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  • 1
    ISSN: 1433-0431
    Keywords: Schlüsselwörter Tiermodell ; Östrogenersatztherapie ; Mikroarchitektur ; Röntgentomographische Mikroskopie ; Biomechanische Tests ; Keywords Animal model ; Estrogen replacement ; Microarchitecture ; X-ray tomographic microscopy ; Mechanical testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Postmenopausal osteoporosis leads to a significant increase in bone fragility. In this study we used the rat tibia plateau fracture model to investigate the efficiency of estrogen replacement therapy (ERT) to mitigate the post-ovariectomy decrease in fracture load. A total of 73 virgin Sprague Dawley rats had been ovariectomized and 26 animals underwent sham operation. The ovariectomized animals were either untreated (n=35) or treated with estrogen injections (10 μg/kg per day 3 days a week until sacrifice), starting treatment at either 0, 5, 8, or 13 days post surgery. Before starting ERT and at 50 days post surgery, the trabecular structure of the right proximal tibial metaphysis of each animal was imaged non-invasively using high resolution X-ray topography. The animals were then sacrificed and the right knee from each animal was harvested and mounted into a servo-hydraulic materials testing system so that the distal femoral condyle could be forced into the proximal tibial plateau until fracture occurred. The failure load (F) of the ovariectomized group without estrogen administration was significantly less than that for the sham group. The mean stiffness (K) of the ovariectomized group was 22 percent less than that of the sham group, though this difference did not reach statistical significance. Across all groups, the failure load and stiffness were significantly correlated with the trabecular bone volume. Our data suggest that prompt ERT can increase the fracture load and stiffness of trabecular bone by allowing bone formation to continue in previously activated bone remodeling units while suppressing the production of new remodeling units. This may be the mechanism by which estrogen and other antiresorptive agents increase bone mass, and thereby reduce the risk of osteoporotic fractures in postmenopausal women.
    Notes: Zusammenfassung Postmenopausalbedingte Osteoporose kann zu einer signifikanten Zunahme der Knochenbrüchigkeit führen. In der vorliegenden Studie wurde das Tibiaplateaufrakturmodell an der ovarektomierten Ratte eingesetzt, um die Wirkung der Östrogenersatztherapie (ÖET) sowohl biomechanisch als auch radiologisch zu untersuchen; 73 “Virgin-Sprague-Dawley-Ratten” wurden ovarektomiert und 26 Tiere wurden einer Scheinoperation unterzogen. Die ovarektomierten Tiere wurden entweder mit Östrogeninjektionen (n=38) oder mit Placebo (n=35) behandelt. Die Behandlung begann entweder am Tag der Ovarektomie oder am 5., 8. bzw. 13. Tag nach Ovarektomie. Vor Ovarektomie und am 50. Tag danach wurde die Trabekelstruktur der proximalen Tibiamethaphyse in jedem Versuchstier mit Hilfe hochauflösender, dreidimensionaler, röntgentomographischer Mikroskopie gemessen. Die Tiere wurden anschließend getötet und die Hinterläufe biomechanisch getestet. Die Bruchlast (N) der ovarektomierten Ratten ohne Östrogengabe war signifikant kleiner als die der Tiere aus der scheinovarektomierten Gruppe. Die Steifigkeit (N/mm) der ovarektomierten Tiere war 22% kleiner als die der nichtovarektomierten Tiere. Die Tibiae ovarektomierter Tiere mit Östrogenbehandlung zeigten im Vergleich zu den Tieren ohne Östrogenbehandlung eine signifikante Zunahme der Bruchlast zu allen 4 Zeitpunkten des Beginns der Östrogenbehandlung und eine signifikante Zunahme in Steifigkeit in den Tieren, bei denen mit der Östrogentherapie am 5. und 8. postoperativen Tag begonnen wurde. Die Veränderungen des Trabekelvolumens waren signifikant bei den ovarektomierten Tieren ohne Östrogentherapie im Vergleich zu den Tieren aus der scheinovarektomierten Gruppe. Die Veränderungen des Trabekelvolumens zwischen den ovarektomierten Tieren ohne Östrogenbehandlung und Tieren aus allen 4 Gruppen mit Östrogenbehandlung waren ebenfalls signifikant. In allen Gruppen korrelierte die Bruchlast und die Steifigkeit signifikant mit dem Trabekelvolumen. Unsere Ergebnisse zeigen, dass eine rasch eingeleitete ÖET die Bruchlast und Steifigkeit in trabekulärem Knochen erhöhen kann. Dies geschieht wahrscheinlich durch Zunahme der Trabekeldicke, was letztlich zu einer Erhöhung des Gesamttrabekelvolumens führt und dadurch zu einer Reduzierung des Risikos von osteoporosebedingten Frakturen.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Osteoporosis international 5 (1995), S. 252-261 
    ISSN: 1433-2965
    Keywords: Fall ; Finite element analysis ; Gait ; Hip fracture ; OsteoporosisStress
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The rates of fracture at sites with different relative amounts of cortical and trabecular bone (hip, spine, distal radius) have been used to make inferences about the pathomechanics of bone loss and the existence of type I and type II osteoporosis. However, fracture risk is directly related to the ratio of tissue stress to tissue strength, which in turn is dependent not only on tissue composition but also tissue geometry and the direction and magnitude of loading. These three elements determine how the load is distributed within the tissue. As a result, assumptions on the relative structural importance of cortical and trabecular bone, and how these tissues are affected by bone loss, can be inaccurate if based on regional tissue composition and bone density alone. To investigate the structural significance of cortical and trabecular bone in the proximal femur, and how it is affected by bone loss, we determined the stress distributions in a normal and osteoporotic femur resulting from loadings representing: (1) gait; and (2) a fall to the side with impact onto the greater trochanter. A three-dimensional finite element model was generated based on a representative femur selected from a large database of femoral geometries. Stresses were analyzed throughout the femoral neck and intertrochanteric regions. We found that the percentage of total load supported by cortical and trabecular bone was approximately constant for all load cases but differed depending on location. Cortical bone carried 30% of the load at the subcapital region, 50% at the mid-neck, 96% at the base of the neck and 80% at the intertrochanteric region. These values differ from the widely held assumption that cortical bone carries 75% of the load in the femoral neck and 50% of the load at the intertrochanteric region. During gait, the principal stresses were concentrated within the primary compressive system of trabeculae and in the cortical bone of the intertrochanteric region. In contrast, during a fall, the trabecular stresses were concentrated within the primary tensile system of trabeculae with a peak magnitude 4.3 times that present during gait. While the distribution of stress for the osteoporotic femur was similar to the normal, the magnitude of peak stress was increased by between 33% and 45%. These data call into question several assumptions which serve as the basis for theories on the pathomechanics of osteoporosis. In addition, we expect that the insight provided by this analysis will result in the improved development and interpretation of non-invasive techniques for the quantification of in vivo hip fracture risk.
    Type of Medium: Electronic Resource
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  • 3
    Publication Date: 2012-06-22
    Description: Magnetic resonance (MR) imaging in patients with persistent low back pain and sciatica effectively demonstrates spine anatomy and the relationship of nerve roots and intervertebral disks. Except in cases with nerve root compression, disk extrusion, or central stenosis, conventional anatomic MR images do not help distinguish effectively between painful and nonpainful degenerating disks. Hypoxia, inflammation, innervation, accelerated catabolism, and reduced water and glycosaminoglycan content characterize degenerated disks, the extent of which may distinguish nonpainful from painful ones. Applied to the spine, "functional" imaging techniques such as MR spectroscopy, T1 calculation, T2 relaxation time measurement, diffusion quantitative imaging, and radio nucleotide imaging provide measurements of some of these degenerative features. Novel minimally invasive therapies, with injected growth factors or genetic materials, target these processes in the disk and effectively reverse degeneration in controlled laboratory conditions. Functional imaging has applications in clinical trials to evaluate the efficacy of these therapies and eventually to select patients for treatment. This report summarizes the biochemical processes in disk degeneration, the application of advanced disk imaging techniques, and the novel biologic therapies that presently have the most clinical promise. © RSNA, 2012
    Keywords: Musculoskeletal Radiology
    Print ISSN: 0033-8419
    Electronic ISSN: 1527-1315
    Topics: Medicine
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