Search PubMed⌕ Search

Biomedical subjects

P Kannus

Publications and source records attributed to P Kannus.

At least 37 records · Page 2Linked to original sources
PubMed2001

Anterior cruciate ligament reconstruction in patients with or without accompanying injuries: A re-examination of subjects 5 to 9 years after reconstruction.

PURPOSE: The purpose of this study was to compare the clinical and radiologic results of an anterior cruciate ligament (ACL) reconstruction in patients with an isolated ACL tear and patients with an ACL tear and accompanying injuries. TYPE OF STUDY: A retrospective investigation. METHODS: Seventy-two patients who did not have previous knee surgery or surgery of the contralateral knee were re-examined 5 to 9 years after the primary ACL reconstruction. The clinical assessment was made using the International Knee Documentation Committee (IKDC) evaluation system, and the Lysholm and the Marshall knee scores. Also, radiographic evaluation and isokinetic strength testing were performed. There were 34 patients (25 men and 9 women) with an isolated ACL tear (group A), and 38 patients (23 men and 15 women) with an ACL tear and accompanying injuries (group B). The mean age was 29 years (SD 9; range, 15 to 49 years) in group A, and 34 years (SD 12; range, 15 to 61 years) in group B. Bone-patellar tendon-bone autograft with mini-arthrotomy technique and screw fixation was used in all patients. Postoperative rehabilitation was also similar in both groups. In group B, 10 medial and 12 lateral (partial or subtotal) arthroscopic meniscectomies were performed at the same time as the ACL reconstruction. Also, 18 of the 19 medial collateral ligament ruptures, the 2 lateral collateral ligament ruptures, and the 1 posterior cruciate ligament rupture were treated surgically at this operation. RESULTS: Subjectively (overall assessment, pain, swelling, and giving way of the knee) and objectively (range of motion, stability, crepitation, isokinetic strength testing, and radiological changes of the knee), the groups did not have any significant differences in the 5- to 9-year results. Also, the final evaluation results using the IKDC and the Lysholm and the Marshall knee scores were similar in both groups. However, there were significantly more subsequent knee surgeries in the injured knee in group B than in group A. CONCLUSIONS: Our results show no large differences between patients with an isolated ACL tear and those with an ACL tear with accompanying injuries 5 to 9 years after an ACL reconstruction with a bone-patellar tendon-bone autograft. Tibiofemoral osteoarthritis was quite rare, and this may be partly attributable to the fact that the ACL reconstructions were successful, so that all the knees were stable at the re-examination. However, the future will show the final outcome for the patients.

Adolescent↗
PubMed2001

Epidemiology of adulthood injuries: a quickly changing injury profile in Finland.

Although developed societies have undergone many profound changes during recent decades, including urbanization, increased traffic and aging of the populations, epidemiologic information on secular trends in profiles of injuries is limited. We investigated such trends in Finland by selecting from the National Hospital Discharge Register all Finns aged 15 years or more who required hospital treatment because of an unintentional injury during 1971-1995. The injury incidences were expressed as the number of patients per 100,000 individuals per year. In Finnish men, road traffic accidents and falls, the two leading causes of injury, produced equal numbers of injuries in 1971 (4935 and 4957), but thereafter the role of the traffic accidents gradually decreased (3512 injuries with unadjusted and age-adjusted incidences of 177 and 183 in 1995) and that of falls clearly increased (13,218 injuries with unadjusted and age-adjusted incidences of 664 and 635 in 1995). Changes in the other injury categories of men were less drastic. In Finnish women, falling was the most common cause of injury in 1971 (5051 injuries), after which its role increased sharply, to 17,250 injuries in 1995 (unadjusted and age-adjusted incidences of 804 and 698, respectively). In 1971, road traffic produced 2369 injuries in women, after which this number somewhat decreased (2160 injuries with unadjusted and age-adjusted incidences of 101 and 101 in 1995). The role of all the other injury categories was small in Finnish women during 1971-1995. We conclude that a quick change in the overall profile of injuries occurred in Finland in 1971-1995, a change in which falls replaced road traffic accidents as the major cause of a serious injury. This epidemiologic change will give a new challenge for injury prevention in the new millennium.

Accidental Falls↗
PubMed2001

Graft placement after the anterior cruciate ligament reconstruction: a new method to evaluate the femoral and tibial placements of the graft.

In order to evaluate graft placement of the anterior cruciate ligament (ACL) reconstruction and its relationship to the clinical outcome of the patient, 100 patients were examined 7 years after an ACL reconstruction. Clinical assessment was performed using the standard knee ligament evaluation form of the International Knee Documentation Committee (IKDC), and the Lysholm and the Marshall knee scores. We developed a new evaluation method of graft placement after an ACL reconstruction, 'the sum score of the graft placement', which takes into account both the femoral and the tibial positions of the graft simultaneously, and our study showed that 'the sum score of the graft placement' has an association to clinical outcome of patients and that it can better explain the long-term osteoarthritic changes at the injured knee than the separate measurements of the femoral and tibial tunnel placements.

Adult↗
PubMed2001

Mineral mass, size, and estimated mechanical strength of triple jumpers' lower limb.

This study was designed to examine the anticipated strong influence of extreme impact loading on the mineral mass, size, and gross structural properties of triple jumpers' lower limb bones. We compared the bone data obtained with peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) from 8 Finnish triple jumpers with corresponding data from gender-, age-, height-, and weight-matched nonathletic peers. The volumetric (trabecular) density was significantly higher in the jumpers than in controls (from an average 18% difference at the distal tibia to a 41% difference at the proximal tibia), whereas the cortical density did not differ between groups. The DXA-derived areal bone mineral density of the femoral neck and lumbar spine was 31% higher in the jumpers than in controls, compared with a 16% difference between groups at the less-loaded distal radius. The lower limb bones were comparable in size between groups except at the distal femur where a significant 4%-6% difference was observed in favor of the triple jumpers. Mean tibial cortical wall thickness and area were substantially greater in the triple jumpers; the mean group difference ranged from about 20% at the shaft sites, to over 50% at the distal tibia. Given the apparently stronger cortices in the triple jumpers, the section moduli (bone strength index) of their femoral necks and tibiae were 19%-31% higher compared with the control group. Our findings indicate the ability of extreme impact loading to considerably improve bone's mechanical competence. Adaptation to loading seems to occur in a site-specific fashion by gross geometric changes, structural or architectural changes, or by their combination. The loading effect was best seen as enlarged bone cortices, probably after the trabecular density had reached its ceiling.

Absorptiometry, Photon↗
PubMed2001

Continuously rising problem of osteoporotic knee fractures in elderly women: nationwide statistics in Finland in 1970-1999 and predictions until the year 2030.

We assessed the current trends in the number and incidence of osteoporotic knee fractures in Finland by collecting data from the National Hospital Discharge Register for all patients > or =60 years of age who were admitted to Finnish hospitals in 1970-1999 for primary treatment of such fractures. The knee fracture was defined "osteoporotic" if it was caused by a low-energy trauma only; that is, a fall from standing height or less. We also predicted fracture development until the year 2030 by a regression model, which took into account the predicted changes in the fracture incidences and population at risk. The number and incidence (per 100,000 persons) of osteoporotic knee fractures in Finnish women aged > or =60 years clearly rose during the study period, from 218 (number) and 55 (incidence) in 1970 to 685 and 113 in 1999. Even after age adjustment, the incidence of women's fractures showed a clear increase, from 59 in 1970 to 105 in 1999. If this trend continues, there will be about 2.5 times more osteoporotic knee fractures in Finnish women in the year 2030 than there were in 1999. In Finnish men aged > or =60 years, the annual number of fractures and its changes were clearly smaller (77 in 1970 vs. 138 in 1999), and the fracture incidence did not show consistent trend changes over time (30 in 1970 vs. 34 in 1999). We conclude that in elderly Finnish women the number of osteoporotic knee fractures shows a rise with a rate that cannot be explained merely by demographic changes and, therefore, vigorous preventive measures are needed to control this development.

Age Distribution↗
PubMed2001

Effects of remobilization on rat femur are dose-dependent.

Seventy 9 to 11-week-old Sprague-Dawley male rats were divided into seven groups [baseline, 3-week, 11-week control groups; a group with a left limb immobilization for 3 weeks; and three groups with a similar immobilization and subsequent 8-week free (FR), low-intensity running (LR) or high-intensity running (HR) remobilization] to determine the site-specific effects of decreased mechanical loading and subsequent increased activity on rat femur. Bone mineral content of the proximal femur (PBMC), femoral midshaft (SBMC) and distal femur (DBMC) and the histomorphometry of the distal femur were used as outcome variables. The 3-week immobilization period resulted in significant bone loss in the proximal and distal ends of the immobilized left limb, the deficit being -5.9% in PBMC and -14.7% in DBMC. Immobilization also led to marked microarchitectural changes in the distal femur, the left-side deficit in trabecular bone volume (BV/TV) being -23.9%. After remobilization, there was a clear indication for dose-dependent response; i.e., immobilization-induced left-to-right side differences in BV/TV persisted in the FR animals (-23.8%), while these left limb deficits were significantly reduced in the LR group (-15.0%) and virtually absent in the HR group (-3.1%). The left limb deficit in PBMC was still significant in all groups after the 8-week period of remobilization [-9.6% in the FR group; -13.4% in the LR group; and -7.2% in the HR group]. The left-limb deficit in SBMC was significant in the HR11 group only (-7.2%), and, contrary to histomorphometric data, virtually absent in DBMC in all remobilization groups. As compared with the age-matched control data, the weight-adjusted BMCs of both limbs of the LR and HR groups were comparable or even higher (right limbs) than those of the controls. In conclusion, this study indicates that remobilization-induced bone recovery depends on the intensity of the remobilization so that during the 8-week period of remobilization, high-intensity running results in better recovery than low-intensity running, both of which are more efficient than free-cage activity only. Immobilization-induced changes in rat femur are also restored in a site-specific fashion, the most trabecular distal region of the femur showing more complete recovery than the more cortical proximal and midshaft regions.

Absorptiometry, Photon↗
PubMed2001

A bioabsorbable plug in bone-tendon-bone reconstruction of the anterior cruciate ligament: Introduction of a novel fixation technique.

PURPOSE: Our aim was to compare the fixation strength of a novel plugging technique with that of the conventional interference technique in bone-patellar tendon-bone reconstruction of the anterior cruciate ligament. TYPE OF STUDY: Randomized experimental study. METHODS: Twenty matched pairs of porcine knees were randomly assigned to 2 groups. The bone block of the graft was secured in the femoral drill hole with either the new bioabsorbable poly-L-lactide/D-lactide (PLA 96/4) copolymer plug (plugging technique) (n = 20) or a conventional interference screw (interference technique) (n = 20). Ten pairs were subjected to a single cycle loading test at a rate of 50 mm/min while the remaining 10 pairs underwent a cyclic loading test to further assess the quality of the fixation. The cyclic loading test consisted of 1,500 loading cycles between 50 and 200 N at half-hertz frequency, after which the specimens were loaded to failure at a rate of 50 mm/min. RESULTS: In the single cycle loading test, the average ultimate failure load was 1,061 +/- 342 N in the plugging technique group and 971 +/- 260 N in the interference technique group (P =.57). Significant group differences were found neither in the yield loads nor in the stiffness of the fixations. In the cyclic loading, significant displacement difference was not observed between the 2 fixation techniques. There were neither significant group differences with regard to the ultimate failure load (plugging technique 994 +/- 376 N versus interference technique 1,001 +/- 343 N, P =.97) nor yield load of the fixations in the subsequent single cycle loading. CONCLUSIONS: The results of this study indicate that, in anterior cruciate ligament reconstruction, the new plugging technique is a reasonable alternative for fixation of the femoral site of a bone-patellar tendon-bone graft.

Absorbable Implants↗
PubMed2001

Sports injuries in floorball: a prospective one-year follow-up study.

Two hundred and ninety-five licensed floorball players from Finnish premier to fifth division were observed prospectively for one season to study the incidence, nature, causes and severity of floorball injuries. During the study period, 100 out of the 295 (34 %) players sustained 120 injuries. Thirty-seven percent (73/199) of the male players and 28 % (27/96) of the females suffered from an injury. The injury rate was 1.0 per 1000 practice hours for both sexes. The injury rates per 1000 game hours were 23.7 for men and 15.9 for women. One hundred injuries (83 %) were acute and the remaining 20 (17 %) were overuse injuries. Sprain was the most common type of injury in men while overuse injuries were the most frequent injury type in women. The lower extremity was involved in 62 %, spine or trunk in 19 % and upper extremity in 10 % of the injuries. The most commonly injured sites were the knee and ankle (22 % and 20 % of all injuries), followed by head and neck (8 %). In both sexes the majority of injuries were minor, level II, injuries. Ten of the knee injuries (38 %) were serious, level IV injuries, of which seven were ACL ruptures. In conclusion, the individual risk of injury in floorball is relatively low in game practice while rather high during the game itself. Before initiation of clinical trials on prevention of floorball injuries, an exact knowledge of the risk factors and mechanisms of floorball injuries are needed.

Adult↗
PubMed2001

Achilles tendon injuries.

The Achilles tendon is the strongest tendon in the human body. Because most Achilles tendon injuries take place in sports and there has been an common upsurge in sporting activities, the number and incidence of the Achilles tendon overuse injuries and complete ruptures have increased in the industrialized countries during the last decades. The most common clinical diagnosis of Achilles overuse injuries is tendinopathy, which is characterized by a combination of pain and swelling in the Achilles tendon accompanied by impaired ability to perform strenuous activities. Most patients with Achilles tendon injury respond favorably to conservative treatment and only those who fail to respond to carefully followed nonoperative treatment should undergo surgery for repair. A complete rupture of the Achilles tendon usually occurs in sports that require jumping, running, and quick turns. Although histopathologic studies have shown that ruptured Achilles tendons include clear degenerative changes before the rupture, many of the Achilles tendon ruptures occur suddenly without any preceding signs or symptoms. Neither conservative nor operative treatment is a treatment of choice for the ruptured Achilles tendon. It is generally accepted that surgery should be performed on ruptured Achilles tendons in young, physically active patients and in those patients for whom the diagnosis or the treatment of the rupture has been delayed, whereas the results of conservative treatment are an acceptable outcome in older patients with sedentary lifestyles. Many important issues still remain unanswered concerning the cause, pathogenesis, diagnosis, and management of the Achilles tendon disorders. Only when these issues have been solved by well-controlled studies can tailored treatment protocols be created.

Achilles Tendon↗
PubMed2001

Good maintenance of exercise-induced bone gain with decreased training of female tennis and squash players: a prospective 5-year follow-up study of young and old starters and controls.

This prospective 5-year follow-up study of 64 adult female racquet sports players and 27 controls assessed the changes in the playing-to-nonplaying arm bone mineral content (BMC) differences to answer three questions: (1) Are training-induced bone gains lost with decreased training? (2) Is the bone response to decreased training different if the playing career has been started before or at puberty rather than after it? (3) Are the possible bone changes related to the changes in training? The players were divided into two groups according to the starting age of their tennis or squash playing. The mean starting age was 10.5 years (SD, 2.2) among the players who had started training before or at menarche (young starters; n = 36) while 26.4 years (SD, 8.0) among those players who had begun training a minimum of 1 year after menarche (old starters; n = 28). At baseline of the 5-year follow-up, the mean age of the young starters was 21.6 years (SD, 7.6) and that of old starters was 39.4 years (SD, 10.5). During the follow-up, the young starters had reduced the average training frequency from 4.7 times a week (2.7) to 1.4 times a week (1.3) and the old starters from 4.0 times a week (1.4) to 2.0 times a week (1.4), respectively. The 5-year follow-up revealed that despite reduced training the exercise-induced bone gain was well maintained in both groups of players regardless of their clearly different starting age of activity and different amount of exercise-induced bone gain. The gain was still 1.3-2.2 times greater in favor of the young starters (at the follow-up, the dominant-to-nondominant arm BMC difference was 22% [8.4] in the humeral shaft of the young starters versus 10% [3.8] in the old starters, and 3.5% [2.4] in controls). In the players, changes in training were only weakly related to changes in the side-to-side BMC difference (r(s) = 0.05-0.34, all NS), and this was true even among the players who had stopped training completely a minimum 1 year before the follow-up. In conclusion, if controlled interventions will confirm our findings that an exercise-induced bone gain can be well maintained with decreased activity and that the maintenance of the bone gain is independent of the starting age of activity, exercise can be recommended for preventing osteoporosis and related fractures.

Adult↗
PubMed2001

Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence.

Falls are a major source of death and injury in elderly people. For example, they cause 90% of hip fractures and the current cost of hip fractures in the US is estimated to be about 10 billion dollars. Age-related changes in the physiological systems (somatosensory, vestibular and visual) which contribute to the maintenance of balance are well documented in older adults. These changes coupled with age-related changes in muscle and bone are likely to contribute to an increased risk of falls in this population. The integrated rehabilitation-based model of fall risk factors reveals multiple sites for interventions that may reverse fall risk factors. Regular exercise may be one way of preventing falls and fall-related fractures. The evidence for this contention comes from a variety of sources. On the basis of 9 randomised controlled studies conducted since 1996, exercise appears to be a useful tool in fall prevention in older adults, significantly reducing the incidence of falls compared with control groups. However, current limitations such as inconsistencies in the measurement of key dependent and independent variables do not, at present, permit a meta-analysis of intervention trials. Further investigation, using trials designed with the current limitations in mind, is necessary to establish the optimum exercise programme to maximise fall prevention in older adults.

Accidental Falls↗
PubMed2001

Is it possible to prevent sports injuries? Review of controlled clinical trials and recommendations for future work.

Sports injuries are one of the most common injuries in modern western societies. Treating sports injuries is often difficult, expensive and time consuming, and thus, preventive strategies and activities are justified on medical as well as economic grounds. A successful injury surveillance and prevention requires valid pre- and post-intervention data on the extent of the problem. The aetiology, risk factors and exact mechanisms of injuries need to be identified before initiating a measure or programme for preventing sports injuries, and measurement of the outcome (injury) must include a standardised definition of the injury and its severity, as well as a systematic method of collecting the information. Valid and reliable measurement of the exposure includes exact information about the population at risk and exposure time. The true efficacy of a preventive measure or programme can be best evaluated through a well-planned randomised trial. Until now, 16 randomised, controlled trials (RCT) have been published on prevention of sports injuries. According to these RCT, the general injury rate can be reduced by a multifactorial injury prevention programme in soccer (relative risk 0.25, p < 0.001, in the intervention group), or by ankle disk training, combined with a thorough warm-up, in European team handball [odds ratio 0.17; 95% confidence interval (CI) 0.09 to 0.32, p < 0.01]. Ankle sprains can be prevented by ankle supports (i.e. semirigid orthoses or air-cast braces) in high-risk sporting activities, such as soccer and basketball (Peto odds ratio 0.49; 95% CI 0.37 to 0.66), and stress fractures of the lower limb by the use of shock-absorbing insoles in footwear (Peto odds ratio 0.47; 95% CI 0.30 to 0.76). In future studies, it is extremely important for researches to seek consultation with epidemiologists and statisticians to be certain that the study hypothesis is appropriate and that the methodology can lead to reliable and valid information. Further well-designed randomised studies are needed on preventive actions and devices that are in common use, such as preseason medical screenings, warming up, proprioceptive training, stretching, muscle strengthening, taping, protective equipment, rehabilitation programmes and education interventions (such as increasing general injury awareness among a team). The effect of a planned rule change on the injury risk in a particular sport could be tested via a RCT before execution of the change. The most urgent needs are in commonly practised or high-risk sports, such as soccer, American football, rugby, ice hockey, European team handball, karate, floorball, basketball, downhill skiing and motor sports.

Athletic Injuries↗
PubMed2000

Prevention of hip fracture in elderly people with use of a hip protector.

BACKGROUND: Hip fractures are common in frail elderly adults worldwide. We investigated the effect of an anatomically designed external hip protector on the risk of these age-related fractures. METHODS: We randomly assigned 1801 ambulatory but frail elderly adults (1409 women and 392 men; mean age, 82 years), in a 1:2 ratio, either to a group that wore a hip protector or to a control group. Fractures of the hip and all other fractures were recorded until the end of the first full month after 62 hip fractures had occurred in the control group. The risk of fracture in the two groups was compared, and in the hip-protector group the risk of fracture was also analyzed according to whether the protector had been in use at the time of a fall. RESULTS: During follow-up, 13 subjects in the hip-protector group had a hip fracture, as compared with 67 subjects in the control group. The respective rates of hip fracture were 21.3 and 46.0 per 1000 person-years (relative hazard in the hip-protector group, 0.4; 95 percent confidence interval, 0.2 to 0.8; P=0.008). The risk of pelvic fracture was slightly but not significantly lower in the hip-protector group than in the control group (2 subjects and 12 subjects, respectively, had pelvic fracture) (relative hazard, 0.4; 95 percent confidence interval, 0.1 to 1.8; P > or = 0.05). The risk of other fractures was similar in the two groups. In the hip-protector group, four subjects had a hip fracture (among 1034 falls) while wearing the protector, and nine subjects had a hip fracture (among 370 falls) while not wearing the protector (relative hazard, 0.2; 95 percent confidence interval, 0.05 to 0.5; P=0.002). CONCLUSIONS: The risk of hip fracture can be reduced in frail elderly adults by the use of an anatomically designed external hip protector.

Aged↗
PubMed2000

A controlled trial of the health benefits of regular walking on a golf course.

PURPOSE: To study the effects of regular walking during a golf game on various health and fitness indicators in middle-aged men. METHODS: Study subjects were 55 healthy male golfers aged 48 to 64 years who had been sedentary during the 7 months before the study, and 55 age-matched, similarly sedentary controls. During the 20-week study, those in the intervention group were encouraged to play golf two to three times a week; the controls were not. Measurements of body composition, cardiorespiratory performance, motor and musculoskeletal fitness, blood pressure, and serum lipid, glucose, and insulin levels were obtained at baseline and after the 20-week study. RESULTS: Walking during a golf game was a practical and safe form of physical activity with high adherence. It significantly increased aerobic performance and trunk muscle endurance, with a net difference (pretraining to posttraining change between the golfers and controls) of 36 seconds (95% confidence interval [CI]: 19 to 53 seconds, P < 0.001) for treadmill walking time and 13 seconds (95% CI: 2 to 24 seconds, P = 0.02) for static back extension. In addition, regular walking favorably affected body composition, including reductions in weight of 1.4 kg (95% CI: 0.6 to 2.1 kg, P < 0.001), in waist circumference of 2.2 cm (95% CI: 1.0 to 3.3 cm, P < 0.001), and in abdominal skin fold thickness of 2.2 cm (95% CI: 0.9 to 3.4 cm, P = 0.001). Golfers also had significantly greater increases in serum high-density lipoprotein (HDL) cholesterol levels and in the ratio of HDL cholesterol to total cholesterol. CONCLUSIONS: Regular walking had many positive effects on the health and fitness of sedentary middle-aged men. Walking during a golf game is characterized by high adherence and low risk of injury and is therefore a good form of health-enhancing physical activity.

Aged↗
PubMed2000

Continuously increasing number and incidence of fall-induced, fracture-associated, spinal cord injuries in elderly persons.

BACKGROUND: Although osteoporosis, falls, and fractures among older adults are said to be a continuously increasing public health problem, reliable epidemiological information on their secular trends is very limited. OBJECTIVE: To determine the current trend in the number and incidence of fall-induced, fracture-associated, spinal cord injuries in a typical white population (Finland, a country with about 5 million inhabitants). METHODS: All Finns aged 50 years or older who were admitted to hospitals from January 1, 1970, through December 31, 1995, for primary treatment of an acute fall-induced, fracture-associated, spinal cord injury were selected from the National Hospital Discharge Register. Similar patients aged 20 through 39 years served as a reference group. In each year of the study, the number and the age-specific and age-adjusted incidences of injuries were expressed as the number of patients per 100,000 persons. RESULTS: The total number of fall-induced, fracture-associated, spinal cord injuries of Finnish older adults increased considerably during the study period, from 60 in 1970 to 419 in 1995 (an average increase of 24% annually). The corresponding injury incidence was 5 in 1970 and 27 in 1995. The age-adjusted incidence of these injuries also increased from 1970 to 1995: in women, from 5 to 29, and in men, from 7 to 17 (relative increases were 480% and 143%, respectively). In the reference group, no trend changes by time were observed. CONCLUSIONS: In Finnish persons aged 50 years or older, the number of fall-induced, fracture-associated, spinal cord injuries shows a rise with a rate that cannot be explained merely by demographic changes. The finding shows an increasing influence of osteoporosis and falls on health and well-being of our older adults, and therefore, vigorous preventive measures are needed to control this development.

Accidental Falls↗
PubMed2000

Physical activity and osteoporotic hip fracture risk in men.

BACKGROUND: Physical activity has been related to reduced risk of osteoporotic hip fractures, but the evidence among men is weak. OBJECTIVE: To determine the association between baseline leisure physical activity and future risk of osteoporotic hip fracture in men. METHODS: At baseline in 1975 our prospective study cohort included 3,262 men who were 44 years or older and did not have chronic disease restricting their ability to exercise. At baseline, physical activity was assessed by a questionnaire. Hip fractures were followed for 21 years, or from the age of 50 years for subjects who were initially younger than 50 years. RESULTS: The hazard ratio of osteoporotic hip fracture, adjusted for other possible predictors (height, body mass index, baseline diseases, smoking, use of alcohol, work-related physical activity, and occupational group), in men participating in vigorous physical activity compared with men not participating was 0.38 (95% confidence interval, 0.16-0.91) (P = .03). CONCLUSION: These results provide further evidence that there is an inverse association between baseline physical activity and future hip fracture risk among men.

Accidental Falls↗
PubMed2000

Disc degeneration and bone density in monozygotic twins discordant for insulin-dependent diabetes mellitus.

The effects of insulin-dependent diabetes mellitus on bone density and connective tissue degeneration have theoretical interest and practical relevance. Several experimental studies in animals have demonstrated the harmful effects of insulin deficiency on connective tissues. However, clinical studies in humans have produced somewhat contradictory results, most likely due to difficulties controlling for general degeneration and factors associated with diabetes. In nine pairs of monozygotic twins discordant for insulin-dependent diabetes mellitus, we compared femoral and lumbar bone mineral density (assessed by dual-energy x-ray absorptiometry) and spinal degeneration (assessed by magnetic resonance imaging). The bone densities were, on average, 0.1-0.3% lower (p = 0.87-0.96) in diabetic patients. However, after controlling for smoking, we found that the bone density in the femoral neck was 2.5% (0.025 g/cm2) lower in diabetic individuals than in their twins (p = 0.09). The five magnetic resonance imaging parameters used to evaluate disc degeneration did not differ between diabetic patients and their twins. In conclusion, our results provide no evidence that insulin-dependent diabetes mellitus has any major effect on bone density or disc degeneration.

Absorptiometry, Photon↗