OBJECTIVETo evaluate the clinical results of continuing skeletal traction and impaction granular bone grafting via window in femoral neck for the treatment of avascular necrosis of femoral head.

METHODSFrom August 2000 to October 2004, 23 patients (35 hips) with femoral head necrosis were treated by continuing skeletal traction and impacting granular bone grafting via bone window on femoral neck. There were 18 males, 5 females, with an average age of 32 years ranging from 19 to 52 years, which included 7 hips of stage II, 28 hips of stage III. All patients had various degrees of hip joint pain and suffered from limited hip motion. The necrotic bone, granulation tissue and hardening zone were completely cleaned via bone window on the femoral neck. The autogenous granular iliac bone was grafted, and impacted persistently. Skeletal traction through femur condyles was applied continually after the operations. The effects before and after operation were compared by the hip pain, function, joint activity and X-ray.

RESULTSRegular follow-up was carried out after the patients were dismissed from the hospital. The follow-up period was 6 months, 1 year, 2 years, 3 years, 4 years, 5 years respectively. According to Wang's standard, the average score was increased from (52.66 +/- 12.53) preoperatively to (88.94 +/- 5.84) preoperatively at half a year, (89.78 +/- 6.18) at 1 year, (86.37 +/- 7.46) at 2 years, (84.08 +/- 7.57) at 3 years, (83.76 +/- 8.08) at 4 years, and (76.83 +/- 8.98) at 5 years. Scores of operation were greatly increased and the difference had statistical significance.

CONCLUSIONContinuing skeletal traction after the operation, completely cleaning the necrotic bone and impacting granular bone grafting via window on femoral neck can greatly raise the satisfactory rate of clinical effect and delay the progression of disease for avascular necrosis of femoral head.

Adult ; Bone Transplantation ; methods ; Female ; Femur Head Necrosis ; physiopathology ; surgery ; Femur Neck ; Humans ; Male ; Middle Aged

Recent studies in Western countries have reported a significant association between glomerular filtration rate (GFR) and bone mineral density (BMD) in the absence of dialysis among the general population. However, there have been few studies regarding renal function and BMD among Korean or Asian subjects with moderate to severe (stage 3 or 4) chronic kidney disease (MS-CKD). The aim of the present study was to investigate the association between MS-CKD and BMD in the general Korean population. BMD, serum creatinine and other measures were obtained from 3,190 subjects (1,428 males and 1,762 females; the fourth Korean National Health and Nutrition Examination Survey). GFR was estimated using the Cockcroft-Gault formula, with adjustment for body surface area. After adjustment for all variables, multiple regression analysis showed that BMD in the femur neck, total femur and lumbar spine were positively associated with eGFR in both males and females. Additional analysis showed that MS-CKD was also significantly associated with osteoporosis in both males and females (odds ratio [OR] 2.20, 95% confidence interval [CI] 1.15-4.20 in males; and OR 1.96, 95% CI 1.33-2.88 in females). Individuals with MS-CKD may be at higher risk of osteoporosis even among Asians.
Adult ; Aged ; *Bone Density ; Creatinine/blood ; Female ; Femur/physiopathology ; Femur Neck/physiopathology ; Glomerular Filtration Rate ; Humans ; Lumbar Vertebrae/physiopathology ; Male ; Middle Aged ; Nutrition Surveys ; Odds Ratio ; Osteoporosis/etiology ; Regression Analysis ; Renal Insufficiency, Chronic/complications/*physiopathology ; Republic of Korea ; Severity of Illness Index

OBJECTIVETo study the relationship between the hip fracture and osteoporosis of the aged.

METHODSThe strength of contralateral unfractured proximal femur (Singh index) in 80 patients with hip fractures from 1998 to 2003 were collected, and the patients' age were all over 50 years. At the same time, the strength of proximal femur of 90 patients without fractures were also measured, and the figures were analyzed.

RESULTSThe results showed that the fractures of proximal femur was closely related to osteoporosis in 50-60 age group and 61-70 age group (P<0.01). The relationship was not obvious when the age was over 70 (P>0.05).

CONCLUSIONThe strength of proximal femur in patients with hip fracture was obvious decreased. The Singh index of proximal femur can be helpful in forecasting the possibility of proximal femur fracture.

Age Factors ; Aged ; Aged, 80 and over ; Aging ; Compressive Strength ; Female ; Femur Neck ; physiopathology ; Hip Fractures ; physiopathology ; Humans ; Male ; Middle Aged ; Osteoporosis ; physiopathology

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.
Aged ; Arthroplasty, Replacement, Knee/*adverse effects ; Bone Density/*physiology ; Female ; Femur Neck/*physiopathology ; Follow-Up Studies ; Humans ; Male ; Middle Aged

Osteoporosis is a widely recognized health problem in postmenopausal women. Osteoporotic fractures reduce independency, limit daily living activities, and increase the mortality rate. Epidemiological studies have demonstrated that low handgrip strength is a risk factor for functional limitations and disabilities, and all-cause mortality. We investigated the relationship between handgrip strength and bone mineral density (BMD) of the spine, femur neck, and total hip, as well the relationship between handgrip strength and previous fragility fractures in 337 healthy postmenopausal Korean women (mean age of 59.5 +/- 6.8 yr) who were free of diseases or medications affecting bone metabolism. Age and handgrip strength were associated with BMD of the spine, femur neck, and total hip in multiple regression models. Low handgrip strength (odds ratio [OR], 0.925; range, 0.877 to 0.975; P = 0.004) and low femur neck BMD (OR, 0.019; range, 0.001 to 0.354; P = 0.008) were independent predictors of previous fragility fractures in a multiple regression model. Our results demonstrate that low handgrip strength is associated with low BMD of the spine, femur neck, and total hip, and with increased risk of previous fragility fractures.
Aged ; *Bone Density ; Female ; Femur Neck/physiopathology ; Fractures, Bone/epidemiology/*etiology/physiopathology ; *Hand Strength ; Hip/physiopathology ; Humans ; Middle Aged ; Odds Ratio ; Osteoporosis/complications/physiopathology ; Postmenopause ; Predictive Value of Tests ; Republic of Korea/epidemiology ; Risk Factors ; Spine/physiopathology

OBJECTIVETo determine whether bone density is related to osteoarthritis and to compare osteoarthritis with osteoporotic fracture of the femoral neck.

METHODSAll 165 femoral heads removed at joint replacement surgery were divided into 4 groups according to radiographic features of hip (osteophytes, subchondral sclerosis, cysts and femoral head deformity). The individual femoral head was divided into 5 zones histologically. Sections were studied histomorphologically, and quantitation was performed using the computer-assisted system to determine the bone density of the femoral head.

RESULTSThe values of bone density in weight-bearing, super lateral non weight-bearing (SL) and inferior medial non weight-bearing (IM) areas after femoral neck fracture in patients with osteoarthritis were lower than normal. The values of bone density in weight bearing area were increased in patients with osteoarthritis in all four groups but lower than normal in one group (I), and higher than normal in other 2 groups (III, IV). The values of bone density in SL and IM areas except IM area in group IV were lower than normal (P > 0.05). The values of bone density in the central area in the 4 groups were relatively consistent and normal. The density of Haversian canals was increased in the 4 groups indicating osteoporosis of the femoral head. The average age of patients with femoral neck fracture associated with OA (group I) was significantly higher than that of group II, III, IV (P < 0.05).

CONCLUSIONSBone density is different in the femoral head and neck. Dividing the weight bearing joint into distinct zones is a method for laboratory and clinical study. Femoral neck fracture associated with OA was caused by osteoporosis which is related to the age of the patient. The data of this study can be regarded as a potential indicator of implant/host bone relations with morphological, morphometric implications.

Adult ; Aged ; Aged, 80 and over ; Bone Density ; Female ; Femoral Neck Fractures ; etiology ; Femur Head ; diagnostic imaging ; pathology ; physiopathology ; Humans ; Male ; Middle Aged ; Osteoarthritis ; complications ; pathology ; physiopathology ; Osteoporosis ; complications ; physiopathology ; Radiography

This study was conducted to assess the relationship between estimated glomerular filtration rate (eGFR) and bone mineral density (BMD) in Korean postmenopausal women with mild renal dysfunction. A total of 328 postmenopausal women who underwent BMD measurement during health check-up was investigated. BMD was measured in lumbar spine (L1-L4), femoral neck, total proximal femur and femoral trochanteric areas by dual energy radiography absorptiometry and renal function was estimated by eGFR using Cockcroft-Gault equation. Of the 328 subjects, 317 (96.6%) had an eGFR > or =60 mL/min/1.73 m2. By using simple linear regression analysis, age, height, weight and eGFR were significantly associated with BMD for the 4 aforementioned anatomic sites, while serum levels of creatinine and blood urea nitrogen did not influence BMD. When multiple regression analyses were applied, age and body weight still had significant associations with BMD at 4 different anatomic sites (P < 0.001). A significant association of eGFR with BMD remained in the lumbar spine, femoral neck and proximal total femur (P < 0.05) but not in the trochanteric area (P = 0.300). Our study suggests that a decline of renal function is associated with lower BMD in the lumbar spine, femoral neck and total proximal femur areas in Korean menopausal women with mild renal dysfunction.
Absorptiometry, Photon ; Aged ; Blood Urea Nitrogen ; *Bone Density ; Creatinine/blood ; Female ; Femur Neck/physiology ; *Glomerular Filtration Rate ; Humans ; Kidney Diseases/*physiopathology ; Kidney Function Tests ; Lumbar Vertebrae/physiology ; Middle Aged ; Osteoporosis, Postmenopausal/*physiopathology ; Republic of Korea