Microindentation for In Vivo Measurement of Bone Tissue Material Properties in Atypical Femoral Fracture Patients and Controls
Microindentation for In Vivo Measurement of Bone Tissue Material Properties in Atypical Femoral Fracture Patients and Controls
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DOI：
10.1002/jbmr.1731
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发表时间：
2013-01-01
影响因子：
6.2
通讯作者：
Diez-Perez, Adolfo
中科院分区：
文献类型：
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作者：
Gueerri-Fernandez, Roberto C.;Nogues, Xavier;Diez-Perez, Adolfo
与长期双磷酸盐（LTB）相关的非典型股骨骨折（AFF）越来越受到关注。它们的病因尚不清楚，但骨材料特性可能会恶化。在 AFF 系列中，我们通过显微压痕分析了骨材料特性。包括四组患者：6 名 AFF、38 名典型骨质疏松性骨折、6 名 LTB 和 20 名无骨折对照患者。典型的骨质疏松性骨折和对照均未接受任何抗骨质疏松药物治疗。所有患者均进行了一般实验室检查、双能 X 射线吸收测定法 (DXA) 骨密度测定以及胫骨显微压痕测试。测量总压痕距离（Total ID）、压痕距离增量（IDI）和蠕变压痕距离（Creep ID）（微米）。使用年龄调整协方差分析（ANCOVA）进行比较。对照组明显比骨折组年轻。 AFF 组双磷酸盐暴露平均为 5.5 年（范围 5 至 12 年），LTB 组为 5.4 年（范围 5 至 8 年）。对照 36 (+/- 6；平均值 +/- SD) 的总 ID（微米）显示出比 AFF 46 (+/- 4) 和典型股骨骨折 47 (+/- 13) 更好的材料特性（较低的总 ID）。 LTB 患者的数值介于对照组和骨折组之间，为 38 (+/- 4)，但与其他三组没有显着差异。 IDI 值显示出类似的模式 13 (+/- 2)、16 (+/- 6)、19 (+/- 3) 和 18 (+/- 5)。按年龄调整后，对照组和典型患者之间存在显着差异（p
Atypical femoral fractures (AFF) associated with long-term bisphosphonates (LTB) are a growing concern. Their etiology is unknown, but bone material properties might be deteriorated. In an AFF series, we analyzed the bone material properties by microindentation. Four groups of patients were included: 6 AFF, 38 typical osteoporotic fractures, 6 LTB, and 20 controls without fracture. Neither typical osteoporotic fractures nor controls have received any antiosteoporotic medication. A general laboratory workup, bone densitometry by dual-energy X-ray absorptiometry (DXA), and microindentation testing at the tibia were done in all patients. Total indentation distance (Total ID), indentation distance increase (IDI), and creep indentation distance (Creep ID) were measured (microns). Age-adjusted analysis of covariance (ANCOVA) was used for comparisons. Controls were significantly younger than fracture groups. Bisphosphonate exposure was on average 5.5 years (range 5 to 12 years) for the AFF and 5.4 years (range 5 to 8 years) for the LTB groups. Total ID (microns) showed better material properties (lower Total ID) for controls 36 (+/- 6; mean +/- SD) than for AFF 46 (+/- 4) and for typical femoral fractures 47 (+/- 13), respectively. Patients on LTB showed values between controls and fractures, 38 (+/- 4), although not significantly different from any of the other three groups. IDI values showed a similar pattern 13 (+/- 2), 16 (+/- 6), 19 (+/- 3), and 18 (+/- 5). After adjusting by age, significant differences were seen between controls and typical (p