The role of adaptive bone formation in the etiology of stress fracture

Hughes, Julie M.; Popp, Kristin L.; Yanovich, Ran; Bouxsein, Mary L.; Matheny, Ronald W.

doi:10.1177/1535370216661646

Cited by 64 publications

(54 citation statements)

References 77 publications

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“…Microdamage is a natural consequence of loading in healthy bone. However, in an attempt to remove microdamage, bone undergoes 'targeted remodelling' and this results in temporarily increased porosity (14). This can impair the mechanical properties of bone (15), increasing susceptibility to a stress fracture.…”

Section: Introductionmentioning

confidence: 99%

Estimating Tibial Stress throughout the Duration of a Treadmill Run

Rice

Weir

Trudeau³

et al. 2019

Medicine &Amp; Science in Sports &Amp; Exercise

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Introduction: Stress fractures of the tibia are a problematic injury amongst runners of all levels. Quantifying tibial stress using a modelling approach provides an alternative to invasive assessments that may be used to detect changes in tibial stress during running. This study aimed to assess the repeatability of a tibial stress model and to use this model to quantify changes in tibial stress that occur throughout the course of a 40-minute prolonged treadmill run. Methods: Synchronised force and kinematic data were collected during prolonged treadmill running from fourteen recreational male rearfoot runners on two separate occasions. During each session, participants ran at their preferred speed for two consecutive 20-minute runs, separated by a 2-minute pause. The tibia was modelled as a hollow ellipse and bending moments and stresses at the distal 1/3 of the tibia were estimated using beam theory combined with inverse dynamics and musculoskeletal modelling. Results: Intraclass correlation coefficients indicated good-to-excellent repeatability for peak stress values between sessions. Peak anterior and posterior stresses increased following 20 minutes of prolonged treadmill running and were 15% and 12% greater respectively after 40 minutes of running compared with the start of the run. Conclusion: The hollow elliptical tibial model presented is a repeatable tool that can be utilised to assess within-participant changes in peak tibial stress during running. The increased stresses observed during a prolonged treadmill run may have implications for the development of tibial stress fracture.

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Section: Introductionmentioning

confidence: 99%

Estimating Tibial Stress throughout the Duration of a Treadmill Run

Rice

Weir

Trudeau³

et al. 2019

Medicine &Amp; Science in Sports &Amp; Exercise

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“…This new bone formation confers a significant protective increase in skeletal fatigue resistance . Suppression of the adaptive bone formation response with NSAID use has been experimentally demonstrated in animals (17–19) and provides biological plausibility for increased stress fracture risk . Nevertheless, the relationship between NSAID use and stress fracture risk in humans is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…(20) Suppression of the adaptive bone formation response with NSAID use has been experimentally demonstrated in animals (17)(18)(19) and provides biological plausibility for increased stress fracture risk. (21,22) Nevertheless, the relationship between NSAID use and stress fracture risk in humans is unknown. Accordingly, we examined the relationship between NSAID prescription and stress fracture risk among the entire US Active Duty Army population, hypothesizing that NSAID prescription would be associated with increased risk of stress fracture diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Nonsteroidal Anti-Inflammatory Drug Prescriptions Are Associated With Increased Stress Fracture Diagnosis in the US Army Population

Hughes

McKinnon

Taylor

et al. 2018

Journal of Bone and Mineral Research

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Stress fractures are common in military personnel and endurance athletes, and nonsteroidal anti‐inflammatory drug (NSAID) use is widespread in these populations. NSAIDs inhibit prostaglandin synthesis, which blunts the anabolic response of bone to physical activity and could therefore increase risk of stress fracture. The objective of this study was to determine whether prescribed NSAIDs were associated with stress fracture diagnoses among US Army soldiers. We also aimed to establish whether acetaminophen, an analgesic alternative to NSAIDs, was associated with stress fracture risk. A nested case‐control study was conducted using data from the Total Army Injury and Health Outcomes Database from 2002 to 2011 (n = 1,260,168). We identified soldiers with a diagnosis of stress fracture (n = 24,146) and selected 4 controls per case matched on length of military service (n = 96,584). We identified NSAID and acetaminophen prescriptions 180 to 30 days before injury (or match date). We also identified soldiers who participated in basic combat training (BCT), a 10‐week period of heightened physical activity at the onset of Army service. Among these individuals, we identified 9088 cases and 36,878 matched controls. Conditional logistic regression was used to calculate incident rate ratios (RR) for stress fracture with adjustment for sex. NSAID prescription was associated with a 2.9‐fold increase (RR = 2.9, 95% confidence interval [CI] 2.8–2.9) and acetaminophen prescription with a 2.1‐fold increase (RR = 2.1, 95% CI 2.0–2.2) in stress fracture risk within the total Army population. The risk was more than 5‐fold greater in soldiers prescribed NSAIDs (RR = 5.3, 95% CI 4.9–5.7) and more than 4‐fold greater in soldiers prescribed acetaminophen (RR = 4.4, 95% CI 3.9–4.9) during BCT. Our results reveal an association between NSAID and acetaminophen prescriptions and stress fracture risk, particularly during periods of heightened physical activity. Prospective observational studies and randomized controlled trials are needed to support these findings before clinical recommendations can be made. © 2018 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).

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“…Yine kemik metabolizmasını gösteren 18F NaF PET/CT ile PFAS'lı dizlerin %85'inde artmış tutulum bildirilmiştir (27). Stres kırıklarında da artmış kemik metabolizması görülmektedir (28…”

Section: Gereç Ve Yöntemlerunclassified

Vitamin D Levels of Patients with Patellofemoral Pain Syndrome

Yüksel

Topçugil

2019

TurkJSportsMed

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Objectives: To compare serum 25-hydroxyvitamin D levels of patellofemoral pain syndrome patients with healthy individuals who admitted for preparticipation screening, retrospectively.Material and Methods: Medical records of patients who were admitted to a sports medicine clinic were reviewed. Twenty five patellofemoral pain syndrome patients whose serum 25-hydroxyvitamin D levels measured at the time of diagnosis and 51 healthy individuals who were admitted for preparticipation screening and whose serum 25-hydroxyvitamin D levels were measured at the time of admission were included in the study. Vitamin D levels and admission dates of the patients were recorded.Results: Serum 25-hydroxyvitamin D levels of all patients with patellofemoral pain syndrome were below normal, and mean levels were 19.5±7.1 ng/ml. Mean serum 25hydroxyvitamin D levels of healthy individuals were 26.9±10.6 ng/ml. Patellofemoral pain syndrome patient's serum 25-hydroxyvitamin D levels were significantly lower (p<0.05) than those of the healthy individuals.Conclusions: Lower levels of serum 25-hydroxyvitamin D may have a role in the pathophysiology of patellofemoral pain syndrome.Keywords: Vitamin D, patellofemoral pain syndrome ÖZ Amaç: Bu çalışmanın amacı patellofemoral ağrı sendromu tanısı konulmuş hastaların serum 25-hidroksivitamin D düzeylerini spora katılım öncesi muayene için başvuran sağlıklı kişilerle retrospektif olarak karşılaştırmaktır.Gereç ve Yöntemler: Spor Hekimliği polikliniğine başvuran hastalar retrospektif olarak tarandı. Serum 25-hidroksivitamin D düzeyine bakılmış 25 patellofemoral ağrı sendromu tanılı hasta ve spora katılım öncesi muayene için başvurmuş 51 sağlıklı kişi çalışmaya dahil edildi. Olguların 25-hidroksivitamin D düzeyleri kaydedildi.Bulgular: Patellofemoral ağrı sendromu hastalarının hepsinin serum 25-hidroksivitamin D düzeyleri normalin altındaydı ve ortalaması 19.5±7.1 ng/ml idi. Spora katılım öncesi muayene için başvuran olguların ortalama D vitamini düzeyi ise 26.9±10.6 ng/ml idi. Patellofemoral ağrı sendromu hastalarının D vitamini düzeyleri sağlıklı grubunkilerden anlamlı olarak düşüktü (p<0.05).Sonuç: Vitamin D düşüklüğünün patellofemoral ağrı sendromu patofizyolojisinde rolü olabilir.Anahtar Sözcükler: D vitamini, patellofemoral ağrı sendromu

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The role of adaptive bone formation in the etiology of stress fracture

Cited by 64 publications

References 77 publications

Estimating Tibial Stress throughout the Duration of a Treadmill Run

Estimating Tibial Stress throughout the Duration of a Treadmill Run

Nonsteroidal Anti-Inflammatory Drug Prescriptions Are Associated With Increased Stress Fracture Diagnosis in the US Army Population

Vitamin D Levels of Patients with Patellofemoral Pain Syndrome

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