Current Concepts of Bone Fragility

ISBN-13: 9783642707117 / Angielski / Miękka / 2011 / 455 str.

Hans K. Uhthoff

Opis

"Physiaians have aZways known, though often they are reZuatant to adrrrit it, that the quaZity of their daiZy praatiae depends on the resuZts of researah * . . Irvine H. Page * The 1985 App1ied Basic Science Course distinguished itse1f for three impor- tant reasons. First, it showed c1ear1y the extent to which biotechnology and biomechanics have become an integral part of orthopedics. Second, it emphasized the increasingly important role the orthopedist will have to play in the treatment of the aging population. Projected Canadian statistics estimate that the population aged 65 years and older will in- crease from the current 9. 7% to 13% by the year 2000. Based on the current total population of almost 25 million, the number of hip fractures caused by age-related bone 1055 will almost double and will reach approximately 28,000 per year in Canada. Extrapolation of these figures according to populations in other countries is easy. The costs in expenditures and human suffering are inestimable. This is an area where orthopedic research will have to redouble its efforts in the hope of finding better preventive measures. Furthermore , knowledge of the pathogenetic mechanisms of bone 1055 becomes increasingly important in osteoporosis associated with weightlessness. The third impressive insight we derived from the presentations at this sym- posium was the revelations of the latest imaging techniques and monitoring devices. Nuclear medicine, computer assisted tomography, and nuclear- magnetic resonance are being applied to bone disease.

Spis treści

Skeleton as an Organ of Physical Support.- Basic Biomechanics of the Skeleton.- Biomechanical Factors in Adaptation of Bone Structure to Function.- Cellular Mechanisms Underlying the Skeleton’s Supportive Function.- Diagnostic and Monitoring Tools.- Diagnosis and Follow-up of Patients with Osteoporosis.- Modern Imaging of Patients with Metabolic Bone Disease.- Nuclear Medicine Applications to Metabolic Bone Disease.- Quantitative Assessment of Bone: Radiologic Methods.- Bone Turnover Assessment Using Bone-Specific Biochemical Markers.- The Role of Bone Biopsy in Metabolic Bone Disease.- Bone Microdamage: Factors That Impair Its Repair.- Loads versus Bone Strength.- Impaired Bone Strength and Fracture Patterns at Different Skeletal Sites.- Fracture Patterns in Children.- Cortical Porosity in Postmenopausal and Adolescent Wrist Fractures.- Pathologic Fractures and Stress Fractures: A Review of Pathogenesis and Assessment.- Disuse Osteoporosis: Current Status and Problems.- Osteoporosis: Limitations of Strain-Related Bone Remodeling in Its Prevention.- Disorganized Bone Structure.- Congenital Osteopetrosis.- Osteogenesis Imperfecta: Current Concepts.- Setpoint Proposal for Osteogenesis Imperfecta.- Osteogenesis Imperfecta: Orthopedic Aspects.- Paget’s Disease of Bone (Osteitis deformans).- Paget’s Disease of Bone: Orthopedic Management.- Reversible Osteopenias.- Bone Fragility in Osteomalacia: Mechanism and Consequences.- Drug-Induced Osteomalacia.- Accelerated Cortical Bone Loss: Primary and Secondary Hyperparathyroidism.- Skeletal Problems in Chronic Renal Diseases.- Glucocorticoid-Induced Osteoporosis.- Etiological Spectrum of Avascular Necrosis.- Reversible Osteopenia: Orthopedic Aspects.- Osteoporosis.- Pathogenic Mechanisms of the Osteoporoses.- Morphology of Bone Tissue Aging.- Biomechanical Compensatory Mechanisms for Age-Related Changes in Cortical Bone.- Hip Fracture and Cortical Bone Density in Aging African and Caucasian Populations.- Hip Fracture: A Disease and an Accident.- Economic and Social Burden of Osteoporosis.- Involutional Osteoporosis. Critical Evaluation of Medical Treatments.- Repetitive Loading to Prevent Osteoporosis in the Vertebral Column.- Orthopedic Management of Osteoporosis: Effects of Nutrition and Exercise on the Skeleton.