Associations between body composition and vertebral fracture risk in postmenopausal women.

INTRODUCTION: Osteoporosis is a metabolic bone disease with low bone mineral density (BMD) and high incidence of vertebral fractures (VFs). Postmenopausal women with osteoporosis have decreased total fat and lean mass. This study aimed to investigate the associations between body composition and VF risk and explore the potential predictor of VF risk in postmenopausal women. METHODS: Enrolled 731 postmenopausal women were referred by various departments and outpatient clinics to assess vertebral status between October 2016 and November 2017. The main measures were total body lean mass, fat mass, and BMD. Patients were divided into osteopenia, osteoporosis, and normal groups based on T-scores. Logistic regression analyses were performed to evaluate associations between body composition parameters and VF. RESULTS: VF was significantly associated with increased age, lower height, and lighter weight in all participants, and higher BMI was observed in VF participants. Participants in the osteoporosis group were older and had lower height, weight, and BMD than those in normal and osteopenia groups. Femoral and total hip T-scores as well as T-scores for lumbar spine were significantly lower in participants with VF than in non-VF participants. Percentage of bone mass was also significantly lower in VF participants compared to that of non-VF participants. Women with increased BMD and lower bone mass had reduced odds for VF occurrence. Bone mass was significantly able to identify VF occurrence. CONCLUSIONS: Body composition analysis discerns differences in the bone status of postmenopausal women with and without VF. The cutoff value of the bone mass might be used effectively as an indicator of risk for VF occurrence.

EAR method: an alternative method of bone grafting following bone tumor resection (a preliminary report).

The EAR (Excision, Alcoholization, Replantation) method consists of a proper tumor resection, removal of tumor tissue extracorporally, soaking the residual bone shell in 95% alcohol for half an hour, and replantation in situ, the cavity being filled with bone graft or bone cement. Eighty-three cases were treated in this manner, of which 95% were followed for 2 years or more, with complete success in cases with IA lesions and no recurrence in two-thirds of those with IB-IIB lesions. Experimentally, it is proved that alcohol can kill tumor cells completely without interfering with osteogenesis. The joint cartilage, although degenerated, is replaced by newly formed fibrocartilage, thus preserving joint function.

Giant-cell tumor of bone: analysis of two hundred and eight cases in Chinese patients.

Giant-cell tumor of bone seems to occur more frequently in Chinese people than in those residing in Western countries. The estimated incidence is about 20 per cent of all primary tumors of bone. Of 208 surgically treated and pathologically proved giant-cell tumors, 194 were benign. We excluded patients with primary or secondary amputation unrelated to recurrence and those followed for less than two years or lost to follow-up. Of the remaining 111 patients who were followed for more than two years, twenty-nine had a recurrence, giving a recurrence rate of 26.1 per cent. The rate of recurrence was highest following curettage and bone-grafting (41.2 per cent) and was much lower in patients who were treated by resection and fusion (7.1 per cent). Since resection of this tumor with reconstructive procedures, either by massive homogenous bone-grafting or artificial joint replacement, is complicated and might cripple the patient if it fails, we propose excision and curettage with bone-grafting as the most suitable method of treatment in the majority of patients with giant-cell tumor of bone.