Increased cortical remodeling after osteotomy causes posttraumatic osteopenia

被引:9
作者
Augat, Peter [1 ,2 ]
Claes, Lutz [3 ]
机构
[1] Paracelsus Med Univ, Biomech Res Lab, A-5020 Salzburg, Austria
[2] Trauma Ctr Murnau, Biomech Res Lab, D-82418 Murnau, Germany
[3] Univ Ulm, Inst Orthopaed Res & Biomech, D-89081 Ulm, Germany
关键词
fracture healing; osteopenia; bone density; bone histomorphometry; remodeling;
D O I
10.1016/j.bone.2008.05.017
中图分类号
R5 [内科学];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
Following a fracture, substantial bone mineral loss can occur at the affected limb. The aim of this study was to analyze the changes in cortical bone around the site of a fracture. We analyzed bone mineral density by quantitative computed tomography and quantified changes in cortical remodeling by histomorphometry adjacent to an experimental osteotomy in sheep metatarsals. In the cortical bone around the osteotomy, we found a statistically significant 16% reduction in app.BMD within 9 weeks following surgery. This reduction was explained (R = -0.71, P<0,01) by a more than 6 fold increase in bone remodeling activity within cortical bone at the affected limb. The remodeling activity significantly increased between surgery and week 6, but remained unchanged between week 6 and week 9. We conclude from these findings that posttraumatic bone mineral loss adjacent to a fracture is related to all elevated number of active osteons, indicating a significant increase in bone remodeling activity. Load shielding by the osteosynthesis material and local recruitment of bone mineral are likely causes for this increased remodeling. This post-traumatic bone loss is likely to contribute significantly to frequently observed healing complications like refracture, failure of implant fixation, implant loosening, or cut out. (C) 2008 Elsevier Inc. All rights reserved
引用
收藏
页码:539 / 543
页数:5
相关论文
共 32 条
[1]
Augat P, 1996, CLIN ORTHOP RELAT R, P194
[2]
Local tissue properties in bone healing: Influence of size and stability of the osteotomy gap [J].
Augat, P ;
Margevicius, K ;
Simon, J ;
Wolf, S ;
Suger, G ;
Claes, L .
JOURNAL OF ORTHOPAEDIC RESEARCH, 1998, 16 (04) :475-481
[3]
Serum osteocalcin, total and bone-specific alkaline phosphatase following isolated tibial shaft fracture [J].
Bowles, SA ;
Kurdy, N ;
Davis, AM ;
France, MW ;
Marsh, DR .
ANNALS OF CLINICAL BIOCHEMISTRY, 1996, 33 :196-200
[4]
Influence of haemorrhagic shock on fracture healing [J].
Bumann, M ;
Henke, T ;
Gerngross, H ;
Claes, L ;
Augat, P .
LANGENBECKS ARCHIVES OF SURGERY, 2003, 388 (05) :331-338
[5]
Influence of size and stability of the osteotomy gap on the success of fracture healing [J].
Claes, L ;
Augat, P ;
Suger, G ;
Wilke, HJ .
JOURNAL OF ORTHOPAEDIC RESEARCH, 1997, 15 (04) :577-584
[6]
Clement EV, 1999, BONE, V24, P131
[7]
CRUESS RL, 1975, CAN J SURG, V18, P403
[8]
Limited bone loss in the hip and heel after reamed intramedullary fixation and early weight-bearing of tibial fractures [J].
Emami, A ;
Larsson, S ;
Hellquist, E ;
Mallmin, H .
JOURNAL OF ORTHOPAEDIC TRAUMA, 2001, 15 (08) :560-565
[9]
BONE LOSS AFTER TIBIAL FRACTURE [J].
EYRES, KS ;
KANIS, JA .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1995, 77B (03) :473-478
[10]
Measurement of bone adjacent to tibial shaft fracture [J].
Findlay, SC ;
Eastell, R ;
Ingle, BM .
OSTEOPOROSIS INTERNATIONAL, 2002, 13 (12) :980-989