Impaired geometric properties of tibia in older women with hip fracture history

Mikkola, Tuija M.; Sipilä, Sarianna; Portegijs, Erja; Kallinen, Mauri; Alén, Markku; Kiviranta, Ilkka; Pekkonen, Mika; Heinonen, Ari

doi:10.1007/s00198-007-0352-x

Cited by 24 publications

(33 citation statements)

References 42 publications

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“…Cortical thickness, cortical cross-sectional area, and area moment of inertia are strong predictors of bone strength and resistance to fracture [10,39]. Positive and strong correlation was found between the bone damage parameters and I pol in this study.…”

Section: Discussionsupporting

confidence: 64%

Analysis of plastic deformation in cortical bone after insertion of coated and non-coated self-tapping orthopaedic screws

Koistinen

Korhonen

Kiviranta

et al. 2011

Proc Inst Mech Eng H

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Insertion of internal fracture fixation devices, such as screws, mechanically weakens the bone. Diamond-like carbon has outstanding tribology properties which may decrease the amount of damage in tissue. The purpose of this study was to investigate methods for quantification of cortical bone damage after orthopaedic bone screw insertion and to evaluate the effect of surface modification on tissue damage. In total, 48 stainless steel screws were inserted into cadaver bones. Half of the screws were coated with a smooth amorphous diamond coating. Geometrical data of the bones was determined by peripheral quantitative computed tomography. Thin sections of the bone samples were prepared after screw insertion, and histomorphometric evaluation of damage was performed on images obtained using light microscopy. Micro-computed tomography and scanning electron microscopy were also used to examine tissue damage. A positive correlation was found between tissue damage and the geometric properties of the bone. The age of the cadaver significantly affected the bone mineral density, as well as the damage perimeter and diameter of the screw hole. However, the expected positive effect of surface modification was probably obscured by large variations in the results and, thus, statistically significant differences were not found in this study. This can be explained by natural variability in bone tissue, which also made automated image analysis difficult.

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Section: Discussionsupporting

confidence: 64%

Analysis of plastic deformation in cortical bone after insertion of coated and non-coated self-tapping orthopaedic screws

Koistinen

Korhonen

Kiviranta

et al. 2011

Proc Inst Mech Eng H

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“…Because the participants represent the highest end of the distribution of hip fracture patients, it is very likely that this truncated distribution underestimates the association between pain and physical inactivity. Despite this, our participants had markedly poorer postural balance, balance confidence [14] , muscle strength and walking speed [41] than ageand sex-matched controls.…”

Section: Discussionmentioning

confidence: 89%

Physical Inactivity and Pain in Older Men and Women with Hip Fracture History

Salpakoski¹,

Portegijs²,

Kallinen³

et al. 2010

Gerontology

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Hip fracture patients often suffer from pain for several months after surgery. This may lead to physical inactivity and subsequent mobility limitation and disability. The purpose of this study was to investigate the association between severe musculoskeletal pain and the level of physical activity in older people with a history of hip fracture. Data were collected from 60- to 85-year-old (n = 78) community-dwelling people, 0.7–7.5 years after hip fracture. Physical activity was assessed with the Yale Physical Activity Survey (YPAS). According to the YPAS summary index distribution, the participants were divided into the physically inactive and physically active groups. Musculoskeletal pain in the lower back, hip or knee region was assessed by the Visual Analog Scale. Pain was defined as severe pain if the subject rated the pain 66 mm or over (upper third of the scale) in at least one of the relevant body regions in the lower body. Thirty-three subjects (42%) experienced severe pain in the lower body, of whom 23 (70%) reported severe pain in the operated hip. Twenty-three patients (30%) used pain medication prescribed by a physician. The level of musculoskeletal pain was significantly higher in the physically inactive (62%) than in the physically active (31%) group (p = 0.011). Logistic regression analysis showed that people with severe pain had over three times (OR: 3.5, 95% CI: 1.30–9.39) the risk for physical inactivity compared to those with less or no pain. Multivariate adjustments for balance confidence, time since fracture, number of chronic diseases and type of surgery did not materially change the estimate (OR: 3.0, 95% CI: 1.00–9.30). Pain is an important associated factor of physical inactivity in older people with a hip fracture history. Pain management may be important in restoring and sustaining the level of physical activity after hip fracture. Further prospective and experimental studies are, however, needed to explore the causality between pain and physical activity as well as the role of pain management and physical activity interventions in preventing mobility limitation and disability among older people recovering from hip fracture.

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“…Detailed description of the recruitment of the subjects has been reported earlier (25,26). To avoid confounding of acute recovery effects, community-living 60Á85-year-old men and women with a femoral neck or trochanteric fracture within 6 months to 7 years prior to baseline were invited to participate in the study.…”

Section: Participants and Study Designmentioning

confidence: 99%

The effects of muscle strength and power training on mobility among older hip fracture patients

Mård¹,

Vaha²,

Heinonen³

et al. 2008

Advances in Physiotherapy

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The incidence of hip fractures is growing in all Western societies. The mobility of hip fracture patients does not return to the pre-fracture level even 2 years after fracture. One reason for mobility limitation may be the persistent muscle weakness on the fractured leg. The purpose of this randomized controlled study was to examine whether 12-week muscle strength and power training twice a week has an effect on mobility in 60Á85-year-old hip fracture patients. Forty-three persons were randomly assigned to an intervention (n 023) and a control (n 020) group. The intervention comprised 12-week supervised intensive progressive strengthÁpower training twice per week. All the measurers were blinded. Mobility was assessed by the timed-up-and-go test (TUG), chair rise and stair climbing time, walking time and self-reported change in mobility. Data were analyzed using the intention-to-treat principle. In addition, an efficacy analysis was performed for those subjects with over 50% training compliance (n 020). Fourteen of the subjects in the training group and only two controls felt that their mobility had improved during the intervention period (p 00.002). Training had no significant effect on TUG, chair rise and stair climbing time and walking time. However, in the efficacy analysis, the average chair rise time improved by 5.4% in the exercise group compared with controls (p00.005). After intensive muscle strength and power training, the self-reported mobility improved. The chair rise improved in participants with higher training compliance.

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Impaired geometric properties of tibia in older women with hip fracture history

Cited by 24 publications

References 42 publications

Analysis of plastic deformation in cortical bone after insertion of coated and non-coated self-tapping orthopaedic screws

Analysis of plastic deformation in cortical bone after insertion of coated and non-coated self-tapping orthopaedic screws

Physical Inactivity and Pain in Older Men and Women with Hip Fracture History

The effects of muscle strength and power training on mobility among older hip fracture patients

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