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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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Related Experiment Video

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Using Real-Time Cell Metabolic Flux Analyzer to Monitor Osteoblast Bioenergetics
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VIRTUAL ORTHOPEDIC-REHABILITATION-METABOLIC COLLABORATION FOR TREATING OSTEOPOROTIC HIP FRACTURES.

Osnat Tell Lebanon, Doron Netzer, Eyal Yaacobi

    Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
    |December 21, 2019
    PubMed
    Summary

    A virtual, closed-loop protocol improved osteoporosis treatment rates in hip fracture patients. This intervention, involving collaboration between orthopedic, rehabilitation, and metabolic specialists, led to higher medication adherence and lower mortality, though rates remain below 50%.

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    Area of Science:

    • Gerontology
    • Orthopedics
    • Endocrinology

    Background:

    • Hip fractures are a significant cause of morbidity and mortality in older adults.
    • Effective osteoporosis management is crucial for preventing secondary fractures after hip fracture.
    • Traditional follow-up protocols often involve in-person clinic visits, which can be challenging for elderly patients.

    Purpose of the Study:

    • To assess the efficacy of a virtual, closed-loop care model for osteoporosis treatment in hip fracture patients.
    • To determine if virtual recommendations without clinic visits can increase osteoporosis medication initiation.
    • To evaluate the impact of this protocol on secondary fracture prevention and patient mortality.

    Main Methods:

    • Prospective cohort study comparing an intervention group (n=85) with a non-intervention group (n=168) of hip fracture patients.
    • Intervention group received virtual osteoporosis treatment recommendations from Metabolic Clinic physicians after achieving adequate vitamin D levels (≥65 nmol/L).
    • Primary endpoint: osteoporosis drug prescription within 12 months post-surgery; secondary endpoints: 3- and 6-month prescription rates and 1-year mortality.

    Main Results:

    • The intervention group showed significantly higher osteoporosis medication initiation rates at 12 months (48.2% vs. 22.0%, P<.001).
    • Earlier medication uptake was observed in the intervention group at 3 months (18.8% vs. 2.9%, P<.001) and 6 months (40% vs. 5.9%, P<.001).
    • Patients receiving any osteoporosis medication had significantly lower 1-year mortality rates (5.1% vs. 26.3%, P<.001).

    Conclusions:

    • A virtual orthopedic-rehabilitation-metabolic collaboration effectively increases osteoporosis treatment rates post-hip fracture.
    • Despite improvements, osteoporosis treatment rates remain below 50%, indicating a need for further optimization.
    • Future strategies may include earlier drug initiation during rehabilitation or adjusting vitamin D thresholds.