Neil Binkley's research while affiliated with James Madison University and other places

Publications (353)

Article
Introduction Osteoporosis is highly prevalent in elective orthopedic surgery. While preoperative bone health optimization decreases osteoporosis-related complications, there is an unmet need to establish who may benefit from preoperative dual-energy x-ray absorptiometry (DXA). This study assesses a novel, simple screening protocol to identify ortho...
Article
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It is unclear how ongoing inflammation in Coronavirus Disease 2019 (COVID-19) affects 25-hydroxyvitamin D (25[OH]D) concentration. The objective of our study was to examine serum 25(OH)D levels during COVID-19 pneumonia. Patients were admitted between 1 November and 31 December 2021. Blood samples were taken on admission (day 0) and every 24 h for...
Article
Background Osteoarthritis (OA) is a significant long term concern after anterior cruciate ligament (ACL) reconstruction (ACLR). A low bone mineral density (BMD), particularly in the subchondral region, has been associated with the development of OA and is evident at the knee in patients long after ACLR. It is unknown if persistent BMD deficits are...
Article
Background Context Normal bone mineral density (BMD) as measured by dual-energy x-ray absorptiometry (DXA) is present in approximately 10% of older adults with fracture. BMD alone does not evaluate bone quality or clinical risk factors, and therefore, may not adequately capture a patient's fracture risk. Thus, despite a normal DXA-measured BMD, the...
Poster
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Objectives: There is no consensus about specific serum 25(OH)D levels associated with higher risk of severe outcome in COVID-19 patients. According to the literature patients with serum 25(OH)D levels < 12 ng/ml are clearly deficient at all ages. Our aim was to assess COVID-19 mortality in the settings of severe 25(OH)D deficiency. Methods: A coho...
Article
Abstract Background Computed tomography (CT)‐derived measures of tissue quality can add to frailty assessment and improve selection of candidates for heart transplant. We investigated the prognostic value of CT measures of tissue density for predicting hospital length of stay (LOS) and mortality post‐transplant. Methods All patients at a quaternary...
Article
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Background: Many older adults with physical limitations living in residential care apartments are unable to exercise in a standing position and are at risk for declining in muscle function leading to falls and injury. Novel approaches to achieve exercise benefits are needed. The purpose of this study was to test the effect of semi-recumbent vibrat...
Article
Introduction The vertebral bone quality (VBQ) score can independently predict fragility fractures and is useful for osteoporosis screening. It is derived by taking the ratio of the median L1-L4 signal intensity (SI) and L3 cerebral spinal fluid SI on opportunistic T1 weighted (fat sensitive) magnetic resonance imaging (MRI) scans. Higher VBQ score...
Article
Introduction The COVID pandemic has altered health care delivery, including clinical research, by introduction of measures to reduce COVID. How these measures affect clinical research participation is unclear. Objectives The purpose of this survey was to document research volunteer's attitudes toward COVID infection control procedures. Methods Ou...
Article
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In December 2019, the first cases of severe acute respiratory syndrome due to a new coronavirus (SARS-Cov-2), later designated as Covid-19, were described in China. With rapid advance of the infection to several continents, in March 2020, WHO declared this to be a pandemic. In April 2020, the first papers suggesting a possible role of Vitamin D def...
Article
Introduction Traditionally, total body (TB) DXA scans to assess body composition include the entire body, however novel abbreviated scan acquisition methods are available in new software. For example, total body less head (TBLH) is recommended given the head contains lean mass that cannot be altered by intervention. Recently, to reduce scan time an...
Article
Introduction DXA technology requires soft tissue attenuation measurement. This sampling is confined within a standard soft tissue region of interest (ROI) defined by the blue squares on Figure 1, which is automatically placed and used to compare with radiation absorption over bone. Variable placement of the soft tissue ROI likely alters BMD measure...
Article
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Objective: Osteoporosis is not rare in thoracolumbar spine fusion patients and may portend poorer surgical outcomes. Implementation of a bone health optimization (BHO) clinic improves osteoporosis screening and treatment in the total joint arthroplasty population. We hypothesize that preoperative osteoporosis is common, under-recognized, and under...
Article
Introduction: Texture Research Imaging Platform (TRIP) applies trabecular bone score (TBS) measurement principles to images acquired with multiple modalities to assess bone texture at various skeletal sites. This study aimed to assess the bone texture score in DXA-acquired lateral vertebral fracture assessment (VFA) images (BTSVFA), evaluate its re...
Article
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The 2021 Virtual Santa Fe Bone Symposium was held August 5-8, with over 300 registered attendees from throughout the USA and at least 18 other countries. This annual meeting focuses on applying advances in basic science and clinical research to the care of patients with osteoporosis and those with inherited and acquired disorders of bone metabolism...
Article
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Objectives: There is no consensus about specific serum 25(OH)D levels associated with higher risk of severe outcome in COVID-19 patients. According to the literature patients with serum 25(OH)D levels < 12 ng/ml are clearly deficient at all ages. Our aim was to assess COVID-19 mortality in the settings of severe 25(OH)D deficiency. Methods: A coho...
Article
Background Excessive vitamin A (VA) can cause bone resorption and impair growth. Government-mandated VA supplementation (VAS) and adequate intake through dietary fortification and liver consumption led to excessive VA in South African children. Objectives We evaluated the relationship of VAS and underlying hypervitaminosis A assessed by retinol is...
Article
Introduction Distal femur BMD declines ∼20% following total knee arthroplasty (TKA) potentially leading to adverse outcomes. BMD knowledge before and following TKA might allow interventions to optimize outcomes. We hypothesized that distal femur and proximal tibial BMD could be reproducibly measured with existing DXA technology. Methods Elective T...
Article
Low bone mineral density is associated with spinal deformity. Dual-energy X-ray absorptiometry (DXA), a modality that assesses bone density, portends a theoretical means to also assess spinal deformity. We found that DXA can reliably assess spine alignment. DXA may permit surveillance of spine alignment, i.e., scoliosis in the clinical setting. Pu...
Article
This 6-month pilot study in osteoporotic postmenopausal women evaluated cyclic TPD/RLX compared to daily subcutaneous TPD with the concept of optimizing bone formation. Compared to daily subcutaneous TPD, cyclic therapy showed comparable increase in spine BMD and favorable effects on total proximal femur BMD and cortical thickness.PurposeThere is n...
Article
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The 4 th International Conference on Controversies in Vitamin D was held as a virtual meeting in September, 2020, gathering together leading international scientific and medical experts in vitamin D. Since vitamin D has a crucial role in skeletal and extra-skeletal systems, the aim of the Conference was to discuss improved management of vitamin D d...
Article
Study design: Expert Consensus Study. Objectives: This expert panel was created to establish best practice guidelines to identify and treat patients with poor bone health prior to elective spinal reconstruction. Summary of background data: Currently, no guidelines exist for the management of osteoporosis and osteopenia in patients undergoing s...
Article
BACKGROUND CONTEXT Osteoporosis is not rare in thoracolumbar spine fusion patients and may portend poorer surgical outcomes. Implementation of a bone health optimization (BHO) clinic improves osteoporosis screening and treatment in the total joint arthroplasty population. We hypothesize that preoperative osteoporosis is common, under-recognized and...
Article
Bone mineral density (BMD) changes during the life span, increasing rapidly during adolescence, plateauing in the third decade of life, and subsequently entering a phase of age-related decline. In women, menopause leads to accelerated bone loss and an increase in fracture risk. Between peak bone mass attainment and menopause, BMD is generally stabl...
Article
Introduction: Recent studies suggest that cortical bone could also play a role in vertebral fracture (VF) development in acromegaly. Objective: Evaluate the occurrence of the VF and their relationship to DXA-derived bone parameters. Patients and methods: A single-center two year prospective study of acromegaly patients was conducted. Each subj...
Article
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Traditional diagnostic criteria for sarcopenia use Dual‐energy X‐ray Absorptiometry (DXA) measured appendicular lean mass (ALM), normalized to height (ALM/ht2) or body mass index (ALM/BMI) to define low muscle mass. However, muscle function declines with aging before the loss of muscle mass is detected by ALM. This is likely due, in part, to qualit...
Article
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Introduction: Vertebral fractures (VFs) in patients with acromegaly are not associated with bone mineral density (BMD) decrease. Previous studies showed impaired trabecular bone parameters among acromegaly patients. However, recent studies suggest that cortical bone could also play a role in VF development. Objective: Evaluate the utility of dual e...
Article
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Introduction: The rate of preoperative osteoporosis in lower extremity arthroplasty is 33%. The prevalence of osteoporosis in shoulder arthroplasty patients is inadequately studied. The purpose of this study was to (1) determine the prevalence of osteoporosis in patients undergoing elective shoulder arthroplasty, (2) report the percentage of patie...
Article
The best screening strategy to identify treatment qualification based upon indicators of high fracture risk (low-trauma fractures of the hip, spine, or multiple fracture episodes at other sites; high fracture probability with the Canadian fracture risk assessment [FRAX®] tool major osteoporotic fracture [MOF] computed with bone mineral density [BMD...
Article
This comparison of osteoporosis treatment strategies and intervention thresholds highlights tradeoffs in terms of number of individuals qualifying for treatment and estimated fractures prevented.PurposeThe current analysis was performed to inform the following key question as part of the Osteoporosis Canada’s Osteoporosis Guidelines Update: “What i...
Article
In 50,330 women undergoing bone mineral density (BMD) testing, adjusting FRAX® major osteoporotic fracture (MOF) probability for T-score differences between lumbar spine and femoral neck had a small impact on treatment qualification, with only 1.1% reclassified from below to above the 20% MOF intervention threshold.PurposeDiscordance between lumbar...
Article
Mini abstractPatients that sustain “osteoporosis-related” fractures may have normal BMD at the hips and spine, but rarely have normal bone when other clinically available studies are considered. Such data often exist and can inform clinical decisions regarding osteoporosis therapy.PurposeDual-energy X-ray absorptiometry (DXA) measured bone mineral...
Article
Among 39,475 women, age 65 years and older, use of fracture history, major osteoporotic fracture (MOF) probability from FRAX®, vertebral fracture assessment (VFA), and bone mineral density (BMD) T-score stratified women into different levels of risk. The majority of women identified as being at high risk from fracture history, FRAX MOF-BMD > 20%, o...
Article
Vertebral fracture assessment (VFA) provides incremental information in identifying women and men aged 70 years and older qualifying for anti-osteoporosis treatment compared with FRAX® major osteoporotic fracture (MOF) probability computed with bone mineral density (BMD).PurposeThis analysis was performed to inform appropriate use of VFA testing as...
Article
Background Atypical femur fractures are widely recognized and associated with anti-resorptive therapy, most commonly bisphosphonates. These fractures generally occur in the femoral shaft or subtrochanteric region. Cases of atypical fractures at non-femur sites, including the ulna, have been reported. Case Report. Here we report a probable atypical...
Article
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The 3rd International Conference on Controversies in Vitamin D was held in Gubbio (PG), Italy, September 10‐13, 2019. The conference was held in follow up to previous meetings held in 2017 and 2018, with the aim being to address topics of controversy in vitamin D. The specific topics were selected by the steering committee of the conference and bas...
Article
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The SARS-CoV-2 virus responsible for the COVID-19 pandemic has generated an explosion of interest both in the mechanisms of infection leading to dissemination and expression of this disease, and in potential risk factors that may have a mechanistic basis for disease propagation or control. Vitamin D has emerged as a factor that may be involved in t...
Article
OBJECTIVE The purpose of this investigation was to characterize the bone health in preoperative spine surgery patients. This information will provide a framework to understand the needs and methods for providing bone health optimization in elective spine surgery patients. METHODS A retrospective study of 104 patients undergoing bone health optimiz...
Article
Objective Radio-dense artifacts, including contrast material, alter DXA results. An apparent diffuse artifact was identified during spine DXA acquisition in a patient without recent radiographic procedures. The patient reported taking sodium zirconium cyclosilicate (SZC; Lokelma®) 10 grams 1 hour before scanning. SZC is a potassium-binding agent re...
Article
Objective The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). Methods Recommendations are bas...
Article
Objective: The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). Methods: Recommendations are ba...
Article
Very dense artifacts confound bone density measurement. Hologic and GE densitometers exclude artifact density and GE also excludes associated area. Consequently, BMD is decreased with Hologic software. Despite different manufacturers’ approaches, when dense artifacts overlay the spine, the affected vertebral body should be excluded from the reporte...
Article
Objective: The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPG). Methods: Recommendations are bas...
Article
Introduction: Hip fracture affects >300,000 Americans each year, and the mortality rate following these fractures is high. Methods: Authors searched the Centers for Disease Control and Prevention Wide-Ranging Online Database for Epidemiologic Research (WONDER) for incidences of hip fracture as a contributing cause of death and stratified by sex,...
Article
Antiresorptive therapies reduce fracture risk; however, long-term bone turnover inhibition may raise concerns about rare, but serious, skeletal adverse events-atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ). Denosumab, a fully human monoclonal antibody against RANKL, has demonstrated sustained low vertebral and nonvertebral fract...
Article
Background: Osteoporosis is associated with adverse orthopaedic surgical outcomes. Bone health optimization is a preoperative intervention intended to reduce the likelihood of postoperative complications. We aimed to characterize a patient cohort referred for bone health optimization to test the hypothesis that poor bone quality is common in ortho...
Article
Background Bone loss after total knee arthroplasty (TKA) may lead to periprosthetic fractures that are associated with significant costs (morbidity, economic, etc.) and pose a challenge to operative fixation. This meta-analysis quantifies the change in bone mineral density (BMD) of the distal femur after primary TKA. Methods A systematic review of...
Article
This analysis was performed in Zambian children who had a high prevalence of hypervitaminosis A, defined as > 1.0 μmol retinol/g liver. Bone parameters included markers of bone formation (P1NP), bone resorption (CTX), parathyroid hormone, calcium, vitamin A, and vitamin D. Low dietary vitamin A intake increased P1NP. Purpose Vitamin A (VA) interac...
Chapter
An essential requirement for translating osteosarcopenia research into clinical care is determining the best method for assessing both muscle and bone tissue composition. Several non-invasive imaging modalities exist that differ in terms of accuracy, reliability, cost, and radiation exposure. Magnetic resonance imaging (MRI), computed tomography (C...
Article
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Objectives Older adults with impaired physical function are at risk for further functional decline in part due to limited ability to engage in regular exercise. Effective approaches to exercise in this vulnerable population are needed to improve functional capacity and optimize independence. Methods Thirty-two residential care apartment complex (R...
Article
Background: Odanacatib, a cathepsin K inhibitor, reduces bone resorption while maintaining bone formation. Previous work has shown that odanacatib increases bone mineral density in postmenopausal women with low bone mass. We aimed to investigate the efficacy and safety of odanacatib to reduce fracture risk in postmenopausal women with osteoporosis...
Article
Worldwide, osteoporosis management is in crisis because of inadequate delivery of care, competing guidelines, and confusing recommendations. Additionally, patients are not readily accepting the diagnosis of poor bone health and often are noncompliant with treatment recommendations. Secondary fracture prevention, through a program such as Own the Bo...
Article
Background Body composition assessment is frequently used in sports medicine and athletic performance environments to assess change in response to strength training and nutrition programs. However, to effectively do so requires knowledge regarding expected body composition values relative to sport and sex. Dual-energy x-ray absorptiometry (DXA) is...
Article
Background: Peri-prosthetic fractures after total knee arthroplasty (TKA) are associated with poorer outcomes and high costs. We hypothesize that osteoporosis is under-recognized in the TKA population. The purpose of this study is to report osteoporosis prevalence in a healthy cohort of patients with well-functioning TKA and to compare prevalence...
Article
Introduction: Impaired bone microarchitecture is involved in vertebral fracture (VF) development among acromegaly (AG) patients. Aim of the study: Comparison of DXA-derived bone parameters; areal BMD (aBMD), trabecular bone score (TBS) and 3D-SHAPER parameters in AG patients with healthy controls. Methods: This cross-sectional study evaluated acrom...
Article
Purpose As the waitlist of heart transplant patients continues to rise, it is important to objectively identify patients who will have positive outcomes post-transplant surgery. Skeletal muscle characterization by computed tomography (CT) is prognostic in various disease states and may provide important information for selecting optimal transplant...
Article
Background: Osteoporosis is common in total joint arthroplasty (TJA) patients and likely contributes to the increasing incidence of periprosthetic fracture. Despite this, the prevalence of osteoporosis in patients undergoing elective TJA is inadequately studied. We hypothesize that preoperative osteoporosis is underrecognized and undertreated in t...
Article
Context Antiresorptive therapy has been associated with osteonecrosis of the jaw (ONJ), an infrequent but potentially serious adverse event. Objective To assess information on invasive oral procedures and events (OPEs) – dental implants, tooth extraction, natural tooth loss, scaling/root planing, jaw surgery – during the 7-year FREEDOM Extension a...
Article
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Vitamin D adequacy is essential for multiple physiologic processes. With limited exposure to sunlight for vitamin D3 synthesis, captive primates are supplemented with vitamin D3 (cholecalciferol). Vitamin D metabolite data from wild primates living indigenously could suggest optimum levels. The purpose of this study was to: 1) to explore whether ba...
Article
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Rationale: Fluid volume estimates may help predict functional status and thereby improve sarcopenia diagnosis. Main result: Bioimpedance-derived fluid volume, combined with DXA, improves identification of jump power over traditional measures. Significance: DXA-measured lean mass should be corrected for fluid distribution in older populations;...
Article
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Introduction: Impaired bone microarchitecture is involved in vertebral fracture (VF) development among acromegaly (AG) patients. Aim: Comparison of DXA-derived bone parameters; areal BMD (aBMD), trabecular bone score (TBS) and 3D-SHAPER parameters in AG patients with healthy controls. Methods: This cross-sectional study of acromegaly patients and a...
Article
Context Vitamin D is classically recognized as a regulator of calcium and phosphorus metabolism. Recent advances in the measurement of vitamin D metabolites, diagnosis of vitamin D deficiency, and clinical observations have led to an appreciation that along with its role in skeletal metabolism, vitamin D may well have an important role in non-class...
Article
Introduction The Fracture Liaison Service (FLS) model improves osteoporosis care following fragility fractures in adults (1). Our institution has implemented the FLS model housed within our Department of Orthopedics utilizing the American Orthopedic Association Own the Bone (OTB) program. Objectives To address the gap in osteoporosis care followin...
Chapter
Although sarcopenia and osteoporosis, which could similarly be defined as the age‐related decline in bone mass and strength, are generally considered as separate processes, their phenotypes are increasingly identified as co‐occurring with aging. The combination of these two diseases exacerbates negative health outcomes and has been described as a “...
Article
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Estrogen depletion leads to bone loss in almost all mammals with frequent regular ovarian cycles. However, subordinate adult female common marmosets (Callithrix jacchus) undergo socially induced anovulation and hypoestrogenism without clinically apparent adverse skeletal consequences. Thus, we speculated that this non human primate might have evolv...
Article
Abbreviations: 25(OH)D = 25-hydroxyvitamin D; BMD = bone mineral density; CV = cardiovascular; GI = gastrointestinal; IOM = Institute of Medicine; PTH = parathyroid hormone; RCT = randomized controlled trial; αTF = α-tocopherol; ucOC = undercarboxylated osteocalcin; VKA = vitamin K antagonist; WHI = Women's Health Initiative.
Article
Chemokine CX3CL1 (fractalkine) may be an important factor linking thyroid status and bone remodeling, through tetrac, a derivative of thyroxine. This study explores the relationship between serum fractalkine levels and parameters of thyroid status and bone in premenopausal women with Graves’ disease (GD) in comparison to healthy controls. This cros...
Article
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Background Low bone mineral density (BMD) and subsequent skeletal fragility have emerged as a long-term complication of phenylketonuria (PKU). Objective To determine if there are differences in BMD and body composition between male and female participants with PKU. Methods From our randomized, crossover trial [1] of participants with early-treate...