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Manon SM, Phuong JM, Moles RJ, Kelly A, Center JR, Luckie K, White C, Carter SR. The role of community pharmacists in delivering interventions for osteoporosis: A systematic review. J Am Pharm Assoc (2003) 2022; 62:1741-1749.e10. [DOI: 10.1016/j.japh.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
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Vanaclocha-Saiz A, Atienza CM, Vanaclocha V, Belloch V, Santabarbara JM, Jordá-Gómez P, Vanaclocha L. ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design. NORTH AMERICAN SPINE SOCIETY JOURNAL 2020; 2:100016. [PMID: 35141586 PMCID: PMC8820058 DOI: 10.1016/j.xnsj.2020.100016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/29/2020] [Accepted: 07/15/2020] [Indexed: 06/14/2023]
Abstract
STUDY DESIGN Biomechanical study in cadaveric specimens. BACKGROUND The commercially available lumbar disc prostheses do not reproduce the intact disc's Instantaneous centre of Rotation (ICR), thus inducing an overload on adjacent anatomical structures, promoting secondary degeneration. AIM To examine biomechanical testing of cadaveric lumbar spine specimens in order to evaluate and define the ICR of intact lumbar discs. MATERIAL AND METHODS Twelve cold preserved fresh human cadaveric lumbosacral spine specimens were subjected to computerized tomography (CT), magnetic resonance imaging (MRI) and biomechanical testing. Kinematic studies were performed to analyse range of movements in order to determine ICR. RESULTS Flexoextension and lateral bending tests showed a positive linear correlation between the angle rotated and the displacement of the ICR in different axes. DISCUSSION ICR has not been taken into account in any of the available literature regarding lumbar disc prosthesis. Considering our results, neither the actual ball-and-socket nor the withdrawn elastomeric nucleus models fit the biomechanics of the lumbar spine, which could at least in part explain the failure rates of the implants in terms of postoperative failed back syndrome (low back pain). It is reasonable to consider then that an implant should also adapt the equations of the movement of the intact ICR of the joint to the post-surgical ICR. CONCLUSIONS This is the first cadaveric study on the ICR of the human lumbar spine. We have shown that it is feasible to calculate and consider this parameter in order to design future prosthesis with improved clinical and biomechanical characteristics.
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Affiliation(s)
| | - Carlos M Atienza
- Instituto de Biomecánica (IBV) Universitat Politècnica de Valencia, Valencia, Spain
- Instituto de Biomecánica de Valencia-CIBER BBN, Grupo de Tecnología Sanitaria (GTS-IBV), Valencia, Spain
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Early Osteoporosis Risks and Associated Factors among Caregivers Working in Disability Institutions: IOF One-Minute Osteoporosis Risk Check. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093319. [PMID: 32397604 PMCID: PMC7246724 DOI: 10.3390/ijerph17093319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 11/17/2022]
Abstract
This study employed the International Osteoporosis Foundation's One-Minute Osteoporosis Risk Test to examine factors related to the osteoporosis risk of institutional caregivers. In this cross-sectional study, a self-developed structured questionnaire comprising the One-Minute Osteoporosis Risk Test was used to obtain data on the caregivers' demographic data, health habits, working style, and osteoporosis risk. Seven disability welfare institutions were selected as research sites, and 465 copies of questionnaires were distributed to the institutions' employees, with 455 valid responses collected for a valid return rate of 98%. SPSS for Windows (Version 20.0) was used to analyze questionnaire data; descriptive-statistical frequency, a χ2 test, and logistic regression were used to determine the correlation between demographic data, health habits, working style, and osteoporosis risk. The results revealed that primary risk factors include < 30 min of daily exercise (38%), lack of dairy product or calcium tablet intake (28%), and < 10 min of daily outdoor activity or not taking vitamin D supplements (29.9%). In total, 395 (86.8%) of the respondents scored less than 5 in the osteoporosis risk test; the remaining 60 (13.2%) scored 5 or higher, revealing a high risk of early osteoporosis. An independent variable analysis revealed that the risk factors of early osteoporosis include age, education level, having undergone bone density tests, prior disease diagnosis, long-term medication use, physical fitness, dietary habits, and average time of exposure to sunlight. In the multivariate analysis, poor physical fitness (odds ratio [OR] = 2.18, 95% confidence interval [CI]: 1.12-4.27, p = 0.023) and average daily time of exposure to sunlight (OR = 0.24, 95% CI: 0.59-2.59, p < 0.001) were significantly correlated with osteoporosis risk. In other words, respondents with poor physical fitness were 2.18 times as likely to have osteoporosis as those with good physical fitness, and those exposed to sunlight for 30 min or longer every day were 0.24 times as likely to have osteoporosis as those exposed to sunlight for less than 30 min every day. Accordingly, institutions must encourage employees to spend more time in the sun every day and improve their physical fitness through exercise.
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Sarmast AH, Kirmani AR, Bhat AR. Osteoporosis Presenting as Low Backache: An Entity not Uncommon to be Missed. Asian J Neurosurg 2018; 13:693-696. [PMID: 30283529 PMCID: PMC6159011 DOI: 10.4103/ajns.ajns_335_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Low backache (LBA) is highly prevalent in osteoporotic patients and affects their quality of life. Overall, osteoporosis incidence is greater in females than in males, and osteoporotic fractures typically occur with only modest or moderate trauma. Aims and Objectives: To evaluate osteoporosis as a cause of LBA in patients attending a neurosurgical outpatient department and to study various risk factors associated with it. Materials and Methods: The study entitled “Osteoporosis presenting as LBA: An entity not uncommon to be missed” was a 2-year hospital-based study conducted from August 2014 to July 2016 in a prospective manner and included 100 patients of osteoporosis with LBA. Analysis of records included their chief complaints, signs and symptoms, diagnostic investigations performed, treatment modalities they underwent, and further recommended management carried on them. Results: Out of total 100 patients evaluated, 33 (33%) were male and 67 (67%) were female; the age of patients was in the range of 35–70 years (mean 56.54 ± 91). The number of patients with a significant medical or surgical history was 31 (31%). The history of drug intake such as thyroxine, steroids, and antiepileptics was present in a total of 11 patients out of which 10 were female and one was male. Regarding lifestyle characteristics of studied patients, a total number of 72 (72%) were having sedentary habits with 15 (45.5%) males and 57 (85.1) females, the total number of moderate workers was 19 (27.3) males and 10 (14.9%) females, and heavy workers were 9 (9%) with 9 (27.3) males and 0 (0%) female. Conclusion: LBA is highly prevalent in osteoporotic patients especially in women. The incidence of osteoporosis and LBA increased with low body mass index, increasing age, and duration of menopause. The various risk factors for osteoporosis include smoking, history of medical diseases such as diabetes mellitus, history of hysterectomy, and history of antiepileptic, thyroxine, and steroid intake.
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Affiliation(s)
- Arif Hussain Sarmast
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Rehman Kirmani
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Abdul Rashid Bhat
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Zaman M, Shah A, Singal R, Kirmani A, Bhat AR, Singal RP. Role of Dual Energy X-ray Absorptiometry (DEXA) Scan in the Diagnosis of Chronic Low Back Pain - a Prospective Randomized Controlled Study in Osteoporotic Patients Hospitalized in a Tertiary Care Institute. MÆDICA 2018; 13:120-124. [PMID: 30069238 DOI: 10.26574/maedica.2018.13.2.120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objectives Osteoporosis is a skeletal disorder characterized by a decrease in bone mass, with accompanying microarchitectural damage that increases the risk of bone fracture. The aim of this study is to evaluate various risk factors for osteoporosis and the role of DEXA scan in diagnosing the problem in an earlier stage. Materials and methods About 100 patients who presented with complaint of low back pain in our outpatient department were studied and subjected to a DEXA scan. Results The age range of patients included in this study was between 35 and 70 years. Of all subjects, 85.10% (n=57) were females and 78.80% (n=26) males. The number of those with significant medical or surgical history was 31% (n=31). The anthropometric characteristics of the studied group included weight, height, and also BMI in kg/m2, which was 20.23, 21.06 in male subjects and 19.343, 20.42 in female ones. Regarding DEXA measurements, the bone mineral density was 0.97±0.27 (0.48, 1.96) for males and 0.83±0.21(0.01, 1.60) for females, with a total of 0.88±0.24 (0.01, 1.96). Conclusion Low back pain is highly prevalent in postmenopausal women. DEXA is a widely accepted radiological tool used to detect osteoporotic changes in bones earlier, with a higher accuracy than plain radiographs of skeletal system. It is relatively cheap, needs no special preparation and involves less radiation hazard.
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Affiliation(s)
- Muzzafar Zaman
- Department of General Surgery, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala, 133207, Haryana, India
| | - Aliya Shah
- Department of Microbiology, MMIMSR, Mullana, Ambala, India
| | - Rikki Singal
- Department of General Surgery, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala, 133207, Haryana, India
| | - Altaf Kirmani
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jandk, India
| | - Abdul Rashid Bhat
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jandk, India
| | - Rajinder Pal Singal
- Department of Orthopaedics, Maharishi Markandeshwar University Solan, Himacha Pradesh, India
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Porter J, Adderley M, Bonham M, Costa RJS, Dart J, McCaffrey T, Ryan L, Davidson ZE. The effect of dietary interventions and nutritional supplementation on bone mineral density in otherwise healthy adults with osteopenia: A systematic review. NUTR BULL 2016. [DOI: 10.1111/nbu.12199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- J. Porter
- Department of Food, Nutrition and Dietetics; Monash University; Notting Hill Australia
- Dietetics Department; Eastern Health; Box Hill Australia
| | - M. Adderley
- Department of Food, Nutrition and Dietetics; Monash University; Notting Hill Australia
| | - M. Bonham
- Department of Food, Nutrition and Dietetics; Monash University; Notting Hill Australia
| | - R. J. S. Costa
- Department of Food, Nutrition and Dietetics; Monash University; Notting Hill Australia
| | - J. Dart
- Department of Food, Nutrition and Dietetics; Monash University; Notting Hill Australia
| | - T. McCaffrey
- Department of Food, Nutrition and Dietetics; Monash University; Notting Hill Australia
| | - L. Ryan
- Department of Food, Nutrition and Dietetics; Monash University; Notting Hill Australia
- Head of Department Natural Sciences; Galway-Mayo Institute of Technology; Galway Ireland
| | - Z. E. Davidson
- Department of Food, Nutrition and Dietetics; Monash University; Notting Hill Australia
- Clinical Sciences Theme; Murdoch Children's Research Institute; Melbourne Australia
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Gates TA, Moldavsky M, Salloum K, Dunbar GL, Park J, Bucklen B. Biomechanical Analysis of a Novel Pedicle Screw Anchor Designed for the Osteoporotic Population. World Neurosurg 2015; 83:965-9. [DOI: 10.1016/j.wneu.2015.01.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 01/22/2015] [Accepted: 01/28/2015] [Indexed: 11/30/2022]
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Nogueira RC, Weeks BK, Beck BR. An in-school exercise intervention to enhance bone and reduce fat in girls: the CAPO Kids trial. Bone 2014; 68:92-9. [PMID: 25151492 DOI: 10.1016/j.bone.2014.08.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 08/13/2014] [Accepted: 08/14/2014] [Indexed: 11/18/2022]
Abstract
UNLABELLED The CAPO Kids trial was a 9-mo, controlled, school-based intervention to examine the effects of a novel, brief, high intensity exercise regime on indices of musculoskeletal and metabolic health in pre- and early-pubertal girls. METHODS A total of 151 pre- and early-pubertal girls (10.6±0.6years), recruited from two different schools consented to participate; 76 in the exercise group (EX) and 75 in the control group (CON). EX performed 10min bouts of thrice-weekly jumping plus capoeira (a Brazilian sport that combines martial art with dance), along with usual physical education (PE) activities. CON continued usual PE alone. Maturity, weight, height, waist circumference, resting heart rate and blood pressure, maximal vertical jump, and aerobic capacity were determined using standard clinical and field measures. Calcaneal broadband ultrasound attenuation (BUA) and stiffness index (SI) were determined from quantitative ultrasonometry. A subsample of children also underwent DXA and pQCT measures. Prior physical activity participation and daily calcium consumption were determined from validated instruments. RESULTS EX girls improved BUA more than CON (+4.5% vs. +1.4%, p=0.019). Resting heart rate (-7.2% vs. -1.8%, p<0.01), maximal vertical jump (+13.4% vs. -1.2%, p<0.001), estimated maximal oxygen consumption (+10.6% vs. +1.0%, p<0.001), and waist circumference (+2.7% vs. +5.6%, p<0.001) also improved more for EX than CON. CONCLUSION Ten minutes of high intensity exercise (capoeira and jumping) three times a week in the primary school setting enhances musculoskeletal and metabolic outcomes in pre- and early-pubertal girls without disrupting the academic schedule. The programme, amenable to broad-scale school implementation, would confer meaningful public health benefits.
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Affiliation(s)
- Rossana C Nogueira
- Griffith Health Institute, Centre for Musculoskeletal Research, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
| | - Benjamin K Weeks
- Griffith Health Institute, Centre for Musculoskeletal Research, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
| | - Belinda R Beck
- Griffith Health Institute, Centre for Musculoskeletal Research, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
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Manning LI, Briggs AM, Van Doornum S, Kale A, Kantor S, Wark JD. Glucocorticoid-induced bone loss is associated with abnormal intravertebral areal bone mineral density distribution. Int J Endocrinol 2013; 2013:768579. [PMID: 23737778 PMCID: PMC3662195 DOI: 10.1155/2013/768579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 04/16/2013] [Indexed: 01/28/2023] Open
Abstract
Individuals with glucocorticoid-induced osteoporosis experience vertebral fractures at an increased rate and at higher vertebral areal bone mineral density (aBMD) than individuals with primary osteoporosis. Standard posteroanterior- (PA-) projection dual energy X-ray absorptiometry (DXA) lacks the diagnostic sensitivity required for reliable estimation of vertebral fracture risk in individuals. Assessment of subregional vertebral aBMD using lateral-projection DXA may improve the predictive value of DXA parameters for fracture. One hundred and four individuals were recruited and grouped for this study: primary osteoporosis with no history of vertebral fracture (n = 43), glucocorticoid-induced bone loss (n = 13), and healthy controls (n = 48). Standard PA-projection and supine-lateral scans were performed, and lateral scans were analysed according to an established protocol to measure aBMD within 6 subregions. Main effects for subregion and group were assessed and observed, by ANCOVA. Ratios were calculated between subregions and compared between groups, to overcome the potentially confounding influence of variability in subregional geometry. Significantly lower values were observed in the glucocorticoid group for the ratios of (i) anterior subregion: whole vertebral body and (ii) posterior: whole vertebral body when compared to the primary osteoporosis and control groups (P < 0.05). Lower anterior subregional aBMD in individuals on glucocorticoid therapy may help to explain the increased vertebral fracture risk in this patient group.
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Affiliation(s)
- Louise I. Manning
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Bone and Mineral Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - Andrew M. Briggs
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia
- Arthritis Victoria and Osteoporosis Victoria, Elsternwick, VIC 3185, Australia
| | - Sharon Van Doornum
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - Ashwini Kale
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Bone and Mineral Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - Susan Kantor
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Bone and Mineral Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - John D. Wark
- University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Bone and Mineral Service, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- *John D. Wark:
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Glintborg B, Hesse U, Houe T, Claus Munk J, Pødenphant J, Zerahn B. Osteoporosis among Fallers without Concomitant Fracture Identified in an Emergency Department: Frequencies and Risk Factors. Adv Orthop 2010; 2011:468717. [PMID: 21991414 PMCID: PMC3170766 DOI: 10.4061/2011/468717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Revised: 08/17/2010] [Accepted: 10/11/2010] [Indexed: 12/01/2022] Open
Abstract
We aimed to determine whether the Emergency Department (ED) is a suitable entrance point for osteoporosis screening among fallers without concomitant fracture compared to referral from general practice. Furthermore, to identify factors associated with osteoporosis among fallers. Methods. Patients aged 50-80 years sustaining a low-energy fall without fracture were identified from an ED (n = 199). Patients answered a questionnaire on risk factors and underwent osteodensitometry. Data was compared to a group of patients routinely referred to osteodensitometry from general practice (n = 201). Results. Among the 199 included fallers, 41 (21%) had osteoporosis. Among these, 35 (85%) reported either previous fracture or reduced body height (>3 cm). These two risk factors were more frequent among fallers with osteoporosis compared to fallers with normal bone mineral density or osteopenia (previous fracture P = .044, height reduction P = .0016). The osteoporosis frequency among fallers from ED did not differ from a similarly aged patient-group referred from general practice (P = .34). Conclusion. Osteodensitometry should be considered among fallers without fracture presenting in the ED, especially if the patient has a prior fracture or declined body height. Since fallers generally have higher fracture risk, the ED might serve as an additional entrance to osteodensitometry compared to referral from primary care.
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Affiliation(s)
- Bente Glintborg
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Copenhagen, Denmark
- Department of Rheumatology and Internal Medicine, 2900 Hellerup, Gentofte Hospital, Denmark
| | - Ulrik Hesse
- Danish Medicines Agency, 2300 Copenhagen, Denmark
| | - Thomas Houe
- Department of Orthopaedic Surgery, 2730 Herlev Hospital, Denmark
| | | | - Jan Pødenphant
- Department of Rheumatology and Internal Medicine, 2900 Hellerup, Gentofte Hospital, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Copenhagen, Denmark
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Määttä M, Moilanen P, Nicholson P, Cheng S, Timonen J, Jämsä T. Correlation of tibial low-frequency ultrasound velocity with femoral radiographic measurements and BMD in elderly women. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:903-911. [PMID: 19216022 DOI: 10.1016/j.ultrasmedbio.2008.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 10/03/2008] [Accepted: 12/03/2008] [Indexed: 05/27/2023]
Abstract
The ultrasonic axial transmission technique has been proposed as a method for cortical bone characterization. Using a low enough center frequency, Lamb modes can be excited in long bones. Lamb waves propagate throughout the cortical bone layer, which makes them appealing for characterizing bone material and geometrical properties. In the present study, a prototype low-frequency quantitative ultrasonic axial transmission device was used on elderly women (n = 132) to investigate the relationships between upper femur geometry and bone mineral density (BMD) and tibial speed of sound. Ultrasonic velocities (V) were recorded using a two-directional measurement set-up on the midtibia and compared with dual-energy X-ray absorptiometry measurements and plain radiographs of the hip. Statistically significant, but weak, correlations were found between V and femoral shaft cortex thickness measured from radiographs (r = 0.20-0.26). V also correlated significantly with various BMD and bone mineral content parameters (r = 0.20-0.35). Femoral BMD and geometry were found to be significant independent predictors of V (R(2) = 0.07-0.16, p < 0.01). This study showed that femoral geometry and BMD affect significantly the axial ultrasound velocity measured at the tibia. In addition, the results confirmed, for the first time, a relationship between tibial ultrasound velocity and cortical bone thickness at the proximal femur.
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Affiliation(s)
- Mikko Määttä
- Department of Medical Technology, University of Oulu, Oulu, Finland.
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