The worldwide problem of osteoporosis: Insights afforded by epidemiology

Riggs, B. Lawrence; Melton, L. Joseph

doi:10.1016/8756-3282(95)00258-4

Cited by 1,236 publications

(671 citation statements)

References 40 publications

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“…Age and/or disease related changes in bone lead to over 200,000 fractures in the UK every year. In addition to the significant reduced quality of life for these patients, this also results in an estimated cost of approximately £1.7 bn (Bukhari, 2009) for the National Health Service (NHS); the equivalent cost in the USA is estimated between $5 -$10 bn (~1.5 million fractures) (Riggs and Melton, 1995). Doubling of these costs is soon to be expected in the western world due to aging and increased lifespan of the population (Bukhari, 2009).…”

Section: Introductionmentioning

confidence: 99%

Load-bearing in cortical bone microstructure: Selective stiffening and heterogeneous strain distribution at the lamellar level

Katsamenis

Chong

Andriotis

et al. 2013

Journal of the Mechanical Behavior of Biomedical Materials

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An improved understanding of bone mechanics is vital in the development of evaluation strategies for patients at risk of bone fracture. The current evaluation approach based on bone mineral density (BMD) measurements lacks sensitivity, and it has become clear that as well as bone mass, bone quality should also be evaluated.The latter includes, among other parameters, the bone matrix material properties, which in turn depend on the hierarchical structural features that make up bone as well as their composition. Optimal load transfer, energy dissipation and toughening mechanisms have, to some extent, been uncovered in bone. Yet, the origin of these properties and their dependence upon the hierarchical structure and composition of bone are largely unknown. Here we investigate load transfer in the osteonal and subosteonal levels and the mechanical behaviour of osteonal lamellae and interlamellar areas during loading. Using cantilever-based nanoindentation, in situ microtensile testing during atomic force microscopy (AFM) and digital image correlation (DIC), we report evidence for a previously unknown mechanism. This mechanism transfers load and movement in a manner analogous to the engineered "elastomeric bearing pads" used in large engineering structures. ȝ-RAMAN microscopy investigations 2 showed compositional differences between lamellae and interlamellar areas. The latter have lower collagen content but an increased concentration of noncollagenous proteins (NCPs). Hence, NCPs enriched areas on the microscale might be similarly important for bone failure as on the nanoscale. Finally, we managed to capture stable crack propagation within the interlamellar areas in a time-lapsed fashion, proving their significant contribution towards fracture toughness.

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Section: Introductionmentioning

confidence: 99%

Load-bearing in cortical bone microstructure: Selective stiffening and heterogeneous strain distribution at the lamellar level

Katsamenis

Chong

Andriotis

et al. 2013

Journal of the Mechanical Behavior of Biomedical Materials

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“…Osteoporosis affects greater than 55% of women older than age 55 years and is characterized by decreased bone mineral density [44,46,50,57] resulting in increased bone fragility and a higher susceptibility to fracture. In the United States, osteoporosis leads to over 700,000 vertebral compression fractures (VCFs) per year and affects women twice as often as men [13].…”

Section: Introductionmentioning

confidence: 99%

Comparison of 5766 Vertebral Compression Fractures Treated With or Without Kyphoplasty

Zampini

White

McGuire

2010

Clinical Orthopaedics &Amp; Related Research

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Background The majority of the 700,000 osteoporotic vertebral compression fractures (VCFs) that occur annually in the United States affect women. The total treatment costs exceed $17 billion and approximate the total costs of breast cancer ($13 billion) and heart disease ($19 billion). Balloon-assisted percutaneous vertebral augmentation with bone cement (kyphoplasty) reportedly reduces VCF-related pain and accelerates return of independent functional mobility. Kyphoplasty may decrease overall cost of VCF treatment costs by reducing use of posttreatment medical resources. Questions/purposes We evaluated complications, mortality, posthospital disposition, and treatment costs of kyphoplasty compared with nonoperative treatment using the Nationwide Inpatient Sample database.Methods We identified 5766 VCFs (71% female) in patients 65 years of age or older with nonneoplastic VCF as the primary diagnosis in nonroutine hospital admissions; 15.3% underwent kyphoplasty. Demographic data, medical comorbidities, and fracture treatment type were recorded. Outcomes, including complications, mortality, posthospital disposition, and treatment costs, were compared for each treatment type. Results Women were more likely to be treated with kyphoplasty than were men. Patients undergoing kyphoplasty had comorbidity indices equivalent to those treated nonoperatively. Kyphoplasty was associated with a greater likelihood of routine discharge to home (38.4% versus 21.0% for nonoperative treatment), a lower rate of discharge to skilled nursing (26.1% versus 34.8%) or other facilities (35.7% versus 47.1%), a complication rate equivalent to nonoperative treatment (1.7% versus 1.0%), and a lower rate of in-hospital mortality (0.3% versus 1.6%). Kyphoplasty was associated with higher cost of hospitalization (mean $37,231 versus $20,112).

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“…As a result of the age-related changes, the incidence of osteoporotic vertebral fractures rises dramatically with age, particularly in the population over 80 years of age [16]. In the United States alone, osteoporosis is responsible for 1.5 million fractures annually, with 700,000 (47%) of these fractures being predominantly vertebral compression fractures (VCF) [16].…”

Section: Introductionmentioning

confidence: 99%

“…In the United States alone, osteoporosis is responsible for 1.5 million fractures annually, with 700,000 (47%) of these fractures being predominantly vertebral compression fractures (VCF) [16].…”

Section: Introductionmentioning

confidence: 99%

Load shift of the intervertebral disc after a vertebroplasty: a finite-element study

Baroud

Nemes

Heini

et al. 2003

European Spine Journal

275

218

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The worldwide problem of osteoporosis: Insights afforded by epidemiology

Cited by 1,236 publications

References 40 publications

Load-bearing in cortical bone microstructure: Selective stiffening and heterogeneous strain distribution at the lamellar level

Load-bearing in cortical bone microstructure: Selective stiffening and heterogeneous strain distribution at the lamellar level

Comparison of 5766 Vertebral Compression Fractures Treated With or Without Kyphoplasty

Load shift of the intervertebral disc after a vertebroplasty: a finite-element study

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