ABSTRACT
BACKGROUND:Increasingly studies report that the normal balance of bone metabolism may be destroyed in the case of postmenopausal osteoporosis or osteoarthritis. The concrete metabolic process of bone turnover could be revealed sensitively by measuring the bone turnover markers in the serum or urine. OBJECTIVE:To study the bone density and bone metabolic index of knee osteoarthritis (KOA) and postmenopausal osteoporosis (PMO), and to discuss the characteristics of bone density and bone metabolic index in KOA and PMO. METHODS:A total of 248 postmenopausal women were detected for bone mineral density and knee X-ray. Final y 180 patients were included in this study and were divided into three groups:KOA group, PMO group, and control group. The levels of bone turnover markers (bone alkaline phosphatase, bone gla protein, col agen type I cross-linked C-telopeptide, and tartrate-resistant acid phosphatase 5b) in serum from the participants were measured. The correlation between bone turnover markers and the disease progression was analyzed by Logistic regression analysis. RESULTS AND CONCLUSION:The bone mineral density in the KOA group was higher than the control group but col agen type I cross-linked C-telopeptide was lower. The levels of bone gla protein, col agen type I cross-linked C-telopeptide, and tartrate-resistant acid phosphatase 5b in serum from PMO group were higher than the control group. The decrease of col agen type I cross-linked C-telopeptide was associated with the incidence of KOA, and the increases of bone gla protein, col agen type I cross-linked C-telopeptide, and tartrate-resistant acid phosphatase 5b were associated with the incidence of PMO. The lower bone absorption can be seen in postmenopausal women with KOA. PMO patients showed a higher bone turnover rate. The difference of bone metabolism between patients with KOA and PMO led to negative relationship of bone mineral density. The serum levels of bone gla protein, col agen type I cross-linked C-telopeptide, and tartrate-resistant acid phosphatase 5b can assist clinical diagnose and therapeutic effect detection of both KOA and PMO.
ABSTRACT
BACKGROUND: Prospective studies concerning bone metabolism and bone mineral density variation after fractures have been reported from the 1960s, but these studies are mainly focused on tibia and fibula and ankle fractures in patients with low sample size. OBJECTIVE:To observe the changes in bone mineral density and bone metabolism indexes in elderly women within 6 to 12 months after hip fractures, and to analyze the correlation. METHODS:We selected 48 elderly women with hip fractures admitted in the Department of Orthopedics, Beijing Aerospace General Hospital in China from May 2011 to July 2013. Standards for fol ow-up were developed to measure the bone mineral density and bone metabolism indexes in the L 1-4 spinal segments and both sides of the hip. The bone metabolism indexes included bone alkaline phosphatase, osteocalcin, cross-linked C-terminal peptide of col agen I, and serum tartrate-resistant acid phosphatase 5b levels. Multiple linear regression analysis was performed based on measurements of bone mineral density and bone metabolism indexes after fracture healing. RESULTS AND CONCLUSION:After fracture healing, bone mineral density of the fractured hip and lumbar vertebra was significantly lower than the baseline value. There was no statistical difference in bone mineral density between the healthy hip and the baseline value. At 6 months after fractures, bone alkaline phosphatase, osteocalcin, cross-linked C-terminal peptide of col agen I, and serum tartrate-resistant acid phosphatase 5b levels were significantly higher than the baseline values. At 12 months after fractures, osteocalcin level was significantly higher than the baseline value, while other indexes of bone metabolism measurements showed no statistical difference from the baseline values. When healing of hip fractures met the clinical and radiographic standards, the partial regression coefficient of delta-Z score reached peak in the changes of serum osteocalcin and bone mineral density of the fractured hip. Under clinical healing of fractures, serum osteocalcin level exhibits a higher value for the assessment of recovery speed of bone mineral density. Monitoring corresponding bone metabolism indexes after fracture healing can improve the accuracy of judging bone mineral density changes to reduce the risk of secondary fractures.
ABSTRACT
Objective To analyze the therapeutic effects of different meth ods in operative treatment of intertrochanteric fractures of femur. Methods 106 cases were treated with operation and their average age was 72 year old. 39 case s of them were treated with external fixation, 3 cases with steeliness, 13 cases with Metanghin nail, 45 cases with DHS, and 6 cases with proximal femoral nail( PFN). Results The therapeutic effects of the dynamic hip screw(DHS) and PFN trea tment were the best among these methods. The excellent and good rates of DHS, PF N, external fixation, steeliness, and Metanghin were 100%, 87.2%, 33.3%, 69. 2%, respectively. Conclusion For the intertrochanteric fracture of lemur,DHS or PFN is recommendable to the patients who can tolerate an operation, whereas uni lateral external fixation is preferable to those who cannot or will not receive an operation.