Changes in Bone Mineral Density of Both Proximal Femurs after Total Knee Arthroplasty

BACKGROUND: This study investigated the effects of total knee arthroplasty (TKA) on bone mineral density (BMD) of the proximal femur in patients who underwent the procedure. METHODS: Forty-eight patients scheduled to undergo unilateral TKA because of primary knee osteoarthritis were included in this study, which was conducted at a medical center between October 2006 and October 2009. In these 48 patients, 96 hips were evaluated. Measurement of BMD was performed preoperatively and one month, three months, six months, and one year after unilateral TKA. Repeated measured analysis of variance and paired t-tests for comparison of two repeated samples were used to compare differences between time points (preoperation, one, three, six, and 12 months) and between the operative and nonoperative sides. RESULTS: Preoperatively, BMD of the femoral neck, trochanter, and total hip on the operative side were lower than on the nonoperative side; however, there was no statistical difference. BMD of both femoral neck areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both trochanter areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both total hips was significantly lower than preoperative BMD at three months after TKA. However, no statistical differences of changes in BMD were observed between the operative and nonoperative sides at each measurement time. CONCLUSIONS: According to our results, TKA was found to affect both proximal femurs during the acute period. However, TKA did not affect a change in BMD of the proximal femur during one year postoperative.

Nested Case-control Study on the Association between Alcohol and the Risk of Proximal Hip Fracture in the Elderly People in Korea / 한국역학회지

OBJECTIVE: To assess the association between alcohol drinking and hip fracture in the elderly people in Korea. BACKGROUND: Hip fracture is known as one of the major health problems because of its high incidence and serious consequences in the elderly people. The association between alcohol consumption and hip fractures has not been directly evaluated yet in Korea. So we conducted a nested case-control study to investigate the relationship between alcohol consumption and hip fracture in the Korean elderly people. DESIGN: Nested case-control study from the Korea Elderly Pharmacoepidemiology Cohort (KEPEC), in Pusan, Korea. METHODS: Seventy incident cases have been selected since 1993, and 280 controls have been matched with the cases by age and gender among the KEPEC. Average alcohol intake was calculated by multiplying frequency and amount of drinking and unit capacity of each alcohol type. Odds ratios of alcohol intake on the hip fracture and their confidence intervals were computed by using multiple logistic regression with Windows version SAS 6.12. RESULTS: The elderly people's drinking rate is lower than the young people in Korea. In univariate analysis, crude odds ratio was 0.26 in male and adjusted odds ratio after contolling for age, smoking status, medication history, physical activity and body mass index was 0.36 in male. So current drinking reduces the risk of hip fracture. Adjusted odds ratio after controlling for age, smoking status, medication history, physical activity and body mass index odds ratio was 0.24 in female with moderate drinking. CONCLUSION: We found that alcohol consumption reduces the risk of hip fracture in the elderly Korean. However, we could not explain the plausible mechanism with our data yet. So, we suggest the further study for elucidating the possible mechanism of the finding including the possible association between nutritional status, alcohol drinking and bone marrow density in the elderly.

Cohort Study on the Association getween Smoking and Proximal Hip Fracture in the Elderly People in Korea / 한국역학회지

OBJECTIVE: To assess the association between cigarette smoking and hip fracture by using the Korea Pharmacoepidemiology Cohort(KPEC). BACKGROUND: Hip fracture is known as one of the major health problems because of its high incidence and serious consequences in the elderly people. Cigarette smoking, old age, female and low body weight have been reported as risk factors for osteoporosis which is regarded as one of the risk factors for hip fracture. But the relationship between cigarette smoking and hip fracture has not been directly evaluated yet. So we conducted a prospective cohort study to investigate the relationship between cigarette smoking and hip fracture in the Korean elderly. DESIGN: Prospective cohort study on the 8,994 elderly person aged 65 or more in Pusan, Korea between 1993 to 1996. METHODS: The Korea Phamacoepidemiology Cohort(KPEC) has been constructed with three kinds of data sources. One is from the Korea Medical Insurance Corporation; Medical Insurance Claims Database and Enrollee's Database. Other sources are from directly constructed pharmacy database and questionnaire data. incidence density and relative risk of smoking for hip fracture were estimated by using the KPEC database. Age and gender specific incidence density was calculated by dividing the number of hip fracture cases by person-years of the follow-up the cohort. Relative risks and their confidence intervals were computed by using multiple logistic regression by Windows version SAS 6.12. RESULTS: The level of incidence density in female was higher than that in male, which was increasing with age in both gender. In the multivariate analysis, we observed significant relationship between soking and hip fracture in female(PR=1.94(1.01-3.76)) in the larger amount smoking group, after adjusting for the confounders; age, alcohol drinking, medication history, physical activity and body mass index, the relative risk became slightly decreased to 1.70(0.84-3.46). CONCLUSION: Accoding to this result, we suggest that effective anti-smoking campaign should be established as soon as possible for the Korean elderly women.