In senile patients with preexisting comorbidities who have sacral insufficiency fractures, teriparatide treatment may achieve earlier pain reduction and mobilization and reduce healing time.
Background: Vertebral fragility fracture (VFF) is a common fracture related to osteoporosis. However, VFF might be asymptomatic and often occurs in patients without osteoporosis. Therefore, we investigated the characteristics of age-related VFF and their correlation with bone mineral density (BMD). Furthermore, we analyzed other factors affecting VFF Methods: Medical records from a single center were retrospectively reviewed for 2,216 patients over 50 years old with vertebral fractures conservatively treated from 2005 to 2016. Patients' age, gender, body mass index (BMI), BMD, fracture level, previous vertebral fractures, and anti-osteoporosis medications were obtained. Patients were divided into fragility/non-fragility groups and age subgroups. The odds ratio for VFF in relation to BMD was evaluated. We also identified other predictive factors for VFF by age groups. Results: The fragility group had a higher women ratio, older age, lower BMI, lower BMD, and greater incidence of previous vertebral fractures than the non-fragility group. VFFs were seen in 41.18% of normal BMD patients aged 50-59 and 67.82% of those aged 60-69. The proportion of VFFs increased with age in all WHO osteoporosis classifications. Patients with osteopenia and osteoporosis were 1.57 and 2.62 fold more likely to develop VFFs than normal BMD. In the younger group (under 70), age, women, BMD, and previous vertebral fracture were significant factors affecting VFF, and in the older group (70 and over), age, women, and BMD were factors. In the fragility group, anti-osteoporosis medication rates were 25.08% before and 45.96% after fracture. Conclusion: Considerable VFFs occurred in the younger age groups without osteoporosis and age itself was another important predictor of VFF especially in older age groups. The discrepancy between the incidence of VFF and BMD suggests the necessity of supplemental screening factors and anti-osteoporosis treatment guidelines using only BMD should be reconsidered.
PurposeThis study aimed at comparing the outcomes of medium‐ to large‐sized rotator cuff repairs performed using the suture bridge technique either with or without tape‐like sutures, and single row techniques with conventional sutures.
MethodsA total of 135 eligible patients with medium to large rotator cuff tears were identified and analyzed retrospectively, from 2017 to 2019. Only repairs using all‐suture anchors were included in the study. Patients were divided into the following three groups: single‐row (SR) repair (N = 50), standard double‐row suture bridge (DRSB) repair with conventional sutures (N = 35), and DRSB with tape‐like sutures (N = 50). The average postoperative follow‐up period was 26.3 ± 9.8 months (range, 18–37).
ResultsDRSB with tapes had the highest re‐tear rate of 16% (8/50), but there was no significant difference with the re‐tear rates observed in SR (8%, 4/50) and DRSB with conventional sutures (11.4%, 4/35) (n.s.). DRSB with tapes demonstrated higher rate of type 2 re‐tears (10%) compared to type 1 re‐tears (6%), but the other two groups showed either similar or higher rates of type 1 re‐tears compared to that of type 2. Post‐operative functional scores of the three groups improved significantly (all p < 0.05), but the differences between the groups were not statistically significant.
ConclusionsNo clinical difference in functional outcomes and re‐tear rates were observed in DRSB with tapes when compared with SR and DRSB using the conventional sutures. Tape‐like DRSB suture which was expected to be superior by its biomechanical advantage was clinically non‐superior to conventional DRSB suture. There were no significant differences in VAS scores and UCLA scores.
Level of evidenceLevel III.
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