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[Purpose] This study compared differences in trabecular bone architecture and strength caused by jump and running exercises in rats. [Methods] Ten-week-old male Wistar rats (n=45) were randomly assigned to three body weight-matched groups: a sedentary control group (CON, n=15); a treadmill running group (RUN, n=15); and a jump exercise group (JUM, n=15). Treadmill running was performed at 25 m/min without inclination, 1 h/day, 5 days/week for 8 weeks. The jump exercise protocol comprised 10 jumps/day, 5 days/week for 8 weeks, with a jump height of 40 cm. We used microcomputed tomography to assess microarchitecture, mineralization density, and fracture load as predicted by finite element analysis (FEA) at the distal femoral metaphysis. [Results] Both jump and running exercises produced significantly higher trabecular bone mass, thickness, number, and fracture load compared to the sedentary control group. The jump and running exercises, however, showed different results in terms of the structural characteristics of trabecular bone. Jump exercises enhanced trabecular bone mass by thickening the trabeculae, while running exercises did so by increasing the trabecular number. FEA-estimated fracture load did not differ significantly between the exercise groups. [Conclusion] This study elucidated the differential effects of jump and running exercise on trabecular bone architecture in rats. The different structural changes in the trabecular bone, however, had no significant impact on trabecular bone strength.

Introduction There are patients with lumbar disc herniation (LDH) having contralateral sciatic symptoms although the mechanisms of this clinical feature are still not well understood. The purpose of this study was to investigate these mechanisms by microendoscopic findings. Methods Patients were performed microendoscopic surgery using over-the-top approach (ME-OTT), with laminoplasty, extirpation of herniation, and observation of the contralateral nerve root. The over-the-top approach was applied through the same incision from the herniation side. Clinical results were assessed according to the clinical scoring system established by the Japanese Orthopedic Association (JOA) score. Results This study consisted of five patients, with the average age of 55.6 years old. The mean preoperative JOA score was 13 points. Three cases were Grade II and two were Grade III degrees of disc herniation. Levels of herniation were one at L3-4 and four at L4-5. Remission of sciatic symptoms was obtained in all cases after surgery. The average and percent improvements (%IP) of JOA scores at 2 months after surgery were 27.8 points and 92%, respectively. By the approach from the herniation side using ME-OTT, image around the contralateral nerve root was obtained without radical intervention. By ME-OTT, redness of the nerve root and fibrosis around the symptomatic nerve root were identified, whereas inflammatory changes were not apparent on the ipsilateral nerve root. Conclusions Operative treatment of LDH with contralateral symptoms by ME-OTT was a useful procedure for decompression and observation of the affected nerve root. Asymptomatic disc herniation, "silent disc herniation," was considered at the herniation side since there were less inflammatory changes around the ipsilateral nerve root. In contrast, compression of dura toward the opposite side by disc herniation could have led to mechanical stress against the contralateral nerve root and triggered inflammation at lateral recess, resulting in radicular pain.

A case of a 62-year-old woman with breast cancer who developed an atypical femoral fracture during denosumab therapy for bone metastasis is reported. About 8.5 years before the fracture, she was diagnosed with breast cancer with liver and bone metastases and started receiving chemotherapy. Three and a half years later, zoledronic acid (40 mg every 4 weeks) was added, which was continued for 2 years and 4 months. At around 1.5 years after discontinuation of zoledronic acid, bone metastasis recurred and she began treatment with denosumab at 120 mg every 4 weeks. Fifteen months after starting denosumab, she sustained a left subtrochanteric fracture. Faint hot spots in the bilateral subtrochanteric regions were found on bone scintigraphy 2 months after the start of denosumab, and the tracer accumulation was slightly increased on bone scintigraphy 1 year later. Prior to the fracture, she had been experiencing a dull ache in her left thigh for a few months. Our case suggests that denosumab treatment for bone metastasis is a risk factor for atypical femoral fractures, and that thigh pain and subtrochanteric hot spots on bone scintigraphy could be signs of an impending fracture.

Swimming is generally considered ineffective for increasing bone mass in humans, at least compared with weight-bearing sports. However, swimming exercise has sometimes been shown to have a strong positive effect on bone mass in small animals. This study investigated the effects of swimming on bone mass, strength, and microarchitecture in ovariectomized (OVX) rats. OVX or sham operations were performed on 18-wk-old female Fisher 344 rats. Rats were randomly divided into four groups: sham sedentary (Sham-CON), sham swimming exercised (Sham-SWI), OVX sedentary (OVX-CON), and OVX swimming exercised (OVX-SWI). Rats in exercise groups performed swimming in a water bath for 60 min/day, 5 days/wk, for 12 wk. Bone mineral density (BMD) in right femurs was analyzed using dual-energy X-ray absorptiometry. Three-dimensional trabecular architecture at the distal femoral metaphysis was analyzed using microcomputed tomography (μCT). Geometrical properties of diaphyseal cortical bone were evaluated in the midfemoral region using μCT. The biomechanical properties of femurs were analyzed using three-point bending. Femoral BMD was significantly decreased following ovariectomy. This change was suppressed by swimming. Trabecular bone thickness, number, and connectivity were decreased by ovariectomy, whereas structure model index (i.e., ratio of rod-like to plate-like trabeculae) increased. These changes were also suppressed by swimming exercise. Femurs displayed greater cortical width and maximum load in SWI groups than in CON groups. Together, these results demonstrate that swimming exercise drastically alleviated both OVX-induced decreases in bone mass and mechanical strength and the deterioration of trabecular microarchitecture in rat models of osteoporosis.

Geometry of the proximal femur is one determinant of fracture risk, and can be analyzed by a simple method using dual-energy X-ray absorptiometry (DXA). The aim of the present study was to investigate the accuracy of hip structural analysis (HSA) using clinical data in postmenopausal Japanese women. A total of 184 postmenopausal women aged 51–88 years (mean, 70.5 ± 8.7 years) who underwent artificial joint replacement surgery for osteoarthrosis of the hip or knee joint were included. Computed tomography (CT) data from preoperative assessment were utilized for analysis of proximal femoral geometry (CT-HSA) using QCTPro Software (Mindways Software Inc., Austin, TX) and compared with HSA results based on DXA (DXA-HSA). The results of femoral geometry were further compared with a CT-based finite-element method (CT/FEM). There was moderate to high correlation between DXA-HSA and CT-HSA (r=0.60-0.90, p

Three-dimensional femoral trabecular architecture was investigated in tail-suspended young growing rats and the effects of jump exercise during the period of tail-suspension were also examined. Eight-week-old male Wistar rats (n = 24) were randomly assigned to three body weight-matched groups: a tail suspended group (SUS, n = 8); a sedentary control group (CON, n = 8) and rats primed with jump exercise during the period of tail suspension (JUM, n = 8). The jump exercise protocol consisted of 30 jumps/day, five days/week with a 40 cm jump height. After 3 weeks of jump exercise, bone mineral density (BMD) of the entire right femur was measured using dual energy X-ray absorptiometry. Three-dimensional trabecular bone architecture at the distal femoral metaphysis was evaluated using microcomputed tomography (micro-CT). Tail suspension caused a decrease in femoral BMD (−5%, p