyses indicated that rugby training had a moderate but non-significant impact on WB BMD (1.19 SMD; 95 % [-0.13, 2.52], p = 0.08) but a greater impact on WB BMC (2.12 SMD; 95 % [0.84, 3.39], p < 0.00); basketball training had a moderate but significant impact on WB BMD (1 SMD; 95 % [0.35, 1.64], p < 0.00) and a trivial non-significant impact on WB BMC (0.18 SMD; 95 % [-1.09, 1.46], p = 0.78); volleyball training had a moderate but non-significant impact on WB BMD (0.63 SMD; 95 % [-0.22, 1.49], p = 0.15) and a significant impact on WB BMC (2.39 SMD; 95 % [1.45, 3.33], p < 0.00). Handball training produced a moderate significant impact on WB BMD (1.02 SMD; 95 % [0.33, 1.71], p < 0.00) and WB BMC (0.97 SMD; 95 % [0.47, 1.48], p < 0.00), and soccer training led to moderate but significant effects on WB BMD (1.16 SMD; 95 % [0.88, 1.44], p < 0.00) and a large effect on WB BMC (1.34 SMD; 95 % [0.92, 1.77], p < 0.00). Rugby training was associated with a higher WB BMC compared to basketball training (p = 0.03). Our systematic review and meta-analysis suggests that team sports, such as rugby, basketball, volleyball, handball and soccer have moderate to large effects on WB BMD and WB BMC. Specifically, our findings indicate that handball and soccer enhance WB BMD and WB BMC, whereas rugby only increases WB BMC. There is currently insufficient evidence indicating the superiority of any type of sport training that improves bone health in adults.
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Affiliation(s)
- Hassane Zouhal
- University of Rennes, M2S (Laboratoire Mouvement, Sport, Santé) - EA 1274, F-35000 Rennes, France; Institut International des Sciences du Sport (2I2S), 35850 Irodouer, France
| | - Abdel-Jalil Berro
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Elie Maliha
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Nour Khalil
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Gisèle El Khoury
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Ayyappan Jayavel
- SRM College of Physiotherapy, SRM Institute of Science and Technology, Kattankulathur, Kanchipuram, India
| | - Fatiha Laziri
- Laboratoire Ecologie, Environnement et Santé Equipe Santé Humaine et Environnement Faculté des Sciences de Université Moulay Ismail, Meknès, Morocco
| | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, University of Kurdistan, Sanandaj, Iran
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, Canada
| | - Rawad El Hage
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon.
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Chatrieh L, Pinti A, El Hage R. Sprinting Performance Correlates with Composite Indices of Femoral Neck Strength in Young Men. J Clin Densitom 2024; 27:101506. [PMID: 38943793 DOI: 10.1016/j.jocd.2024.101506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 06/13/2024] [Indexed: 07/01/2024]
Affiliation(s)
- Lara Chatrieh
- Université Polytechnique Hauts-de-France, INSA Hauts-de-France, LARSH - Laboratoire de Recherche, Sociétés & Humanités, Valenciennes F-59313, France
| | - Antonio Pinti
- Université Polytechnique Hauts-de-France, INSA Hauts-de-France, LARSH - Laboratoire de Recherche, Sociétés & Humanités, Valenciennes F-59313, France
| | - Rawad El Hage
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon.
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Khalil N, Pinti A, El Hage R. The Effects of a 1-Year Recreational Kung Fu Protocol on Bone Health Parameters in a Group of Healthy Inactive Young Men. J Clin Densitom 2023; 26:101418. [PMID: 37356377 DOI: 10.1016/j.jocd.2023.101418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/05/2023] [Indexed: 06/27/2023]
Abstract
The main aim of the current study was to explore the effects of a 1-year recreational Kung Fu protocol on bone health parameters (bone mineral content (BMC), bone mineral density (BMD), femoral neck geometry and composite indices of femoral neck strength) in a group of healthy inactive young men. 54 young inactive men voluntarily participated in this study, but only 51 of them completed it. The participants were assigned to 2 different groups: control group (n=31) and Kung Fu group (n=20). The Kung Fu group performed two sessions of recreational Kung Fu per week; the duration of each session was 45 minutes. The current study has demonstrated that whole body (WB) BMC, ultra-distal (UD) radius BMD, 1/3 radius BMD, total radius BMD, total forearm BMD, maximal strength, maximum oxygen consumption and jumping performance increased in the Kung Fu group but not in the control group. The percentages of variations in WB BMC, forearm BMD and physical performance parameters were significantly different between the two groups. In conclusion, this study suggests that recreational Kung Fu is an effective method to improve WB BMC, forearm BMD and physical performance parameters in young inactive men.
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Affiliation(s)
- Nour Khalil
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon; Université Polytechnique Hauts-de-France, INSA Hauts-de-France, LARSH - Laboratoire de Recherche Sociétés & Humanités, F-59313 Valenciennes, France
| | - Antonio Pinti
- Université Polytechnique Hauts-de-France, INSA Hauts-de-France, LARSH - Laboratoire de Recherche Sociétés & Humanités, F-59313 Valenciennes, France
| | - Rawad El Hage
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon.
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Finianos B, Pinti A, ElHage R. The effects of a 1-year recreational football protocol on bone health parameters in a group of healthy inactive 50-year-old men. J Clin Densitom 2023; 26:101368. [PMID: 37002003 DOI: 10.1016/j.jocd.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
The main aim of the current study was to explore the effects of a 1-year recreational football protocol on bone health parameters (bone mineral content (BMC), bone mineral density (BMD), femoral neck geometry and composite indices of femoral neck strength) in a group of healthy inactive 50-year-old men. 51 middle-aged men voluntarily participated in this study, but only 41 of them completed it. Thus, the study population included 11 former football (FF) players and 30 inactive men. Inactive men were assigned to 3 different groups: controls (n=10), recreational football 30 (RF30; n=10) and recreational football 60 (RF60; n=10). The RF30 group performed two sessions of recreational football per week; the duration of each session was 30 minutes. The RF60 group performed two sessions of recreational football per week; the duration of each session was 60 minutes. The current study has demonstrated that whole body (WB) BMC, femoral neck BMD, cross-sectional moment of inertia, compression strength index, bending strength index and impact strength index increased in both experimental groups (RF30 and RF60) but not in the control group. The percentages of variations in bone health parameters were not significantly different between RF30 and RF60. In conclusion, this study suggests that recreational football is an effective method to improve bone health parameters in middle-aged men. In the studied population, most of the bone health benefits occurred after a low volume training protocol (2 * 30 minutes of recreational football per week).
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Affiliation(s)
- Boutros Finianos
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon
| | - Antonio Pinti
- Université Polytechnique Hauts-de-France, INSA Hauts-de-France, LARSH - Laboratoire de Recherche Sociétés & Humanités, F-59313 Valenciennes, France
| | - Rawad ElHage
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon.
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Paillard T, El Hage R, Rassy NA, Zouhal H, Kaabi S, Passelergue P. Effects of Different Levels of Weightlifting Training on Bone Mineral Density in a Group of Adolescents. J Clin Densitom 2022; 25:497-505. [PMID: 35973884 DOI: 10.1016/j.jocd.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022]
Abstract
The aim of the current study was to evaluate the effects of different levels of weightlifting training on bone mineral density (BMD) at different body sites (whole body (WB), lumbar spine (LS), femoral neck (FN), upper limbs (UL) and lower limbs (LL)) in a group of adolescents. Three groups of pubertal boys aged 13-15 years were recruited, including a control group (which included 13 untrained adolescents), a moderately trained group (which included 13 non-elite weightlifters, with four sessions of 2 hours per week) and a highly trained group (which included 13 elite weightlifters, with eight sessions of 2 hours per week). The three groups were paired for age and maturation index (using Tanner stages). Body composition, bone mineral content (BMC) and BMD were evaluated by dual-energy X ray absorptiometry (DXA). Physical performance variables (including weightlifting specific exercises, counter movement jump and squat jump) were measured using validated methods. Results showed that the values of BMD and physical performance variables were greater in the group of elite weightlifters compared to the group of non-elite weightlifters and the control group. In addition, the values of BMD and physical performance variables were higher in the group of the non-elite weightlifters compared to those of the control group. After adjusting for lean mass and squat jump, lumbar spine BMD, FN BMD, UL BMD and LL BMD remained significantly higher in the elite weightlifters' group compared to the two other groups. In conclusion, the current study suggests that elite adolescent weightlifters have greater bone health parameters compared to moderately-trained adolescent weightlifters and untrained adolescents.
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Affiliation(s)
- Thierry Paillard
- Laboratoire Mouvement, Equilibre, Performance et Santé, EA 4445, Université de Pau et des Pays de l'Adour/E2S, Département STAPS, ZA Bastillac Sud, 65000 Tarbes, France
| | - Rawad El Hage
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon.
| | - Nathalie Al Rassy
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon
| | - Hassane Zouhal
- M2S (Laboratoire Mouvement, Sport, Santé), University of Rennes 2, Rennes F-35000, France; Institut International des Sciences du Sport (2I2S), 35850, Irodouer, France
| | - Sofiane Kaabi
- Laboratoire Mouvement, Equilibre, Performance et Santé, EA 4445, Université de Pau et des Pays de l'Adour/E2S, Département STAPS, ZA Bastillac Sud, 65000 Tarbes, France
| | - Philippe Passelergue
- Laboratoire Mouvement, Equilibre, Performance et Santé, EA 4445, Université de Pau et des Pays de l'Adour/E2S, Département STAPS, ZA Bastillac Sud, 65000 Tarbes, France
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Maliha E, Pinti A, Bassim P, Toumi H, El Hage R. Composite Indices of Femoral Neck Strength in Young Adult Male Handball Players. J Clin Densitom 2022; 25:637-640. [PMID: 34933782 DOI: 10.1016/j.jocd.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/22/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Elie Maliha
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon; I3MTO, EA 4708, Université d'Orléans, Orléans, France
| | - Antonio Pinti
- Laboratoire DeVisu - Design, Visuel, Urbain, EA 2445, Université polytechnique Hauts-de-France (UPHF), Valenciennes, France
| | - Paméla Bassim
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon
| | - Hechmi Toumi
- I3MTO, EA 4708, Université d'Orléans, Orléans, France
| | - Rawad El Hage
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon.
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Lin T, Cai K, Yang P, WuRi S, Chen W, Deng P, Li Z, Chen Z, He W, Zhang Q, Wei Q. Composite indices of femoral neck strength predicts the collapse of steroid-associated osteonecrosis of the femoral head: a retrospective study. BMC Musculoskelet Disord 2022; 23:722. [PMID: 35902852 PMCID: PMC9330666 DOI: 10.1186/s12891-022-05622-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSES The purpose of this study was to investigate the predictive effect exerted by composite indices of femoral neck strength (compressive strength index (CSI), bending strength index (BSI) and impact strength index (ISI) on the femoral head collapse in steroid-associated ONFH patients. METHODS Nonoperative steroid-associated osteonecrosis of the femoral head (ONFH) patients from 2017 to 2019 were selected. The patients fell into the collapsed group and the non-collapsed group according to whether the femoral head collapsed. CSI, BSI and ISI were calculated. Moreover, bone turnover markers were measured. The statistical analysis was conducted on the predictive effects of composite indices of femoral neck strength and bone turnover index on ONFH collapse. RESULTS A total of 62 patients were included. The mean CSI, BSI and ISI were significantly lower in the collapsed group than those in the non-collapsed group (P < 0.05). CSI, ISI,t-P1NP and β-CTx were suggested as the protective risk factors for the femoral head collapse in ONFH patients. The ISI area under the curve values was 0. 878.The mean survival time of the hips of patients with ISI greater than 0.435 was greater (P < 0.05) than that of patients with ISI less than 0.435. CONCLUSION The composite indices of femoral neck strength can predict steroid-associated ONFH femoral head collapse more effectively than the bone turnover markers. The ISI value of 0.435 is a potential cut-off value, lower than this value can predict the early collapse of steroid-associated ONFH.
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Affiliation(s)
- Tianye Lin
- Joint Center, the Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China.,Guangdong Research Institute for Orthopedics & Traumatology of Chinese Medicine, Guangzhou, Guangdong, 510405, China
| | - Kaishen Cai
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China
| | - Peng Yang
- Guangdong Research Institute for Orthopedics & Traumatology of Chinese Medicine, Guangzhou, Guangdong, 510405, China
| | - Shana WuRi
- Guangdong Research Institute for Orthopedics & Traumatology of Chinese Medicine, Guangzhou, Guangdong, 510405, China
| | - Weijian Chen
- Guangzhou Orthopedic Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China
| | - Pan Deng
- Department of Joint Orthopaedic, Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi, 721000, China
| | - Ziqi Li
- Joint Center, the Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China.,Guangdong Research Institute for Orthopedics & Traumatology of Chinese Medicine, Guangzhou, Guangdong, 510405, China
| | - Zhenqiu Chen
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China
| | - Wei He
- Joint Center, the Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China.,Guangdong Research Institute for Orthopedics & Traumatology of Chinese Medicine, Guangzhou, Guangdong, 510405, China
| | - Qingwen Zhang
- Joint Center, the Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China. .,Guangdong Research Institute for Orthopedics & Traumatology of Chinese Medicine, Guangzhou, Guangdong, 510405, China.
| | - Qiushi Wei
- Joint Center, the Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China. .,Guangdong Research Institute for Orthopedics & Traumatology of Chinese Medicine, Guangzhou, Guangdong, 510405, China.
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Abdul Al O, Zakhem E, Zunquin G, El Hage R. Relationships Between Relative Skeletal Muscle Mass Index and Composite Indices of Femoral Neck in a Group of Lebanese Postmenopausal Women. J Clin Densitom 2021; 24:663-665. [PMID: 34391640 DOI: 10.1016/j.jocd.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Obaida Abdul Al
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon; Laboratoire Mouvement, Equilibre, Performance et Santé (EA 4445), Département STAPS, Université de Pau et des Pays de l'Adour, Tarbes, France
| | - Eddy Zakhem
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon
| | - Gautier Zunquin
- Laboratoire Mouvement, Equilibre, Performance et Santé (EA 4445), Département STAPS, Université de Pau et des Pays de l'Adour, Tarbes, France
| | - Rawad El Hage
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon.
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Lin T, Yang P, Cai K, Li Z, Pang F, Zhang Q, He W, Wei Q. [Predictive effect of femoral neck strength composite indexes on femoral head collapse in non-traumatic osteonecrosis of femoral head]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:967-972. [PMID: 34387423 DOI: 10.7507/1002-1892.202103168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To explore the predictive effect of the femoral neck strength composite indexes on femoral head collapse in non-traumatic osteonecrosis of the femoral head (ONFH) compared with bone turnover marker. Methods The non-traumatic ONFH patients who were admitted and received non-surgical treatment between January 2010 and December 2016 as the research object. And 96 cases (139 hips) met the selection criteria and were included in the study. There were 54 males (79 hips) and 42 females (60 hips), with an average age of 40.2 years (range, 22-60 years). According to whether the femoral head collapsed during follow-up, the patients were divided into collapsed group and non-collapsed group. The femoral neck width, hip axis length, height, body weight, and bone mineral density of femoral neck were measured. The femoral neck strength composite indexes, including the compressive strength index (CSI), bending strength index (BSI), and impact strength index (ISI), were calculated. The bone turnover marker, including the total typeⅠcollagen amino terminal elongation peptide (t-P1NP), β-crosslaps (β-CTx), alkaline phosphatase (ALP), 25 hydroxyvitamin D [25(OH)D], and N-terminal osteocalcin (N-MID), were measured. The age, gender, height, body weight, body mass index (BMI), bone mineral density of femoral neck, etiology, Japanese Osteonecrosis Investigation Committee (JIC) classification, femoral neck strength composite indexes, and bone turnover marker were compared between the two groups, and the influencing factors of the occurrence of femoral head collapse were initially screened. Then the significant variables in the femoral neck strength composite indexes and bone turnover marker were used for logistic regression analysis to screen risk factors; and the receiver operating characteristic (ROC) curve was used to determine the significant variables' impact on non-traumatic ONFH. Results All patients were followed up 3.2 years on average (range, 2-4 years). During follow-up, 46 cases (64 hips) had femoral head collapse (collapsed group), and the remaining 50 cases (75 hips) did not experience femoral head collapse (non-collapsed group). Univariate analysis showed that the difference in JIC classification between the two groups was significant ( Z=-7.090, P=0.000); however, the differences in age, gender, height, body weight, BMI, bone mineral density of femoral neck, and etiology were not significant ( P>0.05). In the femoral neck strength composite indexes, the CSI, BSI, and ISI of the collapsed group were significantly lower than those of the non-collapsed group ( P<0.05); in the bone turnover marker, the t-P1NP and β-CTx of the collapsed group were significantly lower than those of the non-collapsed group ( P<0.05); there was no significant difference in N-MID, 25(OH)D or ALP between groups ( P>0.05). Multivariate analysis showed that the CSI, ISI, and t-P1NP were risk factors for femoral collapse in patients with non-traumatic ONFH ( P<0.05). ROC curve analysis showed that the cut-off points of CSI, BSI, ISI, t-P1NP, and β-CTx were 6.172, 2.435, 0.465, 57.193, and 0.503, respectively, and the area under the ROC curve (AUC) were 0.753, 0.642, 0.903, 0.626, and 0.599, respectively. Conclusion The femoral neck strength composite indexes can predict the femoral head collapse in non-traumatic ONFH better than the bone turnover marker. ISI of 0.465 is a potential cut-off point below which future collapse of early non-traumatic ONFH can be predicted.
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Affiliation(s)
- Tianye Lin
- The First Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510080, P.R.China.,Guangdong Research Institute of Orthopedics and Traumatology of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China
| | - Peng Yang
- The First Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510080, P.R.China.,Guangdong Research Institute of Orthopedics and Traumatology of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China
| | - Kaishen Cai
- The First Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510080, P.R.China.,Guangdong Research Institute of Orthopedics and Traumatology of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China
| | - Ziqi Li
- Guangdong Research Institute of Orthopedics and Traumatology of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China.,The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China
| | - Fengxiang Pang
- The First Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510080, P.R.China.,Guangdong Research Institute of Orthopedics and Traumatology of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China
| | - Qingwen Zhang
- Guangdong Research Institute of Orthopedics and Traumatology of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China.,The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China
| | - Wei He
- Guangdong Research Institute of Orthopedics and Traumatology of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China.,The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China
| | - Qiushi Wei
- Guangdong Research Institute of Orthopedics and Traumatology of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China.,The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China
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