Osteology

Bone remodeling is a dynamic process involving bone resorption and formation that is regulated on a cellular level and impacted by mechanical stress. A variety of Orthopedic surgery treatment strategies can affect bone remodeling, which can in turn may have long-term impacts on skeletal stress tolerance and function. This review provides a comprehensive overview of bone remodeling involved in Orthopedic surgery. Materials related to bone remodeling principles across Orthopedic surgery domains were selected and compiled using databases including PubMed, MEDLINE, AccessMedicine, and CINAHL; case studies were not included. Relevant literature was summarized for a general review of bone remodeling and as it relates to treatment principles in trauma, arthroplasty, and amputation with the aim of providing a relevant, comprehensive review. Overall, the purpose of this review is to provide an overview of bone remodeling principles that are implicated in various techniques within Orthopedic surgery.

Background: Low peak bone mass (PBM) is a major contributor to later osteoporosis risk. This study sought to understand young people’s knowledge of factors associated with bone health. Methods: Young people in Aotearoa New Zealand were approached. Eight focus groups (26 participants in total, aged 11 to 17 years) were conducted using a semi-structured approach with open-ended questions and prompts. Transcripts were thematically coded using an inductive content analysis approach. Results: Knowledge of factors associated with good bone health was limited. There was a general awareness of the positive and negative impacts of many lifestyle behaviours on health generally, but not specifically PBM. Dairy intake was commonly mentioned as being beneficial for bone health. Some participants reported potential benefits of sport, but most did not know that weight bearing activity specifically was beneficial. Conclusions: Knowledge of osteoporosis and lifestyle factors that impact PBM was limited. Educational interventions involving promotion of bone health knowledge and supporting weight bearing physical activity in adolescents may be an important contributor to public health strategies.

Background/Objectives: To determine whether patients under 30 years of age who have experienced symptoms for a duration of less than 1 year before undergoing hip arthroscopy (HA) for femoracetabular impingement (FAI) have better patient-reported outcomes than patients aged 40 years or older who have experienced symptoms for a duration of more than 1 year. Methods: This is a single-center, single-surgeon, retrospective analysis performed between August 2007 and May 2023 analyzing patients who underwent hip arthroscopy. Patients were divided into those who were 18 to 30 years old and patients that were 40 years and older. All patients who underwent primary hip arthroscopy for FAI and had completed mHHS or NAHS surveys prior to surgery with at least a 2-year follow-up were initially included in the study. Patients were excluded if they had no symptom duration information documented in their electronic medical record, a history of inflammatory arthritis, previous ipsilateral hip surgery, or future conversion to total hip arthroplasty (THA) before final follow-up. Results: A total of 236 hip arthroscopies were analyzed, including 147 patients ≥40 years and 89 patients 18–30 years, with symptom duration being significantly longer in the older cohort (28.4 vs. 17.5 months, p < 0.001). At 2 years, there was no difference in mHHS or NAHS between groups; however, younger patients with shorter symptom duration were more likely to achieve PASS for NAHS (87.5% vs. 58.7%, p = 0.036). At 5 years, the older cohort showed greater improvement in mHHS (33.1 vs. 22.9, p = 0.048), while patients 18–30 years continued to demonstrate higher absolute mHHS and NAHS at both 2 and 5 years. Regression analysis confirmed that increasing age was associated with lower PROs at follow-up. Conclusions: There was a significantly greater number of patients who achieved PASS for NAHS at 2-year follow-up for patients who were 18–30 years old with symptom duration ≤ 1 year compared to those aged 40+ years old with symptom duration ≥ 1 year. Additionally, patients ≥40 years old experienced a significantly longer symptom duration before surgery and had worse outcomes for mHHS and NAHS at 2- and 5-year follow-up compared to the 18–30 year cohort.