| Title |
Acute bone changes after lower limb amputation resulting from traumatic injury
|
|---|---|
| Published in |
Osteoporosis International, April 2017
|
| DOI | 10.1007/s00198-017-4018-z |
| Pubmed ID | |
| Authors |
D. A. Bemben, V. D. Sherk, W. J. J. Ertl, M. G. Bemben |
| Abstract |
Bone health is critical for lower limb amputees, affecting their ability to use a prosthesis and their risk of osteoporosis. We found large losses in hip bone mineral density (BMD) and in amputated bone strength in the first year of prosthesis use, suggesting a need for load bearing interventions early post-amputation. Large deficits in hip areal BMD (aBMD) and residual limb volumetric BMD (vBMD) occur after lower limb amputation; however, the time course of these bone quality changes is unknown. The purpose of this study was to quantify changes in the amputated bone that occur during the early stages post-amputation. Eight traumatic unilateral amputees (23-53 years) were enrolled prior to surgery. Changes in total body, hip, and spine aBMD (dual-energy X-ray absorptiometry); in vBMD, stress-strain index (SSI), and muscle cross-sectional area (MCSA) (peripheral QCT); and in bone turnover markers were assessed after amputation prior to prosthesis fitting (pre-ambulatory) and at 6 and 12 months walking with prosthesis. Hip aBMD of the amputated limb decreased 11-15%, which persisted through 12 months. The amputated bone had decreases (p < 0.01) in BMC (-26%), vBMD (-21%), and SSI (-25%) from pre-ambulatory to 6 months on a prosthesis, which was maintained between 6 and 12 months. There was a decrease (p < 0.05) in the proportion of bone >650 mg/cm(3) (58 to 43% of total area) or >480 mg/cm(3) (65% to 53%), suggesting an increase in cortical porosity after amputation. Bone alkaline phosphatase and sclerostin were elevated (p < 0.05) at pre-ambulatory and then decreased towards baseline. Bone resorption markers were highest at surgery and pre-ambulatory and then progressively decreased (p < 0.05). Rapid and substantial losses in bone content and strength occur early after amputation and are not regained by 12 months of becoming ambulatory. Early post-amputation may be the most critical window for preventing bone loss. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 2 | 67% |
| Netherlands | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 2 | 67% |
| Members of the public | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 86 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 86 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 15 | 17% |
| Student > Bachelor | 11 | 13% |
| Student > Ph. D. Student | 10 | 12% |
| Student > Doctoral Student | 6 | 7% |
| Researcher | 6 | 7% |
| Other | 14 | 16% |
| Unknown | 24 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 20 | 23% |
| Engineering | 10 | 12% |
| Sports and Recreations | 10 | 12% |
| Nursing and Health Professions | 9 | 10% |
| Psychology | 3 | 3% |
| Other | 8 | 9% |
| Unknown | 26 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 April 2017.
All research outputs
#14,276,970
of 22,962,258 outputs
Outputs from Osteoporosis International
#2,163
of 3,668 outputs
Outputs of similar age
#172,371
of 309,584 outputs
Outputs of similar age from Osteoporosis International
#35
of 87 outputs
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