Knee Hurt

Author: Mokhtar

  • Articles / Effective Remedies for Knee Pain Below Knee Cap Inside

    Articles / Effective Remedies for Knee Pain Below Knee Cap Inside

    Articles / Effective Remedies for Knee Pain Below Knee Cap Inside

    Knee pain under the kneecap can be really uncomfortable and make it hard to move around. It’s important to know what causes this pain and how to treat it. This article will help you understand the reasons behind the pain, home remedies, exercises, diet tips, and medical treatments that can help. Plus, you’ll learn how to prevent knee pain in the future.

    Understanding Knee Pain Below the Knee Cap

    Common Causes

    Knee pain below the knee cap can be caused by various factors. Overuse injuries are common, especially in athletes. Conditions like patellar tendinitis or bursitis can also lead to discomfort. Sometimes, structural issues such as misalignment of the knee cap can be the culprit.

    Symptoms to Watch For

    If you experience pain below the knee cap, you might notice swelling, stiffness, or a popping sensation. Tenderness when pressing on the area is also a common symptom. It’s important to monitor these signs to understand the severity of the issue.

    When to Seek Medical Help

    You should seek medical help if the pain persists despite home remedies or if it worsens over time. Additionally, if you experience severe swelling, inability to bear weight, or if the knee looks deformed, it’s crucial to consult a healthcare professional.

    Early diagnosis and treatment can prevent further complications and help you get back to your daily activities sooner.

    Home Remedies for Alleviating Knee Pain

    Rest and Ice Therapy

    Giving your knee enough rest is crucial. Avoid putting too much weight on it and use ice packs to reduce swelling. Apply ice for 15-20 minutes every few hours.

    Compression and Elevation

    Using a compression bandage can help manage swelling. Make sure it’s snug but not too tight. Elevate your leg on pillows to keep it above heart level, which helps reduce swelling.

    Over-the-Counter Pain Relievers

    Over-the-counter pain relievers like ibuprofen or acetaminophen can be effective. These medications help reduce pain and inflammation. Always follow the dosage instructions on the package.

    Taking care of your knee at home can make a big difference in your recovery. Simple steps like rest, ice, compression, and elevation can help you feel better faster.

    Exercises to Strengthen the Knee

    Stretching Techniques

    Stretching is a great way to keep your knees flexible and reduce pain. Simple stretches like hamstring stretches or calf stretches can make a big difference. Try to stretch every day to keep your muscles loose and your joints healthy.

    Strengthening Workouts

    Strengthening the muscles around your knee can help support the joint and reduce pain. Exercises like leg lifts, squats, and lunges are very effective. Start with light weights and gradually increase as you get stronger. Remember, consistency is key.

    Low-Impact Activities

    Low-impact activities are easier on your knees and can still help you stay active. Swimming, cycling, and walking are great options. These activities help you stay fit without putting too much stress on your knees.

    Regular exercise can help you manage knee pain and improve your overall health. Make sure to choose activities that you enjoy and can stick with over time.

    Diet and Supplements for Joint Health

    knee pain remedies

    Anti-Inflammatory Foods

    Eating the right foods can help reduce knee pain. Foods rich in omega-3 fatty acids like salmon and walnuts can lower inflammation. Adding fruits and vegetables, especially those high in antioxidants, can also help. Try to avoid processed foods and sugary drinks as they can make inflammation worse.

    Essential Vitamins and Minerals

    Certain vitamins and minerals are important for joint health. Vitamin D and calcium are crucial for strong bones. Magnesium helps with muscle function and can reduce cramps. Make sure to get enough of these nutrients through your diet or supplements if needed.

    Herbal Supplements

    Some herbal supplements can help with knee pain. Turmeric, with its active ingredient curcumin, is known for its anti-inflammatory properties. Ginger is another good option. Always talk to your doctor before starting any new supplement to make sure it’s safe for you.

    Eating a balanced diet and taking the right supplements can make a big difference in managing knee pain. It’s important to focus on foods and supplements that support joint health and reduce inflammation.

    Medical Treatments for Persistent Knee Pain

    Physical Therapy

    Physical therapy is often the first step in treating ongoing knee pain. A therapist will guide you through exercises to improve strength and flexibility. This can help reduce pain and prevent further injury. Regular sessions can make a big difference in your recovery.

    Prescription Medications

    When over-the-counter pain relievers aren’t enough, doctors may prescribe stronger medications. These can include anti-inflammatory drugs or painkillers. It’s important to follow your doctor’s instructions to avoid side effects.

    Surgical Options

    In severe cases, surgery might be needed. Procedures can range from arthroscopy to knee replacement. Your doctor will discuss the best option for you based on your condition. Surgery is usually considered only after other treatments have failed.

    Persistent knee pain can be challenging, but there are many medical treatments available to help you find relief.

    Preventing Knee Pain in the Future

    Proper Footwear

    Wearing the right shoes can make a big difference in keeping your knees healthy. Supportive shoes help align your legs and reduce stress on your knees. Avoid high heels and choose shoes with good arch support.

    Regular Exercise

    Staying active is key to preventing knee pain. Focus on exercises that strengthen the muscles around your knee. This can include activities like walking, swimming, or cycling. Remember to warm up before exercising to avoid injury.

    Weight Management

    Keeping a healthy weight is important for your knees. Extra weight puts more pressure on your knees, which can lead to pain. Eating a balanced diet and staying active can help you maintain a healthy weight.

    Taking care of your knees now can save you from pain later. Simple steps like wearing the right shoes, staying active, and keeping a healthy weight can make a big difference.

    Conclusion

    In summary, dealing with knee pain below the kneecap can be challenging, but there are many effective remedies to help manage it. From simple exercises and stretches to over-the-counter medications, there are various ways to find relief. It’s important to listen to your body and not push through the pain. If the pain persists, seeking advice from a healthcare professional is a good idea. Remember, taking care of your knees today can prevent bigger problems in the future. Stay active, stay healthy, and take steps to protect your knees.

    Key Takeaways

    • Understanding the causes of knee pain helps in finding the right treatment.
    • Home remedies like rest, ice, and compression can ease knee pain.
    • Regular exercises can strengthen the knee and prevent future pain.
    • Eating the right foods and taking supplements can improve joint health.
    • Seeking medical help is important for persistent or severe knee pain.

    Frequently Asked Questions

    What are common causes of knee pain below the knee cap?

    Knee pain below the knee cap is often caused by overuse, injuries, or conditions like tendinitis and bursitis. Sometimes, it can also be due to arthritis or a dislocated knee cap.

    What symptoms should I watch for with knee pain?

    Watch for swelling, stiffness, redness, and pain when moving the knee. If you hear popping sounds or feel like your knee might give out, these are also signs to be aware of.

    When should I see a doctor for knee pain?

    You should see a doctor if the pain is severe, if you can’t put weight on your knee, if it looks deformed, or if you have a fever along with the pain. These could be signs of a more serious problem.

    What home remedies can help with knee pain?

    Resting your knee, using ice packs, wearing a compression bandage, and keeping your leg elevated can help. Over-the-counter pain relievers like ibuprofen can also reduce pain and swelling.

    How can exercises help with knee pain?

    Exercises can strengthen the muscles around your knee, improve flexibility, and reduce pain. Stretching, strengthening workouts, and low-impact activities like swimming are good options.

    What foods are good for joint health?

    Foods that fight inflammation, like fruits, vegetables, and fish, are good for joint health. Vitamins and minerals like Vitamin D and calcium, as well as herbal supplements, can also help keep your joints healthy.

  • Staying Active After Knee Surgery: Tips for Safely Resuming Activities After Knee Replacement

    Staying Active After Knee Surgery: Tips for Safely Resuming Activities After Knee Replacement

    July 19, 2024

    Staying Active After Knee Surgery in North Dakota.jpg

    Have you ever dreamed of being able to walk, run or ride your bike again without pain? Knee replacement surgery can open a new, active chapter in your life.

    But how do you safely transition from surgery to an active life? Here are some tips for staying active after knee surgery and safely returning to your favorite activities.

    The Benefits of Knee Replacement Surgery

    Knee replacement surgery involves removing a damaged knee joint and replacing it with an artificial one. It is a common procedure that can dramatically reduce pain and improve function.

    For many, it is an opportunity to resume the activities they enjoy, but due to pain and limited mobility, this is no longer possible.

    The importance of active recovery

    Staying active after knee replacement surgery is not optional, it’s essential. Activity increases blood flow, helps speed the healing process, and strengthens the muscles supporting your new knee, reducing your risk of complications.

    Plus, it improves your mental health and gives you a sense of accomplishment as you progress toward full recovery.

    Activities After Knee Replacement Surgery

    After knee replacement surgery, patients often wonder what activities they can safely resume. The good news is that with proper recovery and care, people can enjoy a variety of low-impact activities, including walking, swimming, biking, and golfing.

    These activities contribute to physical recovery and general well-being.

    Tips for a safe and active recovery

    Start slow

    Your body has just undergone a major procedure and it is important to listen to it. Start with simple movements and activities that do not put stress on your new knee.

    Walking is a good place to start. At first you may only be able to walk short distances, but that’s okay. Gradually increase the distance as you become more comfortable and your strength improves.

    Follow the advice of your physiotherapist

    Your physical therapist will be your best friend during your recovery from knee replacement. He or she will guide you through exercises designed to strengthen your knee and improve its flexibility. These aren’t just random stretches; they’re tailored to your specific needs.

    Make sure you stick to the routine they set for you, even when you start to feel better. They work with your orthopedic surgeon and know what is best for your knee.

    Listen to your body

    Pain is your body’s way of saying, “Hey, take it easy!” If an activity causes discomfort, stop and rest.

    It is important to distinguish between the expected mild discomfort during exercise and the pain that indicates overuse or an injury.

    Stay hydrated and eat well

    Properly nourishing your body can have a significant impact on your recovery from knee replacement. Water is essential for healing, so stay hydrated.

    Likewise, a balanced diet rich in vitamins and minerals will support your body’s recovery process. So try to eat only healthy foods.

    Diversify your activities

    Once you’re moving with more confidence and less discomfort, consider adding new activities to your routine. Swimming and cycling are great low-impact options that can keep you active without putting too much strain on your knee. Plus, they add variety, making your fitness routine more enjoyable and sustainable.

    Celebrate your progress

    Every step you take, no matter how small, is a step toward recovery. Celebrate the milestones, whether it’s walking further than last week or completing a set of exercises without pain.

    Recognizing your progress keeps you motivated and positive, which is just as important to your recovery as physical activity.

    Stay patient

    Recovering from knee surgery is a marathon, not a sprint. There will be good days and challenging days. The key is to stay patient and focus on your long-term health.

    Rushing the process will not get you back to your old self any faster. In fact, it may do the opposite.

    Knee Replacement Surgery in North Dakota

    Knee replacement surgery marks the beginning of a new chapter in which you can enjoy an active lifestyle without pain. You can make this transition smoothly and safely by taking it slow, listening to your body, and following professional advice.

    At The Bone & Joint Center, we specialize in advanced orthopedic care that helps people regain mobility and improve their quality of life. Our team of board-certified and fellowship-trained surgeons uses the latest techniques and technology to perform knee replacement surgeries that focus on reducing pain and restoring function.

    We strive to provide personalized care that meets your unique needs and ensures the best possible results.

    For more information or to schedule a consultation, Call us at (701) 946-7400 or (866) 900-8650 or use our convenient appointment request form. We look forward to serving you!

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  •  Knee Pain Inside and Below Knee Cap: What You Need to Know

     Knee Pain Inside and Below Knee Cap: What You Need to Know

    Knee pain can be a real bother, especially when it’s inside or below the knee cap. It can make simple activities like walking or climbing stairs a challenge. Understanding what causes this pain and how to treat it can help you get back to doing the things you love.

    Key Takeaways

    • Understanding the knee’s anatomy is crucial to identifying the source of pain.
    • Common causes of knee pain include Patellofemoral Pain Syndrome, Chondromalacia Patella, and Tendonitis.
    • Symptoms like pain, swelling, and clicking sounds should not be ignored.
    • Proper diagnosis often requires a physical exam and imaging tests.
    • Treatment can range from rest and physical therapy to medications and surgery.

    Understanding Knee Anatomy

    The knee is a complex joint made up of several important parts. Understanding its anatomy is crucial for identifying the causes of pain. The knee includes bones, cartilage, ligaments, tendons, and muscles that all work together to allow movement and support the body.

    Bones and Cartilage

    The main bones in the knee are the femur (thigh bone), tibia (shin bone), and patella (kneecap). Cartilage is a smooth tissue that covers the ends of these bones, helping them glide smoothly against each other.

    Ligaments and Tendons

    Ligaments are strong bands of tissue that connect bones to other bones. The knee has four main ligaments:

    • Anterior cruciate ligament (ACL)
    • Posterior cruciate ligament (PCL)
    • Medial collateral ligament (MCL)
    • Lateral collateral ligament (LCL)

    Tendons connect muscles to bones, allowing for movement. The patellar tendon connects the kneecap to the shin bone.

    Muscles Involved

    Several muscles around the knee help with movement and stability. The quadriceps at the front of the thigh help straighten the leg, while the hamstrings at the back help bend it.

    Understanding the anatomy of the knee can help you recognize when something is wrong. If you experience pain, it might be a sign that something is not right.

    If you ever see a “page not found – knee hurt” message, it might be a sign to check your knee health. Always consult a professional if you have concerns about your knee.

    Common Causes of Knee Pain Inside and Below the Knee Cap

    Patellofemoral Pain Syndrome

    Patellofemoral Pain Syndrome, often called runner’s knee, is a common issue. It happens when the cartilage under the kneecap is damaged due to overuse or injury. This condition can cause pain during activities like running, squatting, or climbing stairs.

    Chondromalacia Patella

    Chondromalacia Patella involves the softening and breakdown of the cartilage on the underside of the kneecap. This can lead to pain and swelling, especially when moving the knee. It’s often seen in young athletes and older adults.

    Tendonitis

    Tendonitis is the inflammation of the tendons around the knee. This condition is usually caused by repetitive stress or overuse. Symptoms include pain, swelling, and difficulty moving the knee. Rest and physical therapy are common treatments for this condition.

    Symptoms to Watch For

    Pain and Swelling

    Pain and swelling are common signs of knee problems. You might feel a sharp or dull ache inside or below the knee cap. Swelling can make your knee look bigger and feel stiff.

    Clicking or Popping Sounds

    Hearing clicking or popping sounds when you move your knee can be a sign of trouble. These sounds might happen when you bend or straighten your knee.

    Difficulty Bending the Knee

    If you find it hard to bend or straighten your knee, it could be a sign of an issue. This might make it tough to walk, run, or even sit comfortably.

    Important: If you notice any of these symptoms, it’s a good idea to talk to a doctor. Early treatment can help prevent more serious problems.

    Diagnosis and Medical Evaluation

    Physical Examination

    When you visit a doctor for knee pain, the first step is usually a physical examination. The doctor will check for tenderness, swelling, and range of motion. They may also ask you to walk or perform specific movements to see how your knee responds.

    Imaging Tests

    If the physical exam doesn’t provide enough information, imaging tests like X-rays or MRIs might be needed. These tests can show detailed pictures of the bones and soft tissues in your knee, helping to identify any damage or abnormalities.

    When to See a Specialist

    Sometimes, knee pain requires more specialized care. If your pain is severe, doesn’t improve with basic treatments, or is accompanied by other symptoms like fever or significant swelling, it’s important to see a specialist. They can offer more advanced treatments and help you manage your condition effectively.

    Early diagnosis and treatment can make a big difference in managing knee pain and preventing further damage.

    Treatment Options for Knee Pain

    Rest and Physical Therapy

    Taking a break from activities that cause pain is often the first step. Resting the knee can help reduce inflammation and give it time to heal. Physical therapy is also important. A therapist can guide you through exercises that strengthen the muscles around the knee, improving stability and reducing pain.

    Medications and Injections

    Over-the-counter pain relievers like ibuprofen can help manage pain and swelling. In some cases, doctors may recommend injections. These can include corticosteroids to reduce inflammation or hyaluronic acid to lubricate the joint.

    Surgical Interventions

    When other treatments don’t work, surgery might be needed. Common procedures include arthroscopy to remove damaged tissue or realignment surgery to correct the position of the kneecap. Surgery is usually considered a last resort after trying other treatments.

    It’s important to talk to your doctor about the best treatment plan for your specific condition. They can help you decide which options are right for you.

    Preventing Knee Pain

    knee pain illustration

    Strengthening Exercises

    Regular exercise is crucial for keeping your knees healthy. Focus on exercises that strengthen the muscles around your knee, like squats and lunges. These exercises help support the knee joint and reduce the risk of injury. Aim to include these exercises in your routine at least three times a week.

    Proper Footwear

    Wearing the right shoes can make a big difference in preventing knee pain. Choose shoes that provide good arch support and cushioning. Avoid high heels and shoes with worn-out soles. If you have flat feet or other foot issues, consider using orthotic inserts for extra support.

    Avoiding Overuse

    It’s important to listen to your body and avoid overusing your knees. Take breaks during activities that put a lot of stress on your knees, like running or jumping. Mix up your workouts to include low-impact activities like swimming or cycling. This helps prevent overuse injuries and keeps your knees in good shape.

    Taking care of your knees now can help you avoid pain and problems in the future. Make these simple changes to your routine to keep your knees healthy and strong.

    Living with Chronic Knee Pain

    Pain Management Techniques

    Living with chronic knee pain can be challenging, but there are ways to manage it. Finding the right pain management techniques is crucial. This might include over-the-counter pain relievers, prescribed medications, or even alternative therapies like acupuncture. It’s important to find what works best for you.

    Lifestyle Adjustments

    Making some changes in your daily routine can help ease knee pain. Simple adjustments like using supportive footwear, avoiding high-impact activities, and incorporating low-impact exercises such as swimming or cycling can make a big difference. Consistency in these changes is key to managing pain effectively.

    Support and Resources

    Having a support system is essential when dealing with chronic knee pain. This can include family, friends, or support groups. Additionally, there are many resources available, such as physical therapy, online forums, and educational materials, to help you navigate your condition.

    Living with chronic knee pain requires patience and persistence. Remember, you are not alone, and there are many ways to find relief and support.

    Conclusion

    Knee pain inside and below the knee cap can be a real bother, but understanding the causes and treatments can help. Remember, it’s important to listen to your body and not ignore the pain. Simple steps like resting, icing, and doing the right exercises can make a big difference. If the pain doesn’t go away, it’s a good idea to see a doctor. They can help figure out what’s wrong and get you back on your feet. Taking care of your knees now can keep them healthy for years to come.

    Frequently Asked Questions

    What is Patellofemoral Pain Syndrome?

    Patellofemoral Pain Syndrome is a condition where you feel pain around your knee cap. It’s often caused by overuse or misalignment of the knee.

    How can I tell if I have Chondromalacia Patella?

    If you have Chondromalacia Patella, you might feel pain under your knee cap, especially when going up or down stairs. Your knee might also make a grinding sound.

    What are the common symptoms of knee tendonitis?

    Common symptoms of knee tendonitis include pain and swelling in the knee area. You may also find it hard to move your knee.

    When should I see a doctor for knee pain?

    You should see a doctor if your knee pain is severe, doesn’t go away, or if you can’t move your knee. Also, if your knee looks deformed, it’s time to see a specialist.

    What can I do to prevent knee pain?

    To prevent knee pain, you can do strengthening exercises, wear proper shoes, and avoid overusing your knee. It’s also good to keep a healthy weight.

    Are there treatments available for chronic knee pain?

    Yes, there are treatments for chronic knee pain. These include physical therapy, medications, and sometimes surgery. Pain management techniques can also help.

  • AI promises to be a helping hand for this orthopedic hand surgeon

    AI promises to be a helping hand for this orthopedic hand surgeon

    Like many of my orthopedic colleagues, I’m a bit of a skeptic when it comes to flashy new technology. I didn’t know what to expect when I decided to test a second AI-powered ambient listening solution last fall. I’d tried one before that didn’t quite live up to expectations. Would NextGen® Ambient Assist live up to its promise of helping me save time by reducing the burden of documentation? I quickly found out that this solution was the real deal.

    For about 1/10th the cost of a scribe, Ambient Assist interprets patient-provider conversations in real time to summarize appointments and deliver SOAP notes directly into the EHR. With one tap, Ambient Assist “listens” to the entire patient encounter and then uses AI to generate an accurate medical note in about 30 seconds. I can review and edit it immediately or at the end of the day—no copy-pasting required because it’s fully integrated into my EHR.

    The technology is advanced enough to remove mundane conversations about the weather or a patient’s weekend plans, so visit notes remain focused on medically important details. Audio and transcripts are never stored or retained, providing an additional measure of security.

    I’ve discovered my own set of “best practices” that help me customize the solution to my preferred workflow. For example, before I see a patient, I like to review their x-rays and dictate my treatment plan notes. This allows me to enter each appointment with more context. I’m careful not to use medical jargon when I’m with patients, as I feel it could cause confusion or unnecessary worry. Instead, I dictate the physical exam as I leave the room and quickly review the note on my phone or iPad.

    I have used Ambient Assist for over 500 appointments since I implemented it in the fall of 2023. My patients appreciate the shorter wait times for appointments: I can see at least 5 more patients per day, and my family appreciates the extra time with me. Meanwhile, I feel more energetic and effective at work and at home.

    Can AI really revolutionize modern medicine? For me, it has been a real helping hand.

    Keith Michael Nord, MD

    Meet The Doctors

    Last updated: July 21, 2024

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  • Health benefit of patients with established rheumatoid arthritis and its influencing factors: a multicenter study in China

    Health benefit of patients with established rheumatoid arthritis and its influencing factors: a multicenter study in China

    Cross-sectional data of RA patients in the intermediate and advanced stages from 8 tertiary hospitals in four provincial capitals Nanjing, Hangzhou, Chengdu and Shijiazhuang (two of each) were obtained, using the Chinese version of the EQ-5D-5L to measure and rate HRQOL. The patients were enrolled by trained investigators based on quota sampling from June to July 2020.

    Participants in the study

    Based on available sources and rules of thumb, a total of 200 patients (50 in each city, male/female = 1:2) were planned for recruitment. The inclusion criteria were: (1) Informed and voluntary; (2) 18-70 years (Given the challenges and precision associated with completing questionnaires by older people, previous research protocols26and available sources); (3) Diagnosed with RA according to the diagnostic criteria of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification (score ≥ 6)27The exclusion criteria were: (1) pregnant women, persons with psychiatric disorders, and patients who were unconscious and unable to express their condition; (2) patients suffering from other serious illnesses such as tumors and myocardial infarction.

    Data collection

    A total of 16 trained interviewers divided into 8 groups were responsible for data collection in each of the 8 hospitals. In the corresponding departments of each hospital during the study (no distinction between outpatients and inpatients), the interviewers introduced the aim and content of the study to the patients and their attending physicians and obtained written informed consent. Then, the consenting patients and physicians were asked to fill out the respective questionnaires independently in a quiet room. If patients have questions about the questionnaire, the interviewers should provide explanations, but they should not guide or actively hinder the patients in filling out the questionnaire. The completed questionnaires were reviewed by the interviewers to identify any obvious errors or missing data. After the questionnaires were retrieved, the data were digitalized and reviewed by 2 independent and transparent auditors.

    Questionnaires for patients and physicians

    Two respective questionnaires for the patients and physicians were provisionally designed based on the literature15.28. Then, based on the opinions of experts, we revised the questionnaires and conducted a pilot survey in 2 tertiary hospitals in Nanjing to validate the rationality, readability, and comprehensibility of the questionnaires. (Since the subjective questions in the questionnaire are all derived from validated scales, we did not repeat the validation of the psychological measurement properties of the questionnaire.) The questionnaires were revised and formed the final version based on the results of the pilot survey and the suggestions of experts based on the results of the pilot survey. The rationality, readability, and comprehensibility of the questionnaire were confirmed by the experts and supported by the pilot survey.

    The patient questionnaire consists of two parts. Part one collected patients’ HRQOL measured by the Chinese version of the EQ-5D-5L and other self-reported outcomes, including general health, arthritis pain, and disease activity. General health was evaluated using a four-level scale: good, general, poor, and very poor. Arthritis pain and disease activity were assessed using two visual analog scales (VAS), respectively. The patient’s assessment of arthritis pain VAS (PtAAP-VAS)29 measured the degree of pain they experienced on the day of the examination: 0 means no pain, 100 means the most severe pain. The patient’s global assessment of disease activity VAS (PtGADA-VAS)30,31 assessed current disease activity: 0 means patients feel very well and have no symptoms, 100 means patients feel very bad and have severe symptoms. Part two used questions to assess patients’ demographic characteristics, including gender, age, ethnicity, height, weight, region, marital status, education level, occupation, types of health insurance, and personal annual income.

    The physician questionnaire assessed the patients’ clinical characteristics and clinician-reported outcomes, including disease stage (based on the results of joint X-ray examination, Grade I/early stage: no bone-destructive changes; Grade II/middle stage: osteoporosis with mild cartilage damage; Grade III~IV/advanced stage: osteoporosis with cartilage or bone destruction and joint deformity)32treatment modalities (inpatient/outpatient), erythrocyte sedimentation rate (ESR) (unit: mm/h), high-sensitivity C-reactive protein (CRP) (unit: mg/L), symptoms and functional capacity, swollen joints (SJC) and tender joints (TJC). Of these, symptoms and functional capacity were assessed using the Physician’s global assessment of disease activity VAS (PhGADA-VAS)30,31 (0 and 100 mean that patients are asymptomatic and normal activities are not limited, and have severe symptoms that cannot be tolerated and are unable to perform normal activities). SJC, TJC, CRP and ESR were used to calculate the 28 joint counts (DAS28) scores, including DAS28-CRP score and DAS28-ESR score33Higher DAS28 scores indicate higher disease activity. Disease activity can be divided into four states, including remission (DAS28 scores < 2.6), low activity group (2.6 ≤ DAS28 scores < 3.2), moderate activity group (3.2 ≤ DAS28 scores < 5.1), and high activity group (DAS28 scores ≥ 5.1)33.

    EQ-5D-5L

    Compared with EQ-5D-3L, EQ-5D-5L has improved measurement properties in terms of health status descriptive system and HUV34; and its reliability and validity have been verified in China35The descriptive system assesses the subjects’ health status on the day of the survey on five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each using five severity levels (no problems, mild problems, moderate problems, severe problems, and unable/extreme problems) and produces a total of 3125 (55) health conditions34. Each health condition can be expressed by a 5-digit number. For example, “12.345” means no difficulty with mobility, mild difficulty with self-care, moderate difficulty with usual activities, severe pain/discomfort, and extremely anxious/depressed. All health conditions defined by the system can be converted into HUVs using a value set. In this study, Chinese version of the EQ-5D-5L and the value set36 for China was adopted. The EQ-5D-5L also includes the EQ visual analogue scale (EQ-VAS) which assesses subjects’ self-reported health status via a straight line (0: the worst health you can imagine; 100: the best health you can imagine)34.

    Data analysis

    Descriptive statistics

    Descriptive statistics such as mean and standard deviation (SD) for continuous variables, frequency and percentage for categorical variables were used to present the characteristics and outcomes of the patients. The distribution of EQ-5D-5L data (i.e., responses to each dimension, HUV, and VAS score) of the patients with different characteristics were presented. The skewness and kurtosis of EQ-5D-5L HUV were also shown. We also compared the mean age (P> 0.1) and sex ratio (P< 0.01) of patients with that of Chinese RA patients15,37,38and the EQ-5D-5L data weighted by the sex ratio of Chinese RA patients37.

    Univariate analysis

    To identify significant factors of the patients’ HUV, Kruskal-Wallis test or univariate regression were performed on the categorical variables or continuous variables, respectively. The variables included patient characteristics and patient/clinician-reported outcomes, of which age, body mass index (BMI), and the person’s annual income were included as categorical variables. Kruskal-Wallis test was also performed on the patients’ responses to EQ-5D-5L.

    Multivariable analysis

    The beta model was used for the multivariable regression analysis due to the characteristics of HUV distribution (i.e., non-normally distributed and censored at (1). The beta model required the value of the dependent variable to be between 0–1. The EQ-5D-5L scores were adjusted via the formula: adjusted score = (original score + 0.391)/1.391 (The range of EQ-5D-5L score was -0.391 to 1 based on the Chinese value set. If the original score was -0.391 or 1, the adjusted score was added or subtracted e−12 to ensure that it fell between 0 and 1.) Since the sex ratio in the sample was different from that of Chinese RA patients, we used the sex weighting in the regression. The dependent variable was the EQ-5D-5L HUV. Referring to the recommendations of clinical experts, literature15,16,17and the results of univariate analysis, some of the characteristics and outcomes were included as explanatory variables in the regression analysis. To reduce multicollinearity among the variables, Spearman rank correlations were used to test the correlations among them (correlation coefficients: very weak = 0–0.19; weak = 0.20–0.39; moderate = 0.40–0.59; strong = 0.60–0.79; and very strong = 0.80–1.00). For a few variables with the coefficient higher than 0.4, the variable that was also more correlated with other variables would be excluded (Supplementary material Appendix 1). The variables entered into the final model are related to the EQ-5D-5L score, but the correlation among these variables is low, including demographic variables age, gender, BMI, and place of residence; and clinical variables PtGADA-VAS, DAS28-ESR, disease stage and treatment modalities (the correlation heatmap is shown in Fig. 1). Finally, we would measure the multicollinearity in the regression model via the variance inflation factor (VIF).

    Figure 1
    Figure 1

    The correlation heatmap of variables.

    All of the above analyses were performed on Microsoft® Excel 2021 and stata15.

    Ethical approval and consent to participate

    This study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the Clinical Trial Ethics Committee. Clinical Trial Ethics Committee of Huashan Hospital Affiliated to Fudan University (Reference number 2019–252). Written informed consent to participate was signed by all participants.

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  • 3D Shaper technology, an innovative approach to bone analysis

    3D Shaper technology, an innovative approach to bone analysis

    The 3D Shaper Technology emerges as a breakthrough solution to combat the silent but debilitating threat of osteoporosis, a bone disease that has long been a major concern for millions of people worldwide. Accurate diagnosis and monitoring of bone health has been paramount in combating this condition.

    3D Shaper only looks at the hip. Not the spine.

    This chronic condition weakens bones over time, making them fragile and susceptible to fractures. The consequences of osteoporosis can be severe, leading to reduced quality of life, increased risk of disability, and significant healthcare costs. Early detection and effective management are crucial to mitigating the impact of this disease. Enter 3D Shaper Technology, a revolutionary advancement that promises to transform the way we diagnose and treat osteoporosis.

    3D Shaper technology, a groundbreaking innovation

    This advanced technology, developed by 3D Shaper Medical, a Barcelona-based company, takes the standard 2D DEXA scan and recreates the hip bone in a remarkable 3D representation. This groundbreaking approach makes it possible to extract valuable information about the cortical (hard outer shell) and trabecular (soft inner surface) compartments of the bone – aspects often overlooked by traditional DEXA scans.

    By using advanced imaging techniques and statistical modeling, 3D Shaper Technology can transform a generic template into a patient-specific 3D model of the patient. hip bone. This process involves registering the template against the patient’s 2D DEXA scan and adjusting the parameters until perfect alignment is achieved, resulting in an accurate 3D representation. This innovative technology provides healthcare professionals with unprecedented insight into the intricate details of bone structure and density distribution.

    Customized treatment plans for optimal bone health

    The 3D Shaper Technology provides a fast, safe and cost-effective method for assessing bone density and visualizing local changes in the cortical and trabecular compartments, addressing the limitations of DEXA alone. By providing detailed analysis of the individual compartments of the bone, it enables healthcare professionals to tailor treatment plans and medication choices to the unique needs of each patient. This personalized approach is especially critical when considering potent osteoporosis medications, ensuring the most effective treatment is prescribed from the outset.

    Cortical and trabecular compartments

    The ability to assess the cortical and trabecular compartments independently provides a more nuanced understanding of bone health. Clinicians can identify local fragility or discrepancies between the two compartments that may have been missed by conventional DEXA scans. Armed with this knowledge, they can make informed decisions about the appropriate course of action, whether that is initiating treatment with a specific medication or modifying an existing regimen.

    Advanced Bone Health Monitoring with 3D Shape

    One of the key advantages of this technology is its ability to monitor treatment progress with greater accuracy. While DEXA scans can show minimal changes in bone mineral density, the 3D Shaper can detect significant improvements or decreases in the cortical and trabecular compartments – invaluable insights that can inform decisions to modify or continue a treatment regimen. Additionally, the 3D Shaper technology has proven its versatility in assessing the impact of various diseases and medications on bone health.

    From chronic kidney disease to breast cancer treatments, this innovative tool provides a comprehensive view of how these conditions and therapies impact the complex components of bone structure. By separating the cortical and trabecular compartments, clinicians can identify specific areas of concern and tailor interventions accordingly, maximizing treatment effectiveness and minimizing potential side effects.

    A new era in osteoporosis care

    Although 3D Shaper Technology is still in the early stages of adoption in the United States, its potential to revolutionize osteoporosis diagnosis and management is undeniable. As more healthcare facilities embrace this cutting-edge solution, patients will benefit from personalized care, customized treatment plans, and new hope in the fight against this debilitating condition.

    The technology’s ability to provide individualized assessments and accurate monitoring allows healthcare professionals to make informed decisions, ultimately improving patient outcomes. In the words of Irma Jennings, an osteoporosis patient navigator who presented the 3D Shaper Technology, “This is an important thing to get out there.” Indeed, the future of osteoporosis care has taken a remarkable step forward, and the 3D Shaper Technology stands as a beacon of hope for millions of people seeking a better understanding and more effective management of this complex disease.

    30 Essential Foods for Bone Health

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  • You Are Not Alone – Depression, Stress and Anxiety in the Locker Room

    You Are Not Alone – Depression, Stress and Anxiety in the Locker Room

    Trends in student-athlete mental health in the National College Health Assessment, 2011-2019.

    Edwards B, Froehle AW and Fagan SE. J Athl training. 2023,58(4):361-373. doi: 10.4085/1062-6050-0586.21.

    Full text available for free

    Take home message

    College athletes and non-athletes are under a great deal of stress. Reported mental health symptoms and diagnoses are increasing, with 1 in 3 college students reporting a recent diagnosis. Fortunately, more college students are reporting receiving mental health information from institutions and treatment-seeking behaviors over time.

    Background

    Awareness of mental health issues is increasing among the general public, including college athletics. Educational efforts and access to mental health resources have increased, but it is unclear whether these efforts have improved student-athletes’ mental health and treatment seeking.

    Study Objective

    Edwards and colleagues analyzed 8 years of survey data to examine how the mental health of student-athletes, compared to their non-athlete peers, changed between 2011 and 2019.

    Methods

    Researchers obtained data from the National College Health Assessment. The data, which spanned 8 academic years, were reported anonymously by students at participating institutions. Respondents were classified as “athletes” or “non-athletes” based on their responses to specific survey questions. Researchers excluded students who participated only in club or intramural sports. The survey included “yes” or “no” questions grouped into 5 outcome groups: 1) “recent mental health symptoms,” 2) “recent mental health diagnosis,” 3) “mental health treatment seeking behavior,” 4) “mental health information received from institutions,” and 5) “recent impact of mental health on academic performance.”

    Results

    A total of 502,780 students from 607 unique institutions completed the surveys and met the inclusion criteria. This included over 54,400 athletes and 448,300 non-athletes. The main results are described in the table, which show that more students received mental health information from institutions and sought treatment or would consider treatment over time. Meanwhile, more students reported recent mental health symptoms/diagnoses and effects on academic performance over time. Student-athletes were less likely to report mental health symptoms/diagnoses and treatment-seeking behavior. However, more student-athletes reported mental health information from institutions.

    Changes over time Differences between groups
    Recent mental health symptoms Increased over time Athletes < Non-athletes
    Recent mental health diagnosis Increased over time Athletes < Non-athletes
    Behavior Seeking Treatment for Mental Health Improved over time Athletes < Non-athletes
    Receiving mental health information from institutions Improved over time Athletes > Non-athletes
    The Recent Impact of Mental Health on Academic Performance Increased over time Athletes < Non-athletes

    Positions

    More than 1 in 5 students reported symptoms of depression. A majority of students reported feeling very sad, very lonely, exhausted, or overwhelmed. Over the 8 years, we went from 1 in 5 students reporting a diagnosis of a mental health condition to 1 in 3 students. It is encouraging that treatment seeking behaviors and access to mental health information have increased over time. This study cannot address whether the increased symptoms/diagnoses of mental health are due to increased prevalence or increased ease of reporting. As access to educational materials increases, it would stand to reason that reporting of mental health issues would also increase. While the trends over time are encouraging, the overall numbers are still discouraging and we need to do more to encourage student-athletes to seek treatment.

    Clinical implications

    Clinicians need to know that athletes and non-athletes are under immense pressure due to the college experience. This requires clinicians to be fully aware of the signs and symptoms of mental health issues and have an appropriate and empathetic plan to help their athletes get the right treatment. We must also continue to reduce stigma and increase awareness among athletes that treatments are available.

    Questions for discussion

    What changes have you observed regarding mental health awareness, recognition, and treatment in student-athletes? What specific strategies do you think have had the most impact on mental health awareness, recognition, or treatment in student-athletes?

    Written by Kyle Harris
    Reviewed by Jeffrey Driban

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    Many NCAA Clinicians Fail to Screen for Mental Health
    Fresh air can improve performance.
    Want to get better? Take a nap!

    Evidence-Based Assessment of Concussion Course - 5 EBP CEUs

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  • The health technology device that helps people fight insomnia, reduce stress and manage anxiety with Stefanie Broes + BoneCoach™ Osteoporosis and Osteopenia – BoneCoach™

    The health technology device that helps people fight insomnia, reduce stress and manage anxiety with Stefanie Broes + BoneCoach™ Osteoporosis and Osteopenia – BoneCoach™

    What if the key to better health was right under your nose?

    We’re going to explore the hidden power of something you do 22,000 times a day, without even thinking about it…

    To breathe.

    Come with me as I sit with you Stefanie Broesan expert in pharmaceutical sciences, who’s here to reveal how a simple change in the way you breathe could be the game-changer you didn’t know you needed – for your sleep, your stress levels and even your bones.

    We introduce you to Moonbird, a revolutionary device making waves in the world of wellness, and explain why everyone from insomniacs to patients with osteoporosis pay attention to this old practice with a modern twist.

    Episode Timeline

    0:00 – Episode Beginning

    2:27 – Meet Stefanie Broes, CEO and co-founder of Moonbird

    3:45 – Explanation of the science behind breathing techniques and their impact on overall health and well-being

    05:50 – How breathing techniques help reduce stress and anxiety, and why it’s important for people with osteoporosis

    8:22 – Details about the Moonbird device: what it is, how to use it, and how it helps with stress and insomnia

    10:52 – How Moonbird is different from other health technology products on the market

    12:10 – How breathing exercises can improve sleep quality, especially in older adults, and their benefits for bone health

    14:34 – The importance of sleep for bone health, including the risks associated with sleep deprivation and its impact on bone formation and remodeling

    15:58 – Real success stories from Moonbird users

    18:12 – Simple breathing exercises that listeners can begin to improve their health and well-being

    19:32 – Future plans for Moonbird and the future of breathwork in the health tech industry

    21:19 – Recommendation of the book “Breath” by James Nestor for more insight into the importance of breathing

    21:48 – Special offer and where to find more information about Moonbird products

    22:55 – Stefanie’s final tips for listeners

    Sources mentioned

    **Show notes @ https://bonecoach.com/stefanie-broes-moonbird-life-health-tech

    Below you will find Stefanie’s sources!

    >> $10 OFF with code BONECOACH

    >> https://www.moonbird.life/

    >> https://www.instagram.com/moonbird.life

    What can you do to support your bone health and this podcast?

    1. Click the “Subscribe” button on your respective podcast player (e.g. Apple, Google, Spotify, Stitcher, iHeart Radio, and TuneIn). Never miss an episode that can help improve your bone health.

    2. Leave a review. The more positive ratings and reviews and the more subscribers we have, the more people can find us and get the answers to the questions they need. Thank you! 🙂

    3. Tell a friend about The Bone Coach Podcast or share via text, email, or social. Know of a Facebook group where people could benefit from this info? Feel free to click one of the share buttons below.

    About Stefanie Broes:

    Stefanie is the CEO and co-founder of Moonbird, a health tech startup operating in the wellness sector. Moonbird is the world’s first wearable breath pacer and is all about making breathwork accessible so people can live healthier, happier lives.

    The product is used to reduce stress, manage anxiety and combat insomnia. Stefanie has a medical background, a PhD in pharmaceutical sciences and a master’s degree in IP and data protection law. When she discovered how effective breathing exercises are in tackling her own insomnia, she delved deeper into the subject and eventually started the company to help more people discover the positive effects of slow breathing.

    Medical disclaimer

    The information shared above is for informational purposes only and is not intended to provide medical or nutritional advice; it does not diagnose, treat, or cure any disease, condition; it should not be used as a replacement or substitute for medical advice from physicians and trained medical professionals. If you are under the care of a healthcare professional or are currently taking prescription medications, you should discuss any changes to your diet and lifestyle or possible use of dietary supplements with your doctor. You should not discontinue any prescribed medications without first consulting your doctor.



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  • Twee-fase resorptie met TrelCor®-technologie | Biogennix

    Twee-fase resorptie met TrelCor®-technologie | Biogennix

    Bottransplantaatresorptie: een inleiding

    Zoals besproken in een eerdere blog over botafbraakde processen van botmodellering en botremodellering kunnen worden beschreven als een gecoördineerde interactie tussen stamcellen, osteocyten, osteoblasten en osteoclasten. Of bot modellering of remodellering is, hangt af van de balans tussen de resorptie van bestaand bot en de vorming van nieuw bot.

    Dezelfde cellen die bij deze processen betrokken zijn, spelen ook een rol bij de genezingsreactie op bottransplantaatmaterialen. Nadat bottransplantaatmateriaal tijdens een operatie bij een patiënt is geïmplanteerd, begint de botvormingsreactie met de vorming van nieuw bot op het transplantaatoppervlak en vervolgens via de porositeit ervan, indien aanwezig. Naarmate er meer bot het implantaatgebied vult, zullen de cellen het transplantaatresorptieproces initiëren. Uiteindelijk is het doel van het geïmplanteerde transplantaatmateriaal om volledig te worden opgevuld met nieuw bot en na verloop van tijd volledig te worden geresorbeerd.

    Ongeacht het type bottransplantaatmateriaal dat bij een patiënt is geïmplanteerd, speelt de snelheid waarmee dat transplantaat resorbeert een belangrijke rol in het genezingsproces. De meeste transplantaten resorberen met een vaste snelheid, bepaald door hun materiaalsamenstelling. In tegenstelling tot andere synthetische middelen op de markt, is de geavanceerde TrelCor van Biogennix®-gebaseerde transplantaatmaterialen zorgen voor een optimale resorptie in twee fasen die aansluit bij de unieke botvormingssnelheid van de patiënt. In deze blog wordt het proces van TrelCor-resorptie en de gunstige effecten ervan op het genezingsproces gedetailleerd beschreven.

    Voordat we leren hoe de tweefasenresorptie van TrelCor plaatsvindt, gaan we eerst kijken hoe resorptie er radiografisch uitziet. Nadat een bottransplantaatproduct chirurgisch is geïmplanteerd bij een patiënt, willen clinici mogelijk de resorptie van het transplantaat beoordelen om te weten hoe goed de patiënt geneest na de operatie. Meestal gebruiken chirurgen röntgenfoto’s (röntgenfoto’s) of computertomogrammen (CT’s) om te zien wat er in de patiënt gebeurt in de loop van de tijd. Afhankelijk van de samenstelling van een bottransplantaatmateriaal kan de zichtbaarheid ervan op röntgenfoto’s/CT’s variëren van radiolucent (niet zichtbaar) tot radiopaak (zichtbaar). Tijdens de operatie en bij vervolgafspraken van de patiënt is het waardevol om een ​​relatief radiopaak transplantaatmateriaal te hebben dat visueel kan worden geïdentificeerd. Hierdoor kunnen clinici eenvoudig de exacte plaats zien waar het transplantaatmateriaal is geplaatst en de botvorming in dit gebied in de loop van de tijd volgen.

    Sommige transplantaatmaterialen, zoals TrelCor, zijn zichtbaar op een röntgenfoto. Dankzij deze eigenschap kunnen clinici de voortgang van botvorming in de loop van de tijd visualiseren. Direct na implantatie hebben op TrelCor gebaseerde transplantaatmaterialen een gegranuleerd radiografisch uiterlijk met duidelijke randen. Naarmate er nieuw bot begint te vormen op het oppervlak en binnen de porositeit van TrelCor, worden de randen van het implantaat minder gedefinieerd. Vervolgens, naarmate resorptie van het transplantaatmateriaal optreedt en de hoeveelheid nieuw bot toeneemt, is het transplantaat niet langer zichtbaar en lijkt de plek volledig opgevuld met het eigen bot van de patiënt.

    Tdoor Materiaal SamenstellingN

    SEM-dwarsdoorsnede van de HCA- en calciumcarbonaatlagen van TrelCor.
    Figuur 1: SEM-beelden van de HCA-oppervlaktelaag op TrelCor-korrels (rechtsboven) en dwarsdoorsnede van TrelCor-korrels waarop de HCA-oppervlaktelaag en de calciumcarbonaat (CC)-kern te zien zijn (rechtsonder).

    Bij standaard keramische synthetische bottransplantaatmaterialen bepaalt de samenstelling van het transplantaatmateriaal of het transplantaat snel of langzaam zal resorberen. Bijvoorbeeld hydroxyapatiet (HA) [Ca10(PO4)6(OH)2] en tricalciumfosfaat (TCP) [Ca3(PO4)2] zijn beide calciumfosfaatkeramieken die vaak worden gebruikt als bottransplantaatmaterialen. Hun verschillende samenstellingen resulteren in een langzame resorptiesnelheid voor HA (~1% per jaar) en een snellere resorptiesnelheid voor TCP (6-24 maanden). Deze resorptietijden zijn inherent aan de materialen en kunnen alleen worden gewijzigd door HA en TCP te combineren (bifasisch calciumfosfaat – BCP) of door de structuur van het bottransplantaat aan te passen, wat invloed heeft op het oppervlak voor botgroei en resorptie.

    TrelCor verschilt van standaard HA- of TCP-bottransplantaten doordat het een samenstelling met twee regio’s heeft: het oppervlak bestaat uit hydroxycarbanoapatiet (HCA) [Ca10(PO4)x(CO3)y(OH)z] en de kern is calciumcarbonaat (CaCO3) (Figuur 1). Omdat HCA langzamer resorbeert vergeleken met calciumcarbonaat, wordt de resorptie van TrelCor direct gecontroleerd door de dikte van het langzamer resorberende HCA-oppervlak. Als gevolg hiervan, de dikte van de HCA-laag werd geoptimaliseerd tot ~5MMwat voldoende tijd biedt voor botgroei om over het oppervlak te ontstaan ​​voordat het volledig wordt geresorbeerd. Deze combinatie van HCA en calciumcarbonaatsamenstelling stelt TrelCor in staat om een ​​patiëntspecifieke respons te bieden.

    Hoe Dual-Stage ResoRptie van TrelCor Okomt voor

    Patiënten resorberen en hermodelleren bot met verschillende snelheden op basis van hun leeftijd, gezondheid, de grootte van het botdefect en andere factoren. Het ideale resorptieprofiel is er een dat kan worden gecontroleerd door de eigen botvormingssnelheid van elke patiënt. Bijvoorbeeld, kleine, ingeperkte defecten bij kinderen zullen waarschijnlijk sneller bot regenereren, dus een sneller resorberend transplantaat zou ideaal zijn. Omgekeerd zou botvorming bij een oudere patiënt die een grote, complexe spinale fusie ondergaat, plaatsvinden met een langzamer tempo. In dit geval zou een optimaal transplantaat langer meegaan en een langzamere resorptiesnelheid hebben om overeen te komen met de langzamere botvormingssnelheid van de patiënt.

    Het doel van een resorbeerbaar bottransplantaatproduct is om te functioneren als een steiger zolang het duurt om nieuw bot te vormen. Pas dan zou de steiger moeten beginnen met resorberen. Met dit in gedachten is TrelCor specifiek ontworpen om te resorberen naarmate het bot in de porositeit en op het oppervlak groeit. Zoals behandeld in Blog19osteoblasten (botvormende cellen) signaleren de vorming van osteoclasten (bot- en transplantaatresorberende cellen), en vice versa. Het onderstaande proces en Figuur 2 beschrijf gedetailleerd hoe de twee-fase resorptie van TrelCor-gebaseerde transplantaatmaterialen plaatsvindt:

    • Na de implantatie vindt in eerste instantie botvorming plaats op het TrelCor-materiaal dat direct in contact staat met het omliggende bot.
      Het proces van botresorptie met behulp van de TrelCor-technologie van Biogennix.
      Figuur 2: Belangrijke gebeurtenissen die optreden tijdens botregeneratie en resorptie van TrelCor-bottransplantaatproducten.
    • Botgroei verloopt geleidelijk over het oppervlak van het TrelCor-poriesysteem totdat de gehele korrel bedekt is met nieuw bot. Dit proces gaat door naar elke aangrenzende korrel.
    • Naarmate het bot op het oppervlak van de TrelCor-korrels dikker wordt, geven de osteoblasten in dit nieuwe botgebied een signaal aan de osteoclasten om met het resorptieproces te beginnen.
    • Eenmaal geactiveerd, beginnen de osteoclasten de HCA-oppervlaktelaag te resorberen. Omdat het HCA-oppervlak langzamer resorbeert, geeft dit de botvormingsreactie voldoende tijd om het TrelCor-oppervlak volledig te bedekken en de porositeit op te vullen.
    • Nadat de osteoclasten het HCA-oppervlak hebben doorbroken, beginnen ze agressief het onderliggende calciumcarbonaat te resorberen.
    • Vervolgens vindt er nieuw botvorming plaats in het calciumcarbonaatgebied.
    • Uiteindelijk resorberen osteoclasten het hele transplantaat en is het proces voltooid. Het gebied dat ooit werd ingenomen door het TrelCor-transplantaat is nu volledig vervangen door bot.

    Dit effect is duidelijk te zien in histologie afbeeldingen van in vivo-onderzoeken die tonen de helende reactie van TrelCor materialen. In één onderzoek werd TRelCor werd gecombineerd in een 1:1 verhouding met autograft en geïmplanteerd in de posterolaterale wervelkolom van konijnen. Na 12 weken beide een prominent bot formatie respons was zichtbaar, zoals was de resorptie antwoord. Dit tijdstip legde specifiek de initiële resorptie van de HCA-laag en de penetratie van nieuw bot in het calciumcarbonaatgebied vast. Figuur 3 toont een SEM-histologie afbeelding die gekleurd is om de nadruk te leggenze dit effect. Op deze afbeelding, de dubbele samenstelling van TrelCor korrel is zichtbaar met het calciumcarbonaat (groente) en het HCA-oppervlak (wit). Bot (geel) is Ook gezien groeien op het oppervlak van de korrels en doordringend het calciumcarbonaatgebied.

    Histologisch beeld van botvorming die de TrelCor HCA-laag doorbreekt en calciumcarbonaat binnendringt.
    Figuur 3: Histoloogik ik benleeftijd die botvorming laat zien in porositeit, inbreuk makenG van TrelCor HCA-laag, En resorptie van calciumcarbonaatkern gevolgd door extra bot vorming.

    Voordelen van Dual-Stage Bottransplantaat Resorptie

    Resorptie van bottransplantaatmaterialen is belangrijk omdat bottransplantaten voornamelijk functioneren als een steiger voor nieuwe botgroei. Als de steiger te snel resorbeert (voordat de botvorming is voltooid), kan er een holte ontstaan ​​en kan de operatie mislukken. Als het te langzaam resorbeert, neemt het implantaat ruimte in die moet worden opgevuld met nieuw bot.

    Zoals blijkt uit het TrelCor-resorptieproces, kan de balans tussen botvorming en -resorptie worden geregeld door de dikte van het HCA-gebied. Met tientallen jaren ervaring hebben wetenschappers van Biogennix de dikte van de HCA-laag verfijnd om een ​​geavanceerd bottransplantaatmateriaal te creëren met een optimaal resorptieprofiel dat is afgestemd op elke patiënt, d.w.z. “geduldig-gecontroleerde” resorptieDeze geavanceerde bottransplantaateigenschap is uniek voor TrelCor; geen enkel ander bottransplantaatproduct op de markt bezit deze mogelijkheid.

    Verband tussen de snelheid van radiografische resorptie van TrelCor-granulaat en de tijd na implantatie, en de resorptie- en fusiesnelheid van TrelCor.
    Figuur 4: Fusieresorptiegegevens van klinische onderzoeken met 60 patiënten studie. (Gegevens in bestand)

    Bij de tweefasen-resorptierespons van TrelCor worden er uiteindelijk meer osteoclasten geactiveerd als een patiënt snel bot vormt, bijvoorbeeld bij een jonge gezonde patiënt. Dit versnelt de resorptie van de TrelCor HCA-laag en maakt extra botvorming in het calciumcarbonaatgebied mogelijk. Omgekeerd, als de patiënt bot vormt in een langzamer tempo, bijvoorbeeld bij een oudere diabetespatiënt, vertraagt ​​de osteoclastactivatie ook. Dit geeft de botvormingsrespons voldoende tijd om in zijn eigen tempo te vorderen en uiteindelijk de porositeit van TrelCor op te vullen. In dit langzamere genezingsproces treedt het osteoclastproces volledig in werking zodra er voldoende bot is gevormd en maakt het verdere botvorming in het calciumcarbonaatgebied mogelijk.

    Dit “patiëntgecontroleerde” resorptie werd gezien in een multicenter klinische studie met 60 patiënten die de fusie- en resorptierespons van TrelCor-bottransplantaatmateriaal evalueerde dat was geïmplanteerd met autograft bij patiënten met spinale fusie. In deze studie werden zowel fusie als resorptie radiografisch beoordeeld en gescoord op een schaal van 1-4 (1 = geen fusie/resorptie; 4 = volledige fusie/resorptie). Zoals getoond in Figuur 4de progressie van fusies is direct gerelateerd aan de progressie van resorptie met een piekresorptie die over het algemeen optreedt na 6-9 maanden. Deze studie bevestigde de effectiviteit van de dual-stage resorptie van TrelCor.

    De verschuiving Richting Geavanceerde synthetische bottransplantaatproducten

    Terwijl de meeste commercieel verkrijgbare bottransplantaatproducten worden geresorbeerd met een vaste snelheid op basis van hun materiaal samenstellingNext-generatie geavanceerd bottransplantaten werden ontworpen om meer te doen. Geavanceerde synthetische producten zoals TrelCor-gebaseerde bottransplantaatproducten bieden uniek Eigenschappen waar chirurgen, ziekenhuizen en vooral patiënten baat bij hebben. TrelCor-bottransplantaten met hun tweefasensamenstelling zorgen voor een optimale “patiëntgecontroleerde” resorptie, wat aanzienlijke voordelen biedt ten opzichte van ‘one-size-fits-all’” eerste generatie materialen die vandaag de dag nog steeds worden gebruikt. Het is geen verrassing dat de markt steeds meer een verschuiving zien naar meer geavanceerde synthetische bottransplantaatmaterialendie bieden duidelijke voordelen ten opzichte van technologieën van de eerste generatie.

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