生物力学实验与骨科临床研究之间的相关性:系统性审查
Byron A Ward1, Joshua A Parry2
1Denver Health Medical Center, Denver, USA.
概括
骨科的生物力学实验经常报告了与临床研究不同的结果,但这些差异并不能预测临床发现. 骨科生物机械实验的临床相关性需要重新评估.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 翻译研究是翻译研究.
背景情况:
- 生物机械实验对于理解骨科治疗机制至关重要.
- 然而,这些实验的直接临床相关性尚未完全阐明.
- 这项研究系统地审查了骨科文献,以评估生物力学和临床研究结果之间的相关性.
研究的目的:
- 评估骨科医学中生物机械实验的临床相关性.
- 将生物力学实验中的治疗结果与同一研究中的临床研究中的治疗结果进行比较.
- 确定生物力学实验结果是否预测临床研究结果.
主要方法:
- 我们对MEDLINE/PubMed进行了系统的文献搜索.
- 包括的研究比较了使用生物力学实验和临床研究的治疗结果.
- 分析了生物力学与临床研究中不同结果之间的关联.
主要成果:
- 23项骨科研究符合纳入标准,主要涉及创伤 (17项研究).
- 生物力学实验比临床研究更有可能报告结果差异 (82.6%vs30.4%).
- 尽管如此,生物力学和临床研究结果仅在43.4%的病例中达成一致,生物力学差异无法预测临床差异.
结论:
- 骨科生物机械实验的结果并不总是与临床研究的结果相关.
- 生物力学实验对临床结果的预测价值似乎有限.
- 在骨科研究中对生物力学实验的有用性和解释应该被仔细重新考虑.
相关概念视频
01:55Bone Structure
Within the skeletal system, the structure of a bone, or osseous tissue, can be exemplified in a long bone, like the femur, where there are two types of osseous tissue: cortical and cancellous.
01:40Bone Remodeling
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.
01:17Gross Anatomy of Bone
The two main features of a long bone are the diaphysis and the epiphysis.
The diaphysis is the tubular shaft that runs between the proximal and distal ends of the bone. The walls of the diaphysis are composed of dense and hard compact bone made of numerous osteons — the functional unit of the compact bone. The hollow region in the diaphysis is called the medullary cavity, which harbors the bone marrow. In infants and children, this marrow cavity is filled with red marrow, whereas in adults, it...
The diaphysis is the tubular shaft that runs between the proximal and distal ends of the bone. The walls of the diaphysis are composed of dense and hard compact bone made of numerous osteons — the functional unit of the compact bone. The hollow region in the diaphysis is called the medullary cavity, which harbors the bone marrow. In infants and children, this marrow cavity is filled with red marrow, whereas in adults, it...
01:29Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:31Bone Remodeling and Repair
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 bone...