Bone最新文献

{"title":"Effect of type 1 and type 2 diabetes on human femoral trabecular bone composition, microarchitecture, and mechanical behavior","authors":"Shannon R. Emerzian ,&nbsp;Jackson Hanlon ,&nbsp;Ramina Behzad ,&nbsp;Mustafa Unal ,&nbsp;Daniel J. Brooks ,&nbsp;I-Hsien Wu ,&nbsp;John Gauthier ,&nbsp;Surya Jangolla ,&nbsp;Marc Gregory Yu ,&nbsp;Hetal S. Shah ,&nbsp;George L. King ,&nbsp;Fjola Johannesdottir ,&nbsp;Lamya Karim ,&nbsp;Elaine W. Yu ,&nbsp;Mary L. Bouxsein","doi":"10.1016/j.bone.2025.117588","DOIUrl":"10.1016/j.bone.2025.117588","url":null,"abstract":"<div><div>Both type 1 diabetes (T1D) and type 2 diabetes (T2D) increase hip fracture risk beyond what bone mineral density (BMD) explains, potentially due to changes in bone material from advanced glycation end-products (AGEs) and altered matrix composition. However, there are limited data regarding the impact of diabetes on human trabecular bone composition and mechanical behavior.</div><div>We assessed trabecular bone material behavior using cadaveric femoral specimens from older adults with long-duration T1D (≥50 years; <em>n</em> = 24), T2D (<em>n</em> = 21), and non-diabetic controls (<em>n</em> = 21). Femoral head trabecular bone was evaluated via micro-computed tomography, mechanical testing (uniaxial compression), total fluorescent AGEs quantification, and Raman spectroscopy (matrix composition).</div><div>BMD and microarchitecture measures did not differ between groups (<em>p</em> &gt; 0.535). Compared to controls, T1D trabecular bone had higher AGE content (+42 %, <em>p</em> = 0.016), lower mineral-to-matrix ratio (−12 %, <em>p</em> = 0.048), trend toward lower crystallinity (−4 %, <em>p</em> = 0.054), and greater proline hydroxylation (+5 %, <em>p</em> = 0.007), but showed no differences in mechanical behavior (<em>p</em> ≥ 0.415). T2D trabecular bone also had elevated AGE (+60 %, <em>p</em> &lt; 0.001) and altered matrix composition. Unlike T1D, T2D bone demonstrated improved ductility and post-yield energy dissipation versus control, with greater ultimate strain (+36 %, <em>p</em> = 0.008), post-yield strain (+62 %, <em>p</em> = 0.075), and toughness to ultimate force (+38 %, <em>p</em> = 0.044).</div><div>This study reveals distinct effects of T1D and T2D on trabecular bone matrix composition, although these effects did not coincide with reduced mechanical properties under uniaxial compression loading.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117588"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632589","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":"Effect of load orientation on finite element strain predictions in a rabbit tibial loading model","authors":"Jonah M. Dimnik ,&nbsp;Andrew Sawatsky ,&nbsp;Roman J. Krawetz ,&nbsp;W. Brent Edwards","doi":"10.1016/j.bone.2025.117575","DOIUrl":"10.1016/j.bone.2025.117575","url":null,"abstract":"<div><div>Mechanical loading plays an important role in the maintenance of bone quantity and quality. Rodents are the most frequently used <em>in vivo</em> loading model for examining the relationship between applied mechanical loads and the bone adaptation response, but they do not naturally exhibit human-like intracortical remodeling. Instead, our group has developed a non-invasive <em>in vivo</em> rabbit tibial loading model. This study aimed to develop and validate statically equivalent computed tomography (CT)-based finite element (FE) models of the rabbit tibia to capture the micro-mechanical environment produced by our <em>in vivo</em> mechanical loading device. We further sought to investigate the strain prediction sensitivity to changes in the assumed force vector orientation. Twenty hindlimbs from New Zealand White Rabbits were cyclically loaded in uniaxial compression with strain gauge rosettes affixed to the tibia. The hindlimbs were then disarticulated at the hip, imaged with CT in replica experimental fixtures, and processed into specimen-specific FE models. A mathematical optimization routine was used to determine the individual force vector orientations that minimized the error between FE predicted and experimentally measured bone strains, which yielded highly accurate strain predictions (<span><math><mrow><msup><mrow><mi>R</mi></mrow><mrow><mn>2</mn></mrow></msup><mo>=</mo><mn>0</mn><mo>.</mo><mn>96</mn></mrow></math></span>) that exhibited a <span><math><mi>Y= X</mi></math></span> type of relationship after bias adjustment. This approach resulted in substantially lower strain prediction errors when compared to models using various single assumed orientation techniques. We also found that even slight deviations in the assumed hindlimb orientation substantially affect strain predictions. These findings suggest that experimentally informed approaches may be useful for hindlimb-specific loading orientations. This work serves to enable future studies examining the mechanobiology of bone adaptation using the rabbit animal model.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117575"},"PeriodicalIF":3.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613872","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":"Efficacy of stem cell therapy for avascular necrosis of the femoral head: A systematic review and Meta-analysis","authors":"Saroj Kundan Bharti ,&nbsp;Mohammed Safeer V.S. ,&nbsp;Mannuru Venkateswarlu ,&nbsp;Mamidi Niveditha ,&nbsp;Sidharth Sharma ,&nbsp;Dipika Bansal","doi":"10.1016/j.bone.2025.117590","DOIUrl":"10.1016/j.bone.2025.117590","url":null,"abstract":"<div><h3>Background</h3><div>Osteonecrosis of the femoral head (ONFH) is a debilitating orthopaedic condition primarily affecting younger adults, often progressing to femoral head collapse and total hip replacement (THR). Stem cell therapy (SCT) has emerged as a regenerative option to delay disease progression and preserve joint function. This study aimed to evaluate efficacy of SCT, alone or in combination with mechanical support or bone grafting, in improving clinical outcomes in ONFH.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted up to November-2024. Randomized controlled trials (RCTs) comparing SCT with standard care in ONFH patients were included. Primary outcomes were THR incidence and disease progression; secondary outcomes included Harris Hip Score (HHS), Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were pooled using random-effects models, and evidence certainty was assessed using the GRADE approach.</div></div><div><h3>Results</h3><div>Ten RCTs involving 545 hips were included, with overall mean follow-up duration across studies was 36 months. SCT, when used in combination with mechanical support or bone grafts, showed a trend towards reduced THR risk (RR: 0.74; 95 % CI: 0.46–1.20) and significantly improved functional outcomes (e.g., WOMAC MD: –10.7; 95 % CI: −17.2 to −4.3). Pure SCT alone did not yield statistically significant benefits across most outcomes. Subgroup analyses revealed that mechanical support notably enhanced the effect of SCT on HHS and THR prevention. The risk of bias was low in six studies and high in four. GRADE assessment rated the evidence as moderate for THR and low for other outcomes due to methodological limitations.</div></div><div><h3>Conclusion</h3><div>While pure SCT appears deceptive in ONFH treatment, its combined use with mechanical support or bone grafts might be promising.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117590"},"PeriodicalIF":3.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621571","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":"Gastrointestinal complaints in patients with osteogenesis imperfecta: The bright side of a rare genetic disorder","authors":"Disha Sharma ,&nbsp;Gracia M. Viana Rodriguez ,&nbsp;Chunwei Walter Lai ,&nbsp;Bilal Asif ,&nbsp;Sara Talvacchio ,&nbsp;Alexander H. Yang ,&nbsp;Anusha Vittal ,&nbsp;Alberta Derkyi ,&nbsp;Christopher Koh ,&nbsp;Elizabeth C. Wright ,&nbsp;Joan C. Marini ,&nbsp;Theo Heller","doi":"10.1016/j.bone.2025.117589","DOIUrl":"10.1016/j.bone.2025.117589","url":null,"abstract":"<div><h3>Background</h3><div>Osteogenesis imperfecta (OI) is a rare hereditary disorder of connective tissue. A Danish national registry study surprisingly identified digestive causes as one of the leading causes of OI mortality. However, there is a dearth of prospective data describing gastrointestinal symptoms in OI. Our aim was to assess common gastrointestinal symptoms in an OI patient population and compare it to the general U.S. population.</div></div><div><h3>Methods</h3><div>OI patients enrolled in a natural history protocol (<span><span>NCT03575221</span><svg><path></path></svg></span>) were prospectively evaluated for gastrointestinal symptoms and provided with PROMIS questionnaires for six gastrointestinal symptoms. The HMSS application was used to obtain T scores, score of 50 (and standard deviation of 10) representing the average of the general U.S. population.</div></div><div><h3>Results</h3><div>41 OI patients were included. Median age 28 years (IQR 18–26), median BMI 28 kg/m² (IQR 21–34), and 54 % female. OI type IV 61 %, OI type III 20 %, and remaining patients had OI type VI, VII, XIV. The mean T score for the six gastrointestinal symptoms ranged from 46 to 49, within 1 SD from the general U.S. population. Subgroup analyses showed no differences based on age, mobility, BMI, type of OI and genetic mutations (<em>COL1A1</em> vs <em>COL1A2</em>), except increased abdominal pain with age. Patients with severe scoliosis (&gt;50°) reported increased nausea and vomiting, and diarrhea compared to patients with mild to moderate scoliosis.</div></div><div><h3>Discussion</h3><div>We report the largest cohort of OI patients evaluated prospectively and directly for gastrointestinal complaints. Study patients, which excluded type I OI, did not report gastrointestinal symptoms higher than the general population except for abdominal pain in older patients. OI patients should be carefully evaluated in the same way as any other patient presenting with gastrointestinal complaints.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117589"},"PeriodicalIF":3.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621572","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":"Smpd3 regulates odontoblast differentiation through the Shh-Gli1 pathway","authors":"Catherine H. Chu ,&nbsp;Jiaohong Wang ,&nbsp;Chi Zhang ,&nbsp;Guoqing Li ,&nbsp;Lin Wang","doi":"10.1016/j.bone.2025.117587","DOIUrl":"10.1016/j.bone.2025.117587","url":null,"abstract":"<div><div>Teeth, like other ectodermal organs such as hair, skin, and sweat glands, are complex structures. Specifically, teeth are composed of four principal tissues: enamel, dentin, cementum, and pulp. Among these, dentin is a critical component, synthesized by odontoblasts—specialized cells derived from ectomesenchymal precursors originating in the neural crest. Odontoblasts are uniquely responsible for dentinogenesis, a process essential for tooth development and function. However, the molecular mechanisms regulating odontoblast differentiation remain poorly understood.</div><div>In this study, we first analyzed a public single-cell RNA sequencing data set of postnatal (PN1) mouse molars and found <em>Smpd3</em> as a potential gene of odontoblast differentiation. Then, we investigated the functional role of <em>Smpd3</em> in odontoblast differentiation using a combination of histological, molecular, and bioinformatics approaches. Knockdown of <em>Smpd3</em> expression <em>via</em> small interfering RNA (siRNA) significantly impaired odontoblast differentiation of mouse dental papilla cells (mDPCs), as evidenced by reductions in odontoblast-specific markers and mineralization. In contrast, overexpression of <em>Smpd3</em> enhanced odontogenic differentiation and increased mineralized nodule formation of mDPCs. To elucidate the underlying molecular mechanisms, bulk RNA sequencing was conducted, revealing that <em>Smpd3</em> is intricately linked to the Sonic Hedgehog (Shh) signaling pathway. <em>In vitro</em> studies and tooth germ culture were applied to validate the mechanism of <em>Smpd3</em> on odontoblast differentiation through the Shh-Gli1 pathway.</div><div>Mechanistically, we show that <em>Smpd3</em> upregulates dentinogenic markers (Dspp, Dmp1) in a Shh-dependent manner. <em>Smpd3</em> overexpression increased Shh pathway activity and promoted dentin formation <em>ex vivo</em>. This study highlights the critical role of <em>Smpd3</em> in tooth development and provides novel insights into the molecular regulation of dentinogenesis, offering potential therapeutic targets for methods that promote dentin regeneration when natural repairs are compromised.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117587"},"PeriodicalIF":3.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610604","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":"Schip1 promotes osteoclast differentiation via Taok1-mediated activation of the p38 MAPK signaling pathway in mouse models of osteoporosis","authors":"Furui Liu ,&nbsp;Muhang Tian ,&nbsp;Sen Wang ,&nbsp;Lei Guo ,&nbsp;Fangjing Chen","doi":"10.1016/j.bone.2025.117579","DOIUrl":"10.1016/j.bone.2025.117579","url":null,"abstract":"<div><div>Schip1 serves as a pivotal regulatory factor in both the Hippo pathway and the PDGFB signaling pathway, which are significant in the pathogenesis of osteoporosis. However, the role of Schip1 in osteoporosis remains to be elucidated. In this study, we demonstrated for the first time that Schip1 acted as a positive regulator in osteoclastogenesis. We observed a significant upregulation of Schip1 expression during Rankl-induced osteoclast differentiation, and the suppression of Schip1 expression notably reduced Rankl-induced osteoclast formation. Functionally, Schip1 interacted with Taok1 to activate the p38 MAPK signaling pathway, which promoted osteoclast differentiation. Genetic ablation of Schip1 in mice resulted in pronounced osteosclerosis compared to wild-type controls. Furthermore, mice with deletion of Schip1 exhibited significantly mitigated osteoporosis following ovariectomy. Collectively, our findings establish Schip1 as a regulator of osteoclast differentiation and suggest its potential as a therapeutic target for osteoporosis.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117579"},"PeriodicalIF":3.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581064","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":"Statistical shape modelling of the first carpometacarpal joint: A cross-sectional analysis of an osteoarthritis initiative cohort","authors":"J. Shepherd ,&nbsp;F.R. Saunders ,&nbsp;Y. Narang ,&nbsp;K. Hamlin ,&nbsp;D.F.M. Lawrie ,&nbsp;B. Winter ,&nbsp;A.H.K. Riemen","doi":"10.1016/j.bone.2025.117577","DOIUrl":"10.1016/j.bone.2025.117577","url":null,"abstract":"<div><h3>Introduction</h3><div>Statistical shape modelling (SSM) has been used extensively to investigate the relationship between joint shape and hip, knee and spine osteoarthritis (OA), but first carpometacarpal joint (CMCJ) shape and thumb base OA is less understood. We established a statistical shape model of the first CMCJ to investigate the ability of SSM to evaluate CMCJ morphology and determine its ability to investigate association with thumb base OA.</div></div><div><h3>Methods</h3><div>100 participants' bilateral hand and wrist radiographs were selected at random from the OAI database. A model was developed using SSM software to characterise first CMCJ shape and applied to radiographs. Radiographic OA severity was graded using Kellgren-Lawrence. Independent modes of variation in shape within the cohort were identified. Relationship with clinical symptoms and radiological severity was assessed using multivariate regression models adjusted for age, sex, height and weight.</div></div><div><h3>Results</h3><div>Ten and nine modes of variation were identified in right and left models respectively. Concurrent ipsilateral hand pain and stiffness was associated with right-mode-1 (RM1) (multivariate model, co-efficient 0.104, 95 % CI 0.011–0.197, <em>p</em> = 0.028), which anatomically represents greater prominence of ulnar aspect of trapezium joint surface. Stratified radiological OA severity showed CMCJ severity was associated with RM1,6,10 and LM 1,6,7 and STJ severity was associated with RM1 and LM1,6,7.</div></div><div><h3>Conclusions</h3><div>We demonstrate the application of SSM in a novel context, showing its ability to evaluate variation in CMCJ morphology from radiographs. This study identifies and justifies the requirement for novel automation techniques in SSM to facilitate longitudinal studies required to investigate clinical applications.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117577"},"PeriodicalIF":3.5,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593171","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 number of vertebral fractures in indolent systemic mastocytosis is influenced by presence of the KIT-mutation","authors":"Christof Wilke ,&nbsp;Martina Blaschke ,&nbsp;Annette Lamersdorf ,&nbsp;Christina Heppner ,&nbsp;Michael Metz ,&nbsp;Hans-Peter Horny ,&nbsp;Mathias Werner ,&nbsp;Undine Lippert ,&nbsp;Heide Siggelkow","doi":"10.1016/j.bone.2025.117578","DOIUrl":"10.1016/j.bone.2025.117578","url":null,"abstract":"<div><div>Systemic mastocytosis (SM) is a rare disease characterized by aggregation of mast cells in the skin or extracutaneous organs. Disease subtypes range from cutaneous to systemic mastocytosis with highly malignant forms, indolent systemic mastocytosis (ISM) being the most frequent subtype. In ISM, mast cells infiltrate bone marrow, with some patients developing osteoporosis and fractures. However, fractures do not occur in all ISM patients.</div><div>In this retrospective one-center study, we analyzed data from patients evaluated for osteoporosis diagnosed with ISM according to WHO criteria between 2006 and 2019. ISM patients (n = 42) comprised 76.2 % women (n = 32), had a mean age of 52.2 ± 12 years, and presented with skin lesions in 80.5 % (n = 33). Osteoporosis was diagnosed in 42 % (n = 15) according to the WHO definition (T-score ≤ −2.5). Fractures were either peripheral in 19 % (n = 8), or to the spine in 43 % (n = 18); both fracture types presented in 14 % (n = 6). All fracture types correlated to femoral BMD T-scores. The presence of the somatic gain-of-function mutation in the KIT receptor tyrosine kinase (KIT-mutation) in bone biopsy was associated with a significantly greater number of fractures (p = 0.024) and correlated to the number of vertebral fractures in individual patients (p = 0.03). Neither tryptase levels, postmenopausal status, nor bone turnover markers were indicators of an increase in vertebral or peripheral fractures in ISM patients. Smoking was associated with more fractures, however the effect disappeared dependent on KIT-mutation. Those with skin lesions had better femoral BMD T-scores (right femur: −1.05 ± 0.99 vs −2.26 ± 0.59, p = 0.008; right femoral neck: −1.21 ± 0.99 vs −2.22 ± 0.55, p = 0.0023).</div><div>In conclusion, we demonstrate the influence of the KIT-mutation on the severity of fractures in osteoporosis patients with the final diagnosis of ISM. Our results suggest that, in the presence of the KIT-mutation in ISM patients without skin lesions, the timely onset of anti-osteoporotic treatment might be of value.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117578"},"PeriodicalIF":3.5,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593172","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":"Radiomics based on BPX images to detect abnormal bone mineral density","authors":"Yuqi Zhu ,&nbsp;Kun Zhou ,&nbsp;Xiao Luo ,&nbsp;Shan Yang ,&nbsp;Enhui Xin ,&nbsp;Yanwei Zeng ,&nbsp;Junyan Fu ,&nbsp;Zhuoying Ruan ,&nbsp;Rong Wang ,&nbsp;Liqin Yang ,&nbsp;Daoying Geng","doi":"10.1016/j.bone.2025.117570","DOIUrl":"10.1016/j.bone.2025.117570","url":null,"abstract":"<div><h3>Background</h3><div>Abnormal bone mineral density (BMD) is a major contributor to bone fragility and fractures. While dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) are the primary diagnostic modalities, both methods are associated with additional radiation exposure and costs. This study investigates the feasibility of using radiomics to establish an automated tool for identifying patients at high risk for BMD abnormality based on biplanar X-ray radiography (BPX) images.</div></div><div><h3>Methods</h3><div>A total of 906 BPX scans from 453 subjects, including 275 females, were included in this prospective study, with QCT results as the ground truth (GT). Radiomic features were extracted from the anteroposterior and lateral views of the L1-L5 vertebrae using Pyradiomics. The most relevant features were selected using the least absolute shrinkage and selection operator (LASSO) filter. Then, radiomics-only and clinical-radiomics models were established to diagnose BMD abnormality. The performances of the models were calculated and evaluated.</div></div><div><h3>Results</h3><div>The radiomics-only model achieved an accuracy (ACC) of 0.88 for both sexes and 0.91 for women. The clinical-radiomics models achieved an ACC of 0.87 for both sexes and 0.89 for women.</div></div><div><h3>Conclusion</h3><div>The radiomics-only model based on BPX images effectively distinguishes BMD abnormality and demonstrates potential as a decision-support tool in real-world physical examination populations.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"199 ","pages":"Article 117570"},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549431","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":"Unplanned emergency room visits within 30 and 90 days after osteoporotic hip fracture surgery: A comprehensive risk factor analysis","authors":"Chul-Ho Kim,&nbsp;Joon Hyoung Hong,&nbsp;Chan Woo La,&nbsp;Ji Wan Kim","doi":"10.1016/j.bone.2025.117576","DOIUrl":"10.1016/j.bone.2025.117576","url":null,"abstract":"<div><div>Hip fractures in older adults are associated with high comorbidity and mortality rates. Despite efforts to reduce hospital stay, early emergency room (ER) visits and readmissions remain common and can negatively impact outcomes. In this study, we aimed to evaluate the incidence, causes, and risk factors of unplanned ER visits within 30 and 90 days following hip fracture surgery. A retrospective review was conducted of 4551 patients who underwent hip fracture surgery at a single institution between 2005 and 2024. Demographics, perioperative variables, and clinical risk factors were analyzed using univariate and multivariate logistic regression. ER visits within 30 and 90 days post-discharge were categorized as surgical or non-surgical and compared with control groups without ER visits. The rates of unplanned ER visits were 6.8 % within 30 days and 12.2 % within 90 days after discharge. Multivariate analysis identified low body mass index (BMI) and higher Charlson Comorbidity Index scores as significant risk factors for ER visits at both time points. Non-surgical complications—most commonly gastrointestinal and pulmonary—were the leading causes of ER visits. Among surgical complications, hip arthroplasty dislocation was the most frequent cause at both 30 and 90 days. Unplanned ER visits following hip fracture surgery are primarily driven by non-surgical complications. Low BMI and poor preoperative comorbidity status are key risk factors. Targeted preventive strategies, including those addressing modifiable surgical risks, such as prosthetic dislocation, may help reduce ER utilization and improve postoperative outcomes.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"199 ","pages":"Article 117576"},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549586","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}