Topic
Femoral neck
About: Femoral neck is a research topic. Over the lifetime, 13270 publications have been published within this topic receiving 424747 citations. The topic is also known as: femur neck & femoral neck.
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TL;DR: In women with low BMD but without vertebral fractures, 4 years of alendronate safely increased BMD and decreased the risk of first vertebral deformity.
Abstract: Context.—Alendronate sodium reduces fracture risk in
postmenopausal women who have vertebral fractures, but its effects on
fracture risk have not been studied for women without vertebral
fractures.Objective.—To test the hypothesis that 4 years of
alendronate would decrease the risk of clinical and vertebral fractures
in women who have low bone mineral density (BMD) but no vertebral
fractures.Design.—Randomized, blinded, placebo-controlled trial.Setting.—Eleven community-based clinical research centers.Subjects.—Women aged 54 to 81 years with a femoral neck BMD
of 0.68 g/cm2 or less (Hologic Inc, Waltham, Mass) but no
vertebral fracture; 4432 were randomized to alendronate or placebo and
4272 (96%) completed outcome measurements at the final visit (an
average of 4.2 years later).Intervention.—All participants reporting calcium intakes of
1000 mg/d or less received a supplement containing 500 mg of calcium
and 250 IU of cholecalciferol. Subjects were randomly assigned to
either placebo or 5 mg/d of alendronate sodium for 2 years followed by
10 mg/d for the remainder of the trial.Main Outcome Measures.—Clinical fractures confirmed
by x-ray reports, new vertebral deformities detected by morphometric
measurements on radiographs, and BMD measured by dual x-ray
absorptiometry.Results.—Alendronate increased BMD at all sites studied
(P<.001) and reduced clinical fractures from 312 in the
placebo group to 272 in the intervention group, but not significantly
so (14% reduction; relative hazard [RH], 0.86; 95% confidence
interval [CI], 0.73-1.01). Alendronate reduced clinical fractures by
36% in women with baseline osteoporosis at the femoral neck (>2.5
SDs below the normal young adult mean; RH, 0.64; 95% CI, 0.50-0.82;
treatment-control difference, 6.5%; number needed to treat [NNT],
15), but there was no significant reduction among those with higher BMD
(RH, 1.08; 95% CI, 0.87-1.35). Alendronate decreased the risk of
radiographic vertebral fractures by 44% overall (relative risk, 0.56;
95% CI, 0.39-0.80; treatment-control difference, 1.7%; NNT, 60).
Alendronate did not increase the risk of gastrointestinal or other
adverse effects.Conclusions.—In women with low BMD but without vertebral
fractures, 4 years of alendronate safely increased BMD and decreased
the risk of first vertebral deformity. Alendronate significantly
reduced the risk of clinical fractures among women with osteoporosis
but not among women with higher BMD.
2,254 citations
TL;DR: In this article, the femoral neck bone density was measured by dual X-ray absorptiometry is a better predictor of hip fracture than measurements of other bones, including the radius or calcaneus.
2,228 citations
TL;DR: In men and women 65 years of age or older who are living in the community, dietary supplementation with calcium and vitamin D moderately reduced bone loss measured in the femoral neck, spine, and total body over the three-year study period and reduced the incidence of nonvertebral fractures.
Abstract: Background Inadequate dietary intake of calcium and vitamin D may contribute to the high prevalence of osteoporosis among older persons. Methods We studied the effects of three years of dietary supplementation with calcium and vitamin D on bone mineral density, biochemical measures of bone metabolism, and the incidence of nonvertebral fractures in 176 men and 213 women 65 years of age or older who were living at home. They received either 500 mg of calcium plus 700 IU of vitamin D3 (cholecalciferol) per day or placebo. Bone mineral density was measured by dual-energy x-ray absorptiometry, blood and urine were analyzed every six months, and cases of nonvertebral fracture were ascertained by means of interviews and verified with use of hospital records. Results The mean (±SD) changes in bone mineral density in the calcium–vitamin D and placebo groups were as follows: femoral neck, +0.50±4.80 and -0.70±5.03 percent, respectively (P = 0.02); spine, +2.12±4.06 and +1.22±4.25 percent (P = 0.04); and total body,...
2,207 citations
TL;DR: In this paper, the authors found that risedronate increases bone mineral density in elderly women, but whether it prevents hip fracture is not known, and the women were randomly assigned to receive treatment with either oral risingronate (2.5 or 5.0 mg) or placebo for three years.
Abstract: Background Risedronate increases bone mineral density in elderly women, but whether it prevents hip fracture is not known. Methods We studied 5445 women 70 to 79 years old who had osteoporosis (indicated by a T score for bone mineral density at the femoral neck that was more than 4 SD below the mean peak value in young adults [–4] or lower than –3 plus a nonskeletal risk factor for hip fracture, such as poor gait or a propensity to fall) and 3886 women at least 80 years old who had at least one nonskeletal risk factor for hip fracture or low bone mineral density at the femoral neck (T score, lower than –4 or lower than –3 plus a hip-axis length of 11.1 cm or greater). The women were randomly assigned to receive treatment with oral risedronate (2.5 or 5.0 mg daily) or placebo for three years. The primary end point was the occurrence of hip fracture. Results Overall, the incidence of hip fracture among all the women assigned to risedronate was 2.8 percent, as compared with 3.9 percent among those assigned t...
1,719 citations
TL;DR: Late results in 243 arthroplasties with an acrylic prosthesis for traumatic or osteoarthritic conditions are reported, and deterioration of the functional results appear to be caused by bone absorption around the Judet prosthesis and the consequent loosening of the prosthesis.
Abstract: Late results in 243 arthroplasties with an acrylic prosthesis for traumatic or osteoarthritic conditions are reported.
Early results (after one year) show the importance of the restoration of the normal mechanics of the hip joint by the preservation or the restoration of normal length of the femoral neck, the exact correction of anteversion, and the precise fit of the prosthetic head to the acetabulum. A good exposure of the joint through the posterolateral approach appears necessary in order to fulfill these conditions.
Late results (from two to five years) show deterioration of the functional results in 20 per cent. These deteriorations appear to be caused by bone absorption around the Judet prosthesis and the consequent loosening of the prosthesis.
A new type of cervico-capital prosthesis is proposed which makes possible:
1. Restoration of the normal length of the femoral neck when it is congenitally or pathologically short;
2. Correction of anteversion, even when very marked;
3. A weight-bearing surface on a more vascularised part of the femur;
4. The distribution of pressure on bone so as to lessen bone absorption, to prevent its ill effects, and, particularly, to decrease mobility of the prosthesis.
1,683 citations