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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_16 | Pages 9 - 9
1 Apr 2013
Oh Y Wakabayashi Y Kurosa Y Ishizuki M Okawa A
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Introduction

Since the concept of severely suppressed bone turnover (SSBT) after long-term bisphosphonate (BPs) use, SSBT have been believed as the major cause of low-energy femoral fractures, which are called atypical femoral fractures. Here we present several cases of stress fractures with bowing femoral shaft deformity, which can be another cause of low-energy femoral fractures in the elderly.

Materials and Methods

From 1998 to 2012, we treated thirteen cases of low-energy fractures of femoral shaft. All cases were females with an average age of 77.0 (67–88) years. Retrospectively, we assessed fracture type, X-ray of contralateral side, bowing deformity of femur, and duration of BPs use.


The Journal of Bone & Joint Surgery British Volume
Vol. 83-B, Issue 4 | Pages 491 - 495
1 May 2001
Takahashi M Haro H Wakabayashi Y Kawa-uchi T Komori H Shinomiya K

It has been suggested that matrix metalloproteinase-3 (MMP-3, stromelysin-1) has an important role in the degeneration of intervertebral discs (IVDs). A human MMP-3 promoter 5A/6A polymorphism was reported to be involved in the regulation of MMP-3 gene expression. We suggest that IVD degeneration is associated with 5A/6A polymorphism.

We studied 54 young and 49 elderly Japanese subjects. Degeneration of the lumbar discs was graded using MRI in the younger group and by radiography in the elderly. 5A/6A polymorphism was determined by polymerase-chain reaction-based assays. We found that the 5A5A and 5A6A genotype in the elderly was associated with a significantly larger number of degenerative IVDs than the 6A6A (p < 0.05), but there was no significant difference in the young. In the elderly, the IVD degenerative scores were also distributed more highly in the 5A5A and 5A6A genotypes (p = 0.0029).

Our findings indicate that the 5A allele is a possible risk factor for the acceleration of degenerative changes in the lumbar disc in the elderly.