Bone最新文献

{"title":"Automated micro-CT morphometry of femoral biopsies from hip arthroplasties: adaptive local thresholding, volume of interest wrapping and removal of debris","authors":"Deepti K. Sharma , Agatha Labrinidis , Xiangyu Dong , Christopher Schultz , Lucian B. Solomon , Boopalan Ramasamy , Stuart A. Callary , Phil Salmon","doi":"10.1016/j.bone.2025.117502","DOIUrl":"10.1016/j.bone.2025.117502","url":null,"abstract":"<div><div>Bone biopsies are an important biological tool for investigating bone microarchitecture, which can be non-destructively imaged in 3D via micro-computed tomography (micro-CT). Image thresholding and delineation of a region of interest (ROI) are prerequisites for quantifying bone parameters. Validated automatic protocols enable quantification of biopsies that contain trabecular and cortical bone. However, irregularly shaped trabecular bone biopsies with peripheral and internal debris have required manual ROI delineation, which is time-intensive and subject to inter and intra-observer variance. We hypothesise that an automated workflow will be a suitable alternative to overcome these issues and objectively determine bone microarchitecture in surgical biopsies, at higher throughput suitable for clinical studies. Hence, the aim of this study was to develop an objective, reproducible and automated workflow to analyse microarchitecture of trabecular bone biopsies. To accomplish this aim, we tested six different methods of ROI delineation: a whole biopsy ROI, and both manual (slow) and automatically delineated (fast) reduced ROIs to remove peripheral debris, each with (adaptive thresholding and a set of morphological operations to remove debris) and without (global thresholding) processing in a subset (<em>n</em> = 8) of intertrochanteric femoral biopsies obtained from patients undergoing hip arthroplasty. Number of objects, bone volume to tissue volume (BV/TV), trabecular separation (Tb.Sp), structure model index (SMI) and Euler number and trabecular pattern factor (Tb.Pf) were compared between the six workflows using Friedman's test and post-hoc pairwise comparisons with Bonferroni correction was performed. The two most reproducible techniques were tested for validation in a larger cohort of arthroplasty patients (<em>n</em> = 60) and results were compared with appropriate <em>t</em>-test. Subset analysis indicated that the manual and automated ROI with processing increased the ability to resolve real differences between these groups in parameters BV/TV, Tb.Sp and Euler number compared to with no processing and whole biopsy ROI approach. A validation cohort consisted of thirty osteoarthritis patients with a mean age 68.25 ± 8.64 and thirty neck of femur fracture with a mean age 82.4 ± 8.9. The manual technique failed to detect differences in BV/TV, SMI and Tb.Pf between the two patient groups (<em>p</em> > 0.05, for all) while the automated workflow demonstrated significant differences in these parameters between the OA and the NOF patients (<em>p</em> < 0.05). This is probably due to irregularity in the reference VOI volume introduced by manual ROI delineation reducing morphometric precision, compared to the automated method. In conclusion, our automated workflow performed better than customary practice; it represents a user-independent, high throughput technique to measure bone microarchitecture accurately in surgical biopsies.</div><","PeriodicalId":9301,"journal":{"name":"Bone","volume":"197 ","pages":"Article 117502"},"PeriodicalIF":3.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebound hypercalcaemia timing is associated with cumulative weight-based denosumab dose for central giant cell granuloma treatment in children despite a dose weaning regimen","authors":"Alexander D. Chesover ,&nbsp;Jeremy Allgrove ,&nbsp;Alistair Calder ,&nbsp;Catherine Campbell ,&nbsp;Emmeline Heffernan ,&nbsp;Kshitij Mankad ,&nbsp;Rhiannon McBayDoherty ,&nbsp;Dearbhla McKenna ,&nbsp;Caroline Mills ,&nbsp;Madeline Rooney ,&nbsp;Nadeem Saeed","doi":"10.1016/j.bone.2025.117501","DOIUrl":"10.1016/j.bone.2025.117501","url":null,"abstract":"<div><div>Central giant cell granulomas (CGCG) are locally destructive, non-neoplastic lesions that express receptor activator of nuclear factor-κB (RANK) and RANK ligand. Denosumab, a monoclonal antibody against RANK ligand, is licensed in skeletally mature patients, with less experience in children who are at risk of rebound hypercalcaemia.</div><div>We describe the response to denosumab in five skeletally immature children with CGCG. Denosumab was started aged 2.1 to 11.6 years, for 8 to 22 months, with a cumulative dose of 9.6 to 58.8 mg/kg. Three patients followed a weaning protocol (using reducing dose frequency and zoledronic acid).</div><div>Denosumab ossified all lesions. Three patients had subsequent surgery, and one had recurrence. All had rebound hypercalcaemia, 8.9–47 weeks (median 23.3 weeks) after the last treatment dose. Four presented with symptomatic hypercalcaemia and acute kidney injury. Cumulative denosumab treatment dose/kg positively correlated with (1) time to rebound after the last treatment dose (r² = 0.94, <em>p</em> = 0.006); and (2) length of admission for hypercalcaemia treatment (r² = 0.87, <em>p</em> = 0.02). All patients had increased bone mineral density and metaphyseal sclerosis that improved after stopping denosumab. One had a clavicular fracture at the intersection of normal and high-density bone.</div><div>We propose that rebound hypercalcaemia should be an anticipated consequence of stopping denosumab in skeletally immature patients and exists on a spectrum. A higher cumulative denosumab dose/kg increases the time to rebound hypercalcaemia and its severity. Further work is needed to establish the lowest dose and the shortest treatment duration to balance effective treatment with minimising side effects.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"197 ","pages":"Article 117501"},"PeriodicalIF":3.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between estimated pulse wave velocity and hip fracture in middle-aged and older adults: A prospective cohort study in China","authors":"Wen-Kai Ke ,&nbsp;Jing-Ping Cheng ,&nbsp;Ling-Ling Xu","doi":"10.1016/j.bone.2025.117499","DOIUrl":"10.1016/j.bone.2025.117499","url":null,"abstract":"<div><h3>Background</h3><div>Hip fractures represent a significant public health challenge among middle-aged and older adults, with substantial implications for health and quality of life. This study aimed to investigate the association between estimated pulse wave velocity (ePWV) and hip fracture risk, with a comprehensive analysis of both overall and female population cohorts.</div></div><div><h3>Methods</h3><div>Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), this prospective cohort study included 11,024 participants aged 45 and older, with a 9-year follow-up period (2011-2020). The research employed Cox proportional hazards models to analyze the overall population and a specific female subgroup. The female subgroup analysis uniquely adjusted for menopausal status to provide a nuanced assessment of ePWV's relationship with hip fracture risk. Restricted cubic spline (RCS) analysis and threshold analysis were conducted to explore nonlinear associations between ePWV and hip fracture risk.</div></div><div><h3>Results</h3><div>During the follow-up period, 471 hip fractures were documented. In the overall population, each increment in ePWV quartile was associated with a significant 32 % increase in hip fracture risk (Hazard Ratio [HR]: 1.32, 95 % Confidence Interval [CI]: 1.18-1.49, <em>p</em> &lt; 0.001). The female subgroup analysis, after adjusting for menopausal status, revealed a 29 % increased hip fracture risk per ePWV quartile increment (HR: 1.29, 95 % CI: 1.09-1.53, <em>p</em> &lt; 0.05). Nonlinear analysis identified a critical threshold at 11.18 m/s, beyond which hip fracture risk significantly increased [HR (95%CI): 1.28 (1.12-1.47)].</div></div><div><h3>Conclusions</h3><div>The ePWV significantly correlates with hip fracture risk in middle-aged and older Chinese adults, offering novel insights into the relationship between arterial stiffness and fracture vulnerability. Future research should validate these findings and explore vascular health-based strategies for hip fracture prevention.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"197 ","pages":"Article 117499"},"PeriodicalIF":3.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed ultrasound and moderate exercise accelerate bone healing in an experimental tibial fracture model: biochemical, radiological and biomechanical evidence","authors":"Ligia Milanez Venturini ,&nbsp;Daniella Pacheco dos Santos Haupenthal ,&nbsp;João Afonso Spillere Dajori ,&nbsp;Laura de Roch Casagrande ,&nbsp;Rubya Pereira Zaccaron ,&nbsp;Camila da Costa ,&nbsp;Igor Ramos Lima ,&nbsp;Fernando Russo Costa do Bomfim ,&nbsp;Sabrina Zanchetta Lanza ,&nbsp;Yaodong Gu ,&nbsp;Anand Thirupathi ,&nbsp;Paulo Cesar Lock Silveira ,&nbsp;Alessandro Haupenthal","doi":"10.1016/j.bone.2025.117498","DOIUrl":"10.1016/j.bone.2025.117498","url":null,"abstract":"<div><div>Currently, therapeutic strategies involving mechanical stress play a key role in fracture consolidation. However, no literary evidence exists regarding the combined effects of low-intensity pulsed ultrasound (LIPUS) and moderate aerobic exercise. This study aimed to investigate the effects of LIPUS and moderate aerobic exercise on bone consolidation in 48 male Wistar rats. The animals were divided into four groups (<em>n</em> = 12 per group): Bone Fracture (BF); BF + LIPUS; BF + Exercise (Ex); BF + Ex + LIPUS. A transverse osteotomy with Kirschner wire fixation was performed, followed by therapeutic interventions for 19 days, three times a week. LIPUS was applied for 10 min (1.5 MHz, 0.4 W/cm², 3 cm² area), and aerobic exercise lasted 30 min/day with progressive speed. Radiographic analyses were conducted on days 1, 12, and 24 post-fracture, and euthanasia occurred 72 h after the final session. The combined group exhibited improved radiographic scores and increased birefringent collagen fibers. IL-4, IL-10, and TGF-β levels were significantly higher in treated groups, particularly the combined intervention. Additionally, oxidative stress markers showed reduced nitrite levels, controlled sulfhydryl oxidation, and enhanced SOD and GSH activity. Biomechanically, the combined group tolerated higher loads and demonstrated superior deformation capacity and tissue elasticity. The combination of aerobic exercise and LIPUS enhanced radiographic healing, modulated inflammation, reduced oxidative stress, and improved mechanical properties, supporting its potential for fracture rehabilitation.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"197 ","pages":"Article 117498"},"PeriodicalIF":3.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific association between dietary carbohydrate intake and bone mineral density among American adolescents: National Health and Nutrition Examination Survey","authors":"Chunhong Guo ,&nbsp;Jianmin Qu ,&nbsp;Keyi Li","doi":"10.1016/j.bone.2025.117493","DOIUrl":"10.1016/j.bone.2025.117493","url":null,"abstract":"<div><h3>Background</h3><div>The association between dietary carbohydrate intake and bone mineral density (BMD) remains controversial, and research on this topic among adolescents is lacking. This study aimed to examine the relationship between dietary carbohydrate intake and BMD in adolescents.</div></div><div><h3>Methods</h3><div>This study examined data from adolescents (12–19 years) in the National Health and Nutrition Examination Survey (NHANES) (2005–2010). Dietary carbohydrate intake was assessed via two 24-hour recalls. BMD at the lumbar spine, total spine, total femur, and femoral neck was measured by dual-energy X-ray absorptiometry (DXA). A two-day dietary weighted multivariate regression analysis was employed to adjusted for covariates and assess the relationship between carbohydrate intake and BMD. The consistency of the associations and potential modifying factors were further evaluated through stratification and interaction analyses, both weighted by the two-day dietary data. Additionally, stratified curve fitting elucidated sex-specific differences in this relationship.</div></div><div><h3>Results</h3><div>After excluding missing data, 2616 adolescents aged 12–19 years were included in the study. In the fully adjusted two-day dietary sample weighted analysis model, a positive association was observed between dietary carbohydrate intake and BMD among all participants. Dietary carbohydrate intake was positively associated with lumbar spine BMD (β = 1.31, 95 % CI = 0.38–2.23), total spine BMD (β = 1.31, 95 % CI = 0.39–2.24), and femoral neck BMD (β = 0.91, 95 % CI = 0.05–1.77) among all participants. Subgroup analyses revealed a significant sex interaction effect (<em>P</em> &lt; 0.05). Subsequently, stratified curve fitting and sex-specific multivariate regression analyses were conducted. The results indicated a positive correlation between dietary carbohydrate intake and BMD in males, whereas no such correlation was observed in females. The multivariate analysis results further confirmed the sex-specific differences in the relationship between dietary carbohydrate intake and BMD, consistent with the initial findings.</div></div><div><h3>Conclusion</h3><div>Our study demonstrated that carbohydrate consumption significantly enhances BMD during adolescent bone growth. This effect is sex-specific.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"197 ","pages":"Article 117493"},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ergothioneine alleviates osteoporosis via the ROS-MAPK signaling Axis","authors":"Zhen Guo ,&nbsp;Yiwen Huang ,&nbsp;Xiaowei Wang ,&nbsp;Yi Han ,&nbsp;Ang Li ,&nbsp;Yiyang Qu ,&nbsp;Lin Chen ,&nbsp;Meihang Du ,&nbsp;Yiming Zhang ,&nbsp;Yuanzhi Xu","doi":"10.1016/j.bone.2025.117496","DOIUrl":"10.1016/j.bone.2025.117496","url":null,"abstract":"<div><div>The accumulation of reactive oxygen species (ROS) within cells regulates the formation and function of osteoclasts, which is crucial therapeutic target for the treatment of osteoporosis. Ergothioneine (EGT) is a rare amino acid with strong antioxidant and anti-inflammatory properties. However, its application on osteoporosis has not been reported. In this study, we investigated the effects of EGT on osteoclastogenesis in vitro and in ovariectomized (OVX) mice. The results revealed that EGT could suppress RANKL-induced podosome belt formation and osteoclast development in vitro, while reducing intracellular ROS levels by upregulating key antioxidant enzymes, including HO-1 and Catalase. EGT was also found to downregulate the expression of critical osteoclast-specific proteins such as Trap, c-Fos, and Ctsk through attenuation of MAPK signaling. The potential of EGT to protect against trabecular bone loss in OVX mice was further demonstrated by micro-CT imaging, possibly by reducing osteoclast numbers shown by histological outcomes. These findings together highlighted the potential value of EGT as a novel tool for treating osteoporosis through its ability to suppress osteoclastogenesis and mitigate the accumulation of intracellular ROS.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"197 ","pages":"Article 117496"},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small and porous ossicles, with flat stapes footplate and incudal fractures in the oim mouse model of osteogenesis imperfecta","authors":"Maialen Ugarteburu ,&nbsp;Michael Doube ,&nbsp;Lukasz Witek ,&nbsp;Christoph Rau ,&nbsp;Luis Cardoso ,&nbsp;Claus-Peter Richter ,&nbsp;Alessandra Carriero","doi":"10.1016/j.bone.2025.117495","DOIUrl":"10.1016/j.bone.2025.117495","url":null,"abstract":"<div><div>Hearing loss affects approximately 70% of individuals with osteogenesis imperfecta (OI), a genetic connective tissue disorder characterized by bone fragility and deformities. No effective treatments exist for OI hearing loss, and its etiology is unknown limiting the development of new targeted therapies. This work investigates the impact of OI type I collagen mutations on the ossicle bone properties in the homozygous <em>oim</em> mouse model of severe OI, which is known to exhibit hearing loss. The morphology and porosity of the ossicles of 14-week-old <em>oim</em> and wild-type mice were analyzed using high-resolution synchrotron radiation microtomography. Additionally, the collagen fibers structure, bone tissue composition and mechanical properties were evaluated through second harmonic generation microscopy, Raman spectroscopy, and nanoindentation. The results demonstrated that <em>oim</em> ossicles are small, highly porous with an elevated lacunar number density, a flat stapes footplate and a small malleal processus brevis. One-in-two <em>oim</em> ossicles had incudomalleal joint abnormalities, exhibiting either a localized fracture in the incus head or a joint space widening. No differences were observed in collagen fibers structure, bone tissue composition and mechanical properties. These findings suggest that bone fractures observed in the <em>oim</em> incudes may contribute to their reported hearing loss. However, the underlying mechanism for these fractures' development remains to be investigated, as they do not appear to result from changes in bone tissue properties (collagen fibers organization, tissue composition or mechanical properties). Instead, they may be associated with joint space widening, and possibly altered ossicle chain kinematics.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117495"},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of strains induced by in vivo locomotion and axial tibiotarsal loading in a chukar partridge model","authors":"Murat Horasan ,&nbsp;Kari A. Verner ,&nbsp;Russell P. Main ,&nbsp;Eric A. Nauman","doi":"10.1016/j.bone.2025.117497","DOIUrl":"10.1016/j.bone.2025.117497","url":null,"abstract":"<div><div>Rodent models have offered valuable insights into the mechanobiological mechanisms that regulate bone adaptation responses to dynamic mechanical stimuli. However, using avian models may provide new insights into the mechanisms of bone adaptation to dynamic loads, as bird bones have distinct features that differ from mammalian bones. This paper illuminates these aspects by evaluating the mechanical environment in a novel avian, chukar partridge tibiotarsus (TBT), during fast locomotion and in cortical and cancellous tissue under <em>in vivo</em> dynamic compressive loading within the TBT. We measured <em>in vivo</em> mechanical strains at the TBT midshaft on the anterior, medial, and posterior surfaces during locomotion at various treadmill speeds. The mean <em>in vivo</em> strains measured on the anterior, medial, and posterior surfaces of the TBT midshaft were 154 με, -397 με, and -438 με, respectively, at a treadmill speed of 2 m/s. The mean experimentally measured strains on the anterior, medial, and posterior surfaces of the TBT were 114.7 με, -952.6 με, and -593.7 με under an <em>in vivo</em> dynamic compressive load of 130 N. The study, which employs a micro-computed tomography (microCT) based finite element model in combination with diaphyseal strain gauge measures, found that cancellous strains were greater than those in the midshaft cortical bone. Sensitivity analyses revealed that the material property of cortical bone was the most significant model parameter. In the midshaft cortical volume of interest (VOI), daily dynamic loading increased the maximum moment of inertia and reduced the bone area in the loaded limb compared to the contralateral control limb after three weeks of loading. Despite the strong correlations between the computationally modeled strains and experimentally measured strains at the medial and posterior gauge sites, no correlations existed between the computationally modeled strains and strain gradients, and histologically measured bone formation thickness at the mid-diaphyseal cross-section of the TBT.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117497"},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral versus intravenous antibiotics for bone and joint infections: Systematic review and meta-analysis of randomized controlled trials","authors":"João P.C. Lima ,&nbsp;Kauê A. Chagas ,&nbsp;Lucas B.P. Oliveira ,&nbsp;Bruno S.B. Filho ,&nbsp;Flávia M.R. Vital","doi":"10.1016/j.bone.2025.117494","DOIUrl":"10.1016/j.bone.2025.117494","url":null,"abstract":"<div><h3>Background</h3><div>Recent trials suggest oral (PO) antibiotics may be as effective as prolonged intravenous (IV) regimens in specific clinical scenarios. This meta-analysis compared PO and IV antibiotic therapy in bone and joint infections.</div></div><div><h3>Materials and methods</h3><div>PubMed, Embase and CENTRAL databases were searched for published trials from inception until February 2025 for randomized clinical trials (RCTs) that enrolled patients of any age with confirmed bone and/or joint infections compared oral versus intravenous antibiotic therapy and reported at least one of the prespecified outcomes.</div></div><div><h3>Results</h3><div>Nine RCTs (1723 patients) published from 1987 to 2025 were included. PO and IV therapies showed comparable efficacy in treatment failure (RR 0.96; 95 % CI 0.78–1.17; <em>p</em> = 0.68; I² = 0 %) and adverse events (RR 1.00; 95 % CI 0.90–1.12; I² = 10 %; <em>p</em> = 0.94). Overall, recurrence rates were similar. However, a subgroup analysis excluding fracture-related infections favored IV therapy (RR 1.47; 95 % CI 1.08–2.02; I² = 0 %; <em>p</em> = 0.02). Superinfection rates showed no difference (RR 1.12; 95 % CI 0.32–3.98; I² = 0 %; <em>p</em> = 0.86). Although not statistically significant, hospitalization duration may be shorter with PO therapy (MD -5.03 days; 95 % CI -15.84–5.77; I² = 4 %; <em>p</em> = 0.36).</div></div><div><h3>Conclusion</h3><div>Appropriately selected PO antibiotic regimens demonstrate comparable efficacy and safety to IV therapy in bone and joint infections, although there is a slight tendency to increase the recurrence of infections. These findings support a shift toward oral therapy in carefully chosen patients.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117494"},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of oral colchicine and vitamin K1 on bone metabolism in patients with diabetes mellitus: A post-hoc analysis of a 2 × 2 factorial randomized controlled trial with 18F-sodium fluoride positron emission tomography","authors":"Jamie W. Bellinge ,&nbsp;Marc Sim ,&nbsp;Roslyn J. Francis ,&nbsp;Sing Ching Lee ,&nbsp;Dick C. Chan ,&nbsp;Christian M. Girgis ,&nbsp;Gerald F. Watts ,&nbsp;Joshua R. Lewis ,&nbsp;Carl J. Schultz","doi":"10.1016/j.bone.2025.117492","DOIUrl":"10.1016/j.bone.2025.117492","url":null,"abstract":"<div><h3>Purpose</h3><div>Diabetes mellitus (DM) confers an increased risk of fracture. Fracture risk stratification techniques are imperfect, and preventative therapies are sparse. We aimed to describe features associated with a dysfunctional bone metabolism determined by ¹⁸F-Sodium Fluoride Positron Emission Tomography (¹⁸F-NaF PET) in patients with DM and test the effects of vitamin K1 and colchicine therapy on vertebral ¹⁸F-NaF activity.</div></div><div><h3>Methods</h3><div>This is a post-hoc analysis of a 2 × 2 factorial randomized double-blind placebo-controlled trial. Participants aged 50–80 with DM underwent ¹⁸F-NaF PET/CT imaging at baseline, 3 months of therapy with vitamin K1 (10mg/daily) or placebo, and colchicine (0.5 mg/day) or placebo and repeat ¹⁸F-NaF PET/CT. The ¹⁸F-NaF vertebral mean standardized uptake value (SUVmean) and the CT estimated bone mineral density (BMD) (in Hounsfield units) was evaluated from thoracic vertebra.</div></div><div><h3>Results</h3><div>In total, 149 individuals (66.4 % male, mean age 65.5 ± 6.8 years) were included. Male sex (β −1.421, 95 % CI [−1.826, −1.016], <em>p</em> &lt; 0.001), duration of DM in years (−0.021 [−0.039, −0.002], <em>p</em> = 0.030) and CT estimated vertebral BMD (0.011 [0.006, 0.015], p &lt; 0.001) were independently associated with the SUVmean. The change in the SUVmean was similar between vitamin K1 or placebo groups (−0.07 ± 0.64 v 0.07 ± 0.69, <em>p</em> = 0.20). Participants receiving colchicine therapy had a greater reduction in the SUVmean, compared with placebo (−0.12 ± 0.72 v 0.11 ± 0.60, <em>p</em> = 0.039).</div></div><div><h3>Conclusion</h3><div>¹⁸F-NaF PET may be a useful measure of vertebral bone metabolism in people with DM. Three months of oral colchicine reduced the ¹⁸F-NaF vertebral SUVmean, whereas Vitamin K1 had no effect. The findings should be considered hypothesis generating.</div><div><strong>Trial Registration</strong>: <span><span>www.anzctr.org.au</span><svg><path></path></svg></span> (ACTRN12616000024448).</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117492"},"PeriodicalIF":3.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}