Bone Abstracts

Cases of non-vitamin D deficiency rickets have been reported in African countries including The Gambia, South Africa and Nigeria where the likely aetiology is a chronically low dietary calcium intake. Additional aetiological factors in Gambian studies are iron deficiency leading to a disruption in phosphate metabolism.Surgical correction of pathological rickets-like lower-limb deformities is the most common operation performed at the Beit Cure Orthopaedi...

Biographical DetailsDr John Herzenberg graduated from Boston University Medical School and trained at Duke University for Orthopaedics and Toronto Sick Kids for Pediatric Orthopaedics. He specializes in the diagnosis and treatment of adult and pediatric patients with congenital abnormalities, joint contractures, neuromuscular disorders, non-unions, malunions, deformity, and bone defects. ...

Vitamin D deficiency is common within Europe and the Middle East, especially in risk groups. While treatment is simple, there is no consensus on the diagnostic threshold for deficiency and the required dose. The Institute of Medicine and the Endocrine Society have established guidelines on the required 25-hydroxyvitamin D (25(OH)D) levels, supplementation doses and (extra)skeletal effects of vitamin D, coming to very different conclusions. The European Calcified Tissue Society...

We have previously shown a high prevalence of vitamin D inadequacy (serum 25-hydroxyvitamin D (S25(OH)D) <50 nmol/l) in adolescents (14–18 years) in the UK (51°N)(1). It is well recognised that vitamin D deficiency (S25(OH)D <25 nmol/l) increases the risk of rickets and impaired growth in adolescents, however the optimal vitamin D status for bone health is debated. The aim of this study was to investigate the effects of vitamin D status on bone hea...

Suppression of parathyroid hormone (PTH) has been suggested as a potential biochemical outcome measure for determining the optimal serum 25-hydroxyvitamin D (S25(OH)D) concentration for bone health in adults. However, in adolescents increases in PTH may not be driven by the same mechanisms and may not be detrimental to bone health. Adolescent studies have provided a wide range of estimates of the S25(OH)D concentration at which PTH plateaus (40–90 nmol/l), with some repor...

The incidence of hip fractures is declining in later cohorts of older people but, if the cohort effect is controlled for, the period effect shows a steady increase in incidence. This is almost certainly because we are seeing the survival of an increasingly frail group of older people with comorbidities. The great majority of hip fractures result from falls. There is strong research evidence that falls can be prevented. Proven strength and balance programmes reduce the rate of ...

Hormone replacement therapy (HRT) comprises estrogen, with or without progestogen addition, given to postmenopausal women. HRT is by far the most effective treatment for the relief of menopausal symptoms such as vasomotor and genito-urinary symptoms. It is as effective as alternative treatments for the prevention of postmenopausal osteoporosis. It increases bone mass, reduces bone turnover, and reduces fracture risk at all the important skeletal sites. It has a beneficial effe...

External fixation has been the gold standard for patients who require bone lengthening. This method is accurate and reliable, but can result in significant scarring, superficial infection, and pain. Additionally, the daily care of pin sites, unsightly appearance of the device, and reduced function can be emotionally taxing for both the patient and caregivers. An internal device that lengthens through rotational movement was developed to address some of these issues (ISKD). Alt...

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β-tricalcium phosphate (β-TCP) biomaterials have been approved for the repair of osseous defects. However, in large defects, the substitution of biomaterial by authentic bone is inadequate to provide sufficient long-term mechanical stability. We aimed to develop composites of β-TCP ceramics and receptor activator of nuclear factor κ-B ligand (RANKL) to enhance the formation of osteoclasts thereby stimulating material resorption. RANKL was immobilized on &#9...