Osteoporotic hip fractures: 10-year review in a Singaporean hospital.

Purpose: To review records of 2702 patients with osteoporotic hip fractures in a Singaporean hospital.

Methods: Medical records of 1905 women and 797 men, aged 50 to 112 (median, 78) years, who were admitted to a Singaporean hospital with an osteoporotic hip fracture (ICD9 820) between January 2000 and December 2010 were reviewed.

Results: Female patients were significantly older than male patients (p<0.

Total hip replacement using a highly crosslinked polyethylene liner in Asians with small acetabulum.

Purpose: To evaluate the medium-term outcomes of total hip replacement (THR) using a thin highly cross-linked polyethylene (HXLPE) liner in an Asian population.

Methods: Medical records of 20 men and 44 women aged 26 to 80 (mean, 59) years who underwent 80 THRs using a thin HXLPE liner by a single surgeon were reviewed. Indications for THR included dysplasia (n = 26), avascular necrosis (n=26), osteoarthritis (n = 22), rheumatoid arthritis (n = 4), and ankylosing spondylitis (n = 2).

Mediolateral subchondral tibial bone mineral density difference does not predict osteoarthritis progression.

Data on the relationship between osteoporosis and osteoarthritis are conflicting. Most studies report "snapshot" prevalences, and there are few studies evaluating localized knee bone mineral density (BMD) measurements with respect to subsequent osteoarthritis progression. The authors hypothesize that increased mediolateral difference of the proximal tibial BMD may predict progression of knee osteoarthritis.

Patients with knee osteoarthritis demonstrate improved gait pattern and reduced pain following a non-invasive biomechanical therapy: a prospective multi-centre study on Singaporean population.

Background: Previous studies have shown the effect of a unique therapy with a non-invasive biomechanical foot-worn device (AposTherapy) on Caucasian western population suffering from knee osteoarthritis. The purpose of the current study was to evaluate the effect of this therapy on the level of symptoms and gait patterns in a multi-ethnic Singaporean population suffering from knee osteoarthritis.

Methods: Fifty-eight patients with bilateral medial compartment knee osteoarthritis participated in the study.

The relationship between body mass index and physical activity levels in relation to bone mineral density in premenopausal and postmenopausal women.

Unlabelled: We prospectively analyzed 283 women to evaluate the effects of body mass index (BMI) and physical activity levels on bone mineral density (BMD) progression in pre- and postmenopausal women over 2 years. In postmenopausal women, lower BMI was linked with worsening BMD, and moderate activity levels were associated with a lower likelihood of worsening BMD at 2 years.

Purpose: The aim of our study is to evaluate the effects of BMI and physical activity levels on BMD progression in pre- and postmenopausal Asian women over 2 years.

A subtrochanteric femoral fracture 15 years after radiotherapy: a case report.

Pathological fracture is a rare but serious complication of radiotherapy. We report on a 44-year-old man who presented with a subtrochanteric femoral fracture 15 years after radiotherapy for a soft-tissue sarcoma in the thigh. We discuss its potential causes, a scoring system to identify high-risk patients for prophylactic intramedullary nailing of the femur, and radiographic signs to identify an impending insufficiency fracture.

Administration of PTH and ibandronate increases ovariectomized rat compact bone viscoelasticity.

In this study, the bone mineral density (BMD), geometry, macroscopic viscoelastic properties and mechanical strength in five different groups of Sprague-Dawley rats (sham operated, ovariectomized with vehicle, parathyroid hormone and/or ibandronate administration) were examined by peripheral quantitative computed tomography (pQCT), dynamic mechanical analysis (DMA) and three-point bending test. At the end of the study, storage modulus (E'), loss tangent (tanδ), ultimate force (Fu) and stiffness (S) had greatly decreased in vehicle-treated ovariectomized group as compared to sham group (p<0.05).

Improving stability of locking compression plates through a design modification: a computational investigation.

Femoral shaft fractures are common in both the young and elderly due to high-impact trauma and low-impact trauma, respectively. Its treatment by indirect reduction through use of locking compression plates (LCPs) has been on the rise. The LCP possess several advantages in fracture fixation, combining angular stability through use of locking screws with misalignment correction and fracture reduction onto the plate through use of conventional screws.

Localized sclerotic bone response demonstrated reduced nanomechanical creep properties.

Sclerosis (tissue hardening) development is a common occurrence in slow growing or benign osteolytic lesions. However, there is lack of knowledge on the mechanical and material property changes associated with sclerotic bone response. The immune system is postulated to play a relevant role in evoking sclerotic bone responses.

Positive alterations of viscoelastic and geometric properties in ovariectomized rat femurs with concurrent administration of ibandronate and PTH.

Besides bone mineral density (BMD), structural and nano-level viscoelastic properties of bone are also crucial determinants of bone strength. However, treatment induced viscosity changes in osteoporotic bone have seldom been characterized. In this study, the effects of anabolic, antiresorptive and concurrent treatments on ovariectomized rat bones were thoroughly analyzed using multiple bone strength parameters.

'Not Always a Baker's Cyst' - An Unusual Presentation of a Central Voluminous Postero-Medial Meniscal Cyst.

Meniscal cysts are rare and often are a result of extrusion of synovial fluid through a tear of the meniscus, resulting in a one-way valve effect of the tear. Arthroscopic partial meniscectomy of the meniscus with intra-articular cyst drainage has become the standard of care. We report a case of an unusually large symptomatic medial meniscal cyst, situated postero-medially and pressing on the posterior cruciate ligament, which was initially clinically misdiagnosed as a Baker's cyst.

Femoral canal obliteration secondary to prolonged alendronate use: a case report.

Insufficiency fractures secondary to prolonged alendronate use is due to inhibition of osteoclastic activity and suppressed bone turnover. Complications of fracture fixation include non-union, mal-union, and difficulty in intramedullary nail insertion. We report a technical challenge in intramedullary nailing of an obliterated femoral canal in a patient on long-term bisphosphonate treatment.

The susceptibility of the femoral neck to fracture: an assessment incorporating the effects of age-remodeling and stress reduction.

Age-related bone remodeling may cause fragility of the femoral neck, thereby increasing fracture risk in elderly populations. We investigated the effects of age-remodeling and stress-reduction on the femoral neck region using the Finite Strip Method (FSM). We verified the possibility that the femoral neck is likely to undergo fracture through two mechanisms: yielding and local buckling.

Clinical outcome following treatment of stable and unstable intertrochanteric fractures with dynamic hip screw.

Introduction: Intertrochanteric (IT) fractures are associated with significant morbidity and mortality in the elderly population. We aim to compare the clinical outcome of unstable with stable IT fractures after treatment with dynamic hip screw (DHS).

Materials And Methods: Patients with IT fractures treated with DHS at National University Hospital between 2003 and 2005 were included in the study.

Comparative analysis of uniplanar external fixator and retrograde intramedullary nailing for ankle arthrodesis in diabetic Charcot's neuroarthropathy.

Background: Charcot's neuroarthropathy of ankle leads to instability, destruction of the joint with significant morbidity that may require an amputation. Aim of surgical treatment is to achieve painless stable plantigrade foot through arthrodesis. Achieving surgical arthrodesis in Charcot's neuroarthropathy has a high failure rate.

Medium-term outcome of total hip replacement for dysplastic hips in Singapore.

Purpose: To review medium-term outcomes of 46 patients who underwent total hip replacement (THR) for osteoarthritis secondary to dysplastic hips.

Methods: Records of 58 hips in 6 men and 40 women aged 32 to 76 (mean, 62) years who underwent THR for osteoarthritis secondary to dysplastic hips and had been followed up for a mean of 4 (range, 2-8) years were retrospectively reviewed. The hips were classified according to the Crowe's grading, Sharp's acetabular angle, and centre-edge angle.

The ten-year pattern of hip diseases in Singapore.

Purpose: To review patients with hip diseases undergoing total hip arthroplasty (THA) during 2 different periods.

Methods: During the periods 1994 to 1996 and 2004 to 2006, 12 men and 28 women (mean age, 57 years) and 55 men and 78 women (mean age, 62 years) underwent THA for hip diseases, respectively. The aetiologies of the hip diseases were classified.

Fast tool for evaluation of iliac crest tissue elastic properties using the reduced-basis methods.

Computationally expensive finite element (FE) methods are generally used for indirect evaluation of tissue mechanical properties of trabecular specimens, which is vital for fracture risk prediction in the elderly. This work presents the application of reduced-basis (RB) methods for rapid evaluation of simulation results. Three cylindrical transiliac crest specimens (diameter: 7.

Modified Mitchell's osteotomy for moderate to severe hallux valgus--an outcome study.

The purpose of this study was to evaluate the outcome of a modified technique of Mitchell's osteotomy for treatment of moderate to severe hallux valgus deformity with the aims of reducing first metatarsal shortening and osteonecrosis. Between February 2001 and December 2007, a total of 69 patients (90 feet) underwent Mitchell's corrective osteotomy for moderate to severe hallux valgus deformity. Mean duration of follow-up after surgery was 37 months.

Vesico-hip fistula from bladder puncture with subsequent infected total hip arthroplasty.

The association of total hip arthroplasty and bladder injury has been well documented. Most cases of fistula formation between the bladder and the hip arthroplasty have occurred, either at the time of hip arthroplasty or subsequently. We report on this rare case where a bladder puncture resulted in infection of the arthroplasty.

Efficacy of bone marrow-derived stem cells in strengthening osteoporotic bone in a rabbit model.

Osteoporosis might be due to defects in mesenchymal stem cells (MSCs) that lead to reduced proliferation and osteoblast differentiation. We hypothesized that transplantation of MSCs into sites at risk for developing osteoporotic bone could improve bone structure and biomechanics. The aim of this study was to establish an osteoporosis rabbit model by ovariectomy (OVX), characterize the autologous MSCs from the OVX rabbits, and transplant the autologous MSCs into the OVX rabbits.

Contact stresses in the knee joint in deep flexion.

The contact stresses in the knee that arise from activities involving deep flexion have not been given due consideration in view of social and cultural practice amongst many Asians that frequently cause the engagement of these activities. Excessively large stresses (>25 MPa) can cause cartilage damage and may be the precursor to the development of degenerative disease of the joint. In this study, forces in the knee derived from previous studies of human walking and squatting were applied to five cadaver knees that underwent quasi-static mechanical testing.

Bone mineral density and hip axis length in Singapore's multiracial population.

Ethnic differences in bone density and hip geometry are known to exist, even within the same population. A recent study in Singapore showed that there were significant racial differences in hip fracture rates, with Chinese having the highest incidence of hip fractures. The aim of this study was to compare the bone mineral density (BMD) and hip axis length in Chinese, Malay, and Indian women.