Purpose The influence of regular exercise on bone properties is not well defined. Frail subjects have limitations to perform exercise with skeletal impact. This study aims to analyze whole-bone vibration treatment (WBV) as an enhancer of bisphosphonate effects in postmenopausal frail women with osteopenia / osteoporosis. Methods Fiftythree postmenopausal sedentary osteopenic women were treated during 12 months with a drinkable alendronate (ALN) formulation. By randomization, 21 of them underwent a WBV (15-min sessions, 3 days per week) as an additional treatment. The serum C-terminal telopeptide of type I collagen (CTx) and total alkaline phosphatase (TAP) were determined at 0, 6 and 12 months of ALN therapy. In subgroups of 19/13 women, peripheral quantitative computerized tomography (pQCT) was applied at the tibia mid shaft to determine the volumetric BMD of cortical bone (CtBMDv) and the polar strain-strength index (SSIp). Results CTx levels fell significantly deeper in the WBV subgroup (-39.3% and -30.3%, respectively, p<0.01), suggesting that in these women WBV promotes a greater effect of ALN on bone resorption inhibition. Basal CtBMDv and SSIp values were similar in both groups and were weakly (negatively) associated with basal CTx values. After treatment, the correlation between CtBMDv or SSIp values with CTx values were also weak and negative in the Sedentary subgroup but become positive and closer in the WBV subgroup. Conclusions Vibration treatment enhanced the ALN-induced inhibition of bone resorption and may affect positively bone properties. Protracted treatments should show whether this trend is maintained as to effectively reduce the incidence of falls and skeletal fractures in frail subjects.
The cortical bone is a hierarchically organised biocomposite tissue ranging from the nanoscopic to the macroscopic scale. The present paper is concerned with the new morphological observations of human femoral cortical bone at the nanostructural/submicrostructural levels of older patients. The objective of this study is to verify and refine the descriptions of nanostructures and submicrostructures in selected localities of the human femoral diaphyses by the scanning electron microscope - Quanta 450 with the ETD detector. The great interest has been focused on identifying the orientations of basic structural domains of bones at each of their structural levels. The bearing structural domains are composed and oriented not only to effectively resist localized mechanical stresses/strains, but to promote uniform dissipations of energy of deformation into lower structural levels of tissue. As the domains of the 2nd structural level are mineralized nanofibrils, then dominant domains of the 3rd structural level are layered nanoshalls, creating the mineralized cylindrical columns, i.e. mineralized microfibres. Each mineralized nanoshell is composed of parallel oriented mineralized nanofibrils (nanorods). The nano/substructural elements are formed (during the bone remodeling) under the influence of the dominant biomechanical effects as are torsional micromoments, microforces in tension and/or in compression.
The surgical procedure of total hip replacement is one of the most successful operations in the medical field today. Being introduced back in 1960, THR represents the eradication of the present degradation. Post-surgically, there are some functional precautions that should be followed during the RHB plan as well an increased danger of occurrence of falling incidence. During the RHB plan, which should be followed after the total hip replacement operation, the inclusion of a diagnostic as well therapeutic intervention regarding fallings is of major importance.
