Publications (5)4.15 Total impact
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Article: A meta-analysis of bisphosphonates for periprosthetic bone loss after total joint arthroplasty.
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ABSTRACT: BACKGROUND: Periprosthetic bone loss, which is common after joint arthroplasty, may cause bone loosening and lead to failed prosthetic fixation. Two previous meta-analyses have confirmed the mid-term effect of bisphosphonates (BPs) in preventing bone loss after arthroplasty. To determine long-term efficacy and gender bias of BPs after joint arthroplasty, we conducted a meta-analysis based on 17 RCTs involving 781 patients to evaluate the effect of BPs. METHODS: Meta-analysis was conducted after a systematic search of Medline, Embase, the Cochrane Collaboration Central Register of Controlled Clinical Trials, CINAHL, and ISI Web of Science, and manual examination of references in selected articles and conference abstracts of key orthopedic journals. Methodological quality and abstracted relevant data were evaluated. In addition to analysis of bone mineral density (BMD), we also conducted systematic analysis of clinically relevant outcomes and bone biochemical markers. RESULTS: Seventeen trials involving a total of 781 patients were assessed. Significantly less periprosthetic bone loss occurred in the BP-treated group than in the control group at 6 and 12 months (p < 0.0001). This protective effect was not noted at 3 months (p = 0.11) nor from 24-72 months (p = 0.14). The efficacy of BPs in the gender balance, shorter duration, and the non-nitrogenous BPs groups was no different from that for controls. Biochemical bone markers were suppressed in the BPs group. However, clinically relevant outcomes in the BPs group and controls were similar at all times. CONCLUSIONS: The overall moderate-quality evidence from the RCTs confirmed the significant mid-term efficacy of BPs on periprosthetic bone loss after joint arthroplasty. Long-term efficacy of BPs was not observed, and the therapy was of more benefit to women, especially postmenopausal women. To achieve better efficacy, nitrogenous BPs and long duration of treatment may be recommended.Journal of Orthopaedic Science 06/2013; · 0.84 Impact Factor -
Article: Osteonecrosis of the femoral head in SARS patients: seven years later.
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ABSTRACT: This study is aimed to explore the progression of osteonecrosis of the femoral head (OFNH) in severe acute respiratory syndrome patients 7 years after steroid administration and to analyze factors affecting the prognosis. One-hundred and ninety hips in 117 patients with more than 7 years of follow-up were studied. The prevalence of progression to symptoms and collapse was determined. The total dose of steroid, gender, age, stage, lesion location, volume of necrosis, viable lateral column and bone marrow edema were analyzed and correlated with progression. During the 7 years of follow-up, 66 hips progressed to symptoms, 50 hips collapsed and 10 hips showed complete regression. Fifty-seven hips (86.36 %) caused pain and 32 (64.00 %) collapsed within 3 years of steroid administration. The lesion was relatively larger, and there was relatively less viable lateral column in hips that exhibited symptoms or collapsed. Mechanical failure of the necrotic segment of bone principally occurred within 3 years after the administration of steroids. Larger lesions and less viable lateral column were the main risk factors for progression. Small ONFH lesions seldom collapsed.European Journal of Orthopaedic Surgery & Traumatology 07/2012; · 0.10 Impact Factor -
Article: Clinical analysis of osteonecrosis of the femoral head induced by steroids.
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ABSTRACT: To explore the clinical characteristics of osteonecrosis of the femoral head (ONFH) induced by steroids. From January 2000 to October 2009, 497 hips in 270 cases of ONFH induced by steroids were studied. A questionnaire was administered when the patients were admitted; the questions concerned the underlying disease, duration of steroid usage, total dosage of steroid, incubation period (time interval between commencement of steroid therapy and onset of pain), severity of pain, location of initial complaint, primary diagnosis, time lag from onset of pain to final diagnosis and physical signs when admitted. The correlations between pain and Association Research Circulation Osseous (ARCO) stage, bone marrow edema (BME) and lesion size were analyzed. The median of time between commencing steroid medication and developing ONFH for the 269 cases was 18 months (range, 2-384 months). 78.82% cases presented with pain within three years of steroid initiation, only 10.41% patients first complained of pain six or more years after commencing steroid therapy. Fifty-six cases (20.82%) were misdiagnosed, lumbar disorders being the most frequent misdiagnoses. 79.29% of symptomatic hips presented with abnormal physical tests. Of 420 symptomatic hips, 166 hips were type C1, 223 hips type C2; 299 hips had collapsed; and there was BME in 209 hips. Most patients with ONFH induced by steroids complained of pain within 3 years of commencing steroid therapy. Pain was associated with lesion size, collapse and BME. Atypical location of pain, failure to perform a physical examination and MRI findings were the main causes of misdiagnoses.Orthopaedic Surgery 02/2012; 4(1):28-34. -
Article: Osteonecrosis in patients after severe acute respiratory syndrome (SARS): possible role of anticardiolipin antibodies.
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ABSTRACT: This study examined the anticardiolipin antibodies in post-SARS (severe acute respiratory syndrome) osteonecrosis patients to investigate the etiology of post-SARS osteonecrosis, and to eventually provide valuable information for the early diagnosis of nontraumatic osteonecrosis and for the susceptible population screening. This study recruited 62 post-SARS osteonecrosis patients and 52 age- and gender-matched healthy controls. Fasting blood samples were collected from all the subjects through cubital veins. Immunoglobulins A, G and M (IgA, G and M) types of anticardiolipin antibodies were examined by enzyme-linked immunosorbent assay. The routine examinations of prothrombin time, thrombin time, prothrombin activity, and international normalized ratio were also performed. There were 21 of 62 post-SARS osteonecrosis patients (33.9%) who showed at least one type of anticardiolipin antibodies. The titers of specific IgA, IgG, and IgM were 11.33 +/- 11.209 APL, 5.127 +/- 5.927 GPL, and 17.821 +/- 10.606 MPL, respectively. There were only 4 of 52 subjects in the control group (7.7%) who showed positive anticardiolipin antibody with titers of IgA at 10.702 +/- 3.126 APL, IgG at 5.184 +/- 4.780 GPL, and IgM at 14.684 +/- 5.516 MPL. There were significant differences between the 2 groups confirmed by t-Test and chi(2) test (P < 0.05), while no significant differences were observed in prothrombin time, thrombin time, prothrombin activity, and international normalized ratio results between the 2 groups. The incidences of anticardiolipin antibodies were increased in the post-SARS osteonecrosis patients and anticardiolipin antibodies may play a role in the pathogenesis of post-SARS osteonecrosis.Journal of clinical rheumatology: practical reports on rheumatic & musculoskeletal diseases 03/2010; 16(2):61-3. · 1.19 Impact Factor -
Article: Lesion size changes in osteonecrosis of the femoral head: a long-term prospective study using MRI.
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ABSTRACT: Osteonecrosis of the femoral head (ONFH) is one of the intractable diseases. It is controversial whether the lesion size assessed by magnetic resonance imaging (MRI) can change over time without any operative treatment. In this study, we used MRI to observe the lesion size changes of ONFH induced by corticosteroid administration in severe acute respiratory syndrome (SARS) patients. The study included 51 SARS patients (84 hips) with early-stage ONFH who did not receive any operative treatment and were diagnosed by MRI. All of the patients underwent MRI follow-ups. Each patient was evaluated on the basis of the lesion volume on MRI at every follow-up for further comparisons. At the first MRI scan, the mean lesion volume was 10.12 +/- 8.05 cm(3) (range: 0.39-41.62 cm(3)). At the mid-term follow-up (2.5 years), the mean lesion volume was 7.82 +/- 7.59 cm(3) (range: 0.11-39.65 cm(3)). At the final follow-up (five years), complete regression of the lesion was observed in six hips, and the mean lesion volume was 5.67 +/- 6.58 cm(3) (range: 0.00-31.47 cm(3)). Overall, the lesion volume was reduced by >15% in 80 hips, and only four hips with relatively larger lesion volumes showed no apparent reductions. The reduction in lesion size of ONFH observed on MRI is a slow, discontinuous and time-dependent process.International Orthopaedics 06/2009; 34(6):799-804. · 2.03 Impact Factor
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Institutions
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2012
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Xuzhou Medical College
Tongshan, Jiangsu Sheng, China
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2009
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China-Japan Friendship Hospital
Beijing, Beijing Shi, China
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