Skip to main content
Erschienen in: Osteoporosis International 7/2013

01.07.2013 | Original Article

Bisphosphonates as a supplement to exercise to protect bone during long-duration spaceflight

verfasst von: A. LeBlanc, T. Matsumoto, J. Jones, J. Shapiro, T. Lang, L. Shackelford, S. M. Smith, H. Evans, E. Spector, R. Ploutz-Snyder, J. Sibonga, J. Keyak, T. Nakamura, K. Kohri, H. Ohshima

Erschienen in: Osteoporosis International | Ausgabe 7/2013

Einloggen, um Zugang zu erhalten

Abstract

Summary

We report the results of alendronate ingestion plus exercise in preventing the declines in bone mass and strength and elevated levels of urinary calcium and bone resorption in astronauts during 5.5 months of spaceflight.

Introduction

This investigation was an international collaboration between NASA and the JAXA space agencies to investigate the potential value of antiresorptive agents to mitigate the well-established bone changes associated with long-duration spaceflight.

Methods

We report the results from seven International Space Station (ISS) astronauts who spent a mean of 5.5 months on the ISS and who took an oral dose of 70 mg of alendronate weekly starting 3 weeks before flight and continuing throughout the mission. All crewmembers had available for exercise a treadmill, cycle ergometer, and a resistance exercise device. Our assessment included densitometry of multiple bone regions using X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and assays of biomarkers of bone metabolism.

Results

In addition to pre- and post-flight measurements, we compared our results to 18 astronauts who flew ISS missions and who exercised using an early model resistance exercise device, called the interim resistance exercise device, and to 11 ISS astronauts who exercised using the newer advanced resistance exercise device (ARED). Our findings indicate that the ARED provided significant attenuation of bone loss compared with the older device although post-flight decreases in the femur neck and hip remained. The combination of the ARED and bisphosphonate attenuated the expected decline in essentially all indices of altered bone physiology during spaceflight including: DXA-determined losses in bone mineral density of the spine, hip, and pelvis, QCT-determined compartmental losses in trabecular and cortical bone mass in the hip, calculated measures of fall and stance computed bone strength of the hip, elevated levels of bone resorption markers, and urinary excretion of calcium.

Conclusions

The combination of exercise plus an antiresoptive drug may be useful for protecting bone health during long-duration spaceflight.
Literatur
1.
Zurück zum Zitat Rambaut PC, Johnston RS (1979) Prolonged weightlessness and calcium loss in man. Acta Astronaut 6:1113–1122PubMedCrossRef Rambaut PC, Johnston RS (1979) Prolonged weightlessness and calcium loss in man. Acta Astronaut 6:1113–1122PubMedCrossRef
2.
Zurück zum Zitat Rambaut PC, Leach CS, Whedon GD (1979) A study of metabolic balance in crewmembers of Skylab IV. Acta Astronaut 6(10):1313–1322PubMedCrossRef Rambaut PC, Leach CS, Whedon GD (1979) A study of metabolic balance in crewmembers of Skylab IV. Acta Astronaut 6(10):1313–1322PubMedCrossRef
3.
Zurück zum Zitat Whedon GD, Lutwak L, Rambaut PC, Whittle MW, Smith MC, Reid J, Leach C, Stadler CR, Sanford DD (1977) Mineral and nitrogen metabolic studies, experiment M071. In: Johnston RS, Dietlein LF (eds) Biomedical results from Skylab (NASA SP-377). National Aeronautics and Space Administration, Washington, DC, pp 164–174 Whedon GD, Lutwak L, Rambaut PC, Whittle MW, Smith MC, Reid J, Leach C, Stadler CR, Sanford DD (1977) Mineral and nitrogen metabolic studies, experiment M071. In: Johnston RS, Dietlein LF (eds) Biomedical results from Skylab (NASA SP-377). National Aeronautics and Space Administration, Washington, DC, pp 164–174
4.
Zurück zum Zitat Smith SM, Nillen JL, LeBlanc A, Lipton A, Demers LM, Lane HW, Leach CS (1998) Collagen cross-link excretion during space flight and bed rest. J Clin Endocrinol Metab 83(10):3584–3591PubMedCrossRef Smith SM, Nillen JL, LeBlanc A, Lipton A, Demers LM, Lane HW, Leach CS (1998) Collagen cross-link excretion during space flight and bed rest. J Clin Endocrinol Metab 83(10):3584–3591PubMedCrossRef
5.
Zurück zum Zitat Nicogossian AE, Sawin CF, Grigoriev AI (1994) Countermeasures to space deconditioning. In: Nicogossian AE, Huntoon CL, Pool SL (eds) Space physiology and medicine, 3rd edn. Lea & Febiger, Philadelphia, pp 447–467 Nicogossian AE, Sawin CF, Grigoriev AI (1994) Countermeasures to space deconditioning. In: Nicogossian AE, Huntoon CL, Pool SL (eds) Space physiology and medicine, 3rd edn. Lea & Febiger, Philadelphia, pp 447–467
6.
Zurück zum Zitat Oganov VS, Grigoriev AI, Voronin LI, Rakhmanov AS, Bakulin AV, Schneider VS, LeBlanc AD (1992) Bone mineral density in cosmonauts after flights lasting 4.5–6 months on the Mir orbital station. Aviakosm Ekolog Med 26(5–6):20–24PubMed Oganov VS, Grigoriev AI, Voronin LI, Rakhmanov AS, Bakulin AV, Schneider VS, LeBlanc AD (1992) Bone mineral density in cosmonauts after flights lasting 4.5–6 months on the Mir orbital station. Aviakosm Ekolog Med 26(5–6):20–24PubMed
7.
Zurück zum Zitat LeBlanc A, Schneider V, Shackelford L, West S, Oganov V, Bakulin A, Voronin L (2000) Bone mineral and lean tissue loss after long duration space flight. J Musculoskelet Neuronal Interact 1:157–160PubMed LeBlanc A, Schneider V, Shackelford L, West S, Oganov V, Bakulin A, Voronin L (2000) Bone mineral and lean tissue loss after long duration space flight. J Musculoskelet Neuronal Interact 1:157–160PubMed
8.
Zurück zum Zitat LeBlanc A, Schneider V, Spector E, Evans H, Rowe R, Lane H, Demers L, Lipton A (1995) Calcium absorption, endogenous excretion, and endocrine changes during and after long-term bed rest. Bone 16(4 Suppl):301S–304SPubMed LeBlanc A, Schneider V, Spector E, Evans H, Rowe R, Lane H, Demers L, Lipton A (1995) Calcium absorption, endogenous excretion, and endocrine changes during and after long-term bed rest. Bone 16(4 Suppl):301S–304SPubMed
9.
Zurück zum Zitat Smith SM, Wastney ME, O’Brien KO, Morukov BV, Larina IM, Abrams SA, Davis-Street JE, Oganov V, Shackelford LC (2005) Bone markers, calcium metabolism, and calcium kinetics during extended-duration space flight on the Mir space station. J Bone Miner Res 20(2):208–218PubMedCrossRef Smith SM, Wastney ME, O’Brien KO, Morukov BV, Larina IM, Abrams SA, Davis-Street JE, Oganov V, Shackelford LC (2005) Bone markers, calcium metabolism, and calcium kinetics during extended-duration space flight on the Mir space station. J Bone Miner Res 20(2):208–218PubMedCrossRef
10.
Zurück zum Zitat Lang T, LeBlanc A, Evans H, Lu Y, Genant H, Yu A (2004) Cortical and trabecular bone mineral loss from the spine and hip in long-duration spaceflight. J Bone Miner Res 19(6):1006–1012PubMedCrossRef Lang T, LeBlanc A, Evans H, Lu Y, Genant H, Yu A (2004) Cortical and trabecular bone mineral loss from the spine and hip in long-duration spaceflight. J Bone Miner Res 19(6):1006–1012PubMedCrossRef
11.
Zurück zum Zitat Keyak JH, Koyama AK, LeBlanc A, Lu Y, Lang TF (2009) Reduction in proximal femoral strength due to long-duration spaceflight. Bone 44(3):449–453PubMedCrossRef Keyak JH, Koyama AK, LeBlanc A, Lu Y, Lang TF (2009) Reduction in proximal femoral strength due to long-duration spaceflight. Bone 44(3):449–453PubMedCrossRef
12.
Zurück zum Zitat Loehr JA, Lee SM, English KL, Sibonga J, Smith SM, Spiering BA, Hagan RD (2011) Musculoskeletal adaptations to training with the advanced resistive exercise device. Med Sci Sports Exerc 43(1):146–156PubMedCrossRef Loehr JA, Lee SM, English KL, Sibonga J, Smith SM, Spiering BA, Hagan RD (2011) Musculoskeletal adaptations to training with the advanced resistive exercise device. Med Sci Sports Exerc 43(1):146–156PubMedCrossRef
13.
Zurück zum Zitat Schneider SM, Amonette WE, Blazine K, Bentley J, Lee SM, Loehr JA, Moore AD Jr, Rapley M, Mulder ER, Smith SM (2003) Training with the International Space Station interim resistive exercise device. Med Sci Sports Exerc 35(11):1935–1945PubMedCrossRef Schneider SM, Amonette WE, Blazine K, Bentley J, Lee SM, Loehr JA, Moore AD Jr, Rapley M, Mulder ER, Smith SM (2003) Training with the International Space Station interim resistive exercise device. Med Sci Sports Exerc 35(11):1935–1945PubMedCrossRef
14.
Zurück zum Zitat Hilliard-Robertson PC, Schneider SM, Bishop SL, Guilliams ME (2003) Strength gains following different combined concentric and eccentric exercise regimens. Aviat Space Environ Med 74(4):342–347PubMed Hilliard-Robertson PC, Schneider SM, Bishop SL, Guilliams ME (2003) Strength gains following different combined concentric and eccentric exercise regimens. Aviat Space Environ Med 74(4):342–347PubMed
15.
Zurück zum Zitat Smith SM, Heer MA, Shackelford L, Sibonga JD, Ploutz-Snyder L, Zwart SR (2012) Benefits for bone from resistance exercise and nutrition in long-duration spaceflight: evidence from biochemistry and densitometry. J Bone Miner Res 27(9):1896–1906PubMedCrossRef Smith SM, Heer MA, Shackelford L, Sibonga JD, Ploutz-Snyder L, Zwart SR (2012) Benefits for bone from resistance exercise and nutrition in long-duration spaceflight: evidence from biochemistry and densitometry. J Bone Miner Res 27(9):1896–1906PubMedCrossRef
16.
Zurück zum Zitat Shackelford LC, LeBlanc AD, Driscoll TB, Evans HJ, Rianon NJ, Smith SM, Spector E, Feeback DL, Lai D (2004) Resistance exercise as a countermeasure to disuse-induced bone loss. J Appl Physiol 97(1):119–129PubMedCrossRef Shackelford LC, LeBlanc AD, Driscoll TB, Evans HJ, Rianon NJ, Smith SM, Spector E, Feeback DL, Lai D (2004) Resistance exercise as a countermeasure to disuse-induced bone loss. J Appl Physiol 97(1):119–129PubMedCrossRef
17.
Zurück zum Zitat LeBlanc AD, Driscol TB, Shackelford LC, Evans HJ, Rianon NJ, Smith SM, Feeback DL, Lai D (2002) Alendronate as an effective countermeasure to disuse induced bone loss. J Musculoskelet Neuronal Interact 2(4):335–343PubMed LeBlanc AD, Driscol TB, Shackelford LC, Evans HJ, Rianon NJ, Smith SM, Feeback DL, Lai D (2002) Alendronate as an effective countermeasure to disuse induced bone loss. J Musculoskelet Neuronal Interact 2(4):335–343PubMed
18.
Zurück zum Zitat Watanabe Y, Ohshima H, Mizuno K, Sekiguchi C, Fukunaga M, Kohri K, Rittweger J, Felsenberg D, Matsumoto T, Nakamura T (2004) Intravenous pamidronate prevents femoral bone loss and renal stone formation during 90-day bed rest. J Bone Miner Res 19(11):1771–1778PubMedCrossRef Watanabe Y, Ohshima H, Mizuno K, Sekiguchi C, Fukunaga M, Kohri K, Rittweger J, Felsenberg D, Matsumoto T, Nakamura T (2004) Intravenous pamidronate prevents femoral bone loss and renal stone formation during 90-day bed rest. J Bone Miner Res 19(11):1771–1778PubMedCrossRef
19.
Zurück zum Zitat Shapiro J, Smith B, Beck T, Ballard P, Dapthary M, Brintzenhofeszoc K, Caminis J (2007) Treatment with zoledronic acid ameliorates negative geometric changes in the proximal femur following acute spinal cord injury. Calcif Tissue Int 80(5):316–322, 2007PubMedCrossRef Shapiro J, Smith B, Beck T, Ballard P, Dapthary M, Brintzenhofeszoc K, Caminis J (2007) Treatment with zoledronic acid ameliorates negative geometric changes in the proximal femur following acute spinal cord injury. Calcif Tissue Int 80(5):316–322, 2007PubMedCrossRef
20.
Zurück zum Zitat LeBlanc AD, Evans HJ, Marsch C, Schneider V, Johnson PC, Jhingran SG (1986) Precision of dual photon absorptiometry measurements. J Nucl Med 27(8):1362–1365PubMed LeBlanc AD, Evans HJ, Marsch C, Schneider V, Johnson PC, Jhingran SG (1986) Precision of dual photon absorptiometry measurements. J Nucl Med 27(8):1362–1365PubMed
21.
Zurück zum Zitat LeBlanc AD, Schneider VS, Engelbretson DA, Evans HJ (1990) Precision of regional bone mineral measurements obtained from total-body scans. J Nucl Med 31:43–45PubMed LeBlanc AD, Schneider VS, Engelbretson DA, Evans HJ (1990) Precision of regional bone mineral measurements obtained from total-body scans. J Nucl Med 31:43–45PubMed
22.
Zurück zum Zitat Spector E, LeBlanc A, Shackelford L (1995) Hologic QDR 2000 whole-body scans: a comparison of three combinations of scan modes and analysis software. Osteoporos Int 5(6):440–445PubMedCrossRef Spector E, LeBlanc A, Shackelford L (1995) Hologic QDR 2000 whole-body scans: a comparison of three combinations of scan modes and analysis software. Osteoporos Int 5(6):440–445PubMedCrossRef
23.
Zurück zum Zitat Lang TF, Leblanc AD, Evans HJ, Lu Y (2006) Adaptation of the proximal femur to skeletal reloading after long-duration spaceflight. J Bone Miner Res 21(8):1224–1230PubMedCrossRef Lang TF, Leblanc AD, Evans HJ, Lu Y (2006) Adaptation of the proximal femur to skeletal reloading after long-duration spaceflight. J Bone Miner Res 21(8):1224–1230PubMedCrossRef
24.
Zurück zum Zitat Keyak JH, Kaneko TS, Tehranzadeh J, Skinner HB (2005) Predicting proximal femoral strength using structural engineering models. Clin Orthop Relat Res Aug 437:219–228CrossRef Keyak JH, Kaneko TS, Tehranzadeh J, Skinner HB (2005) Predicting proximal femoral strength using structural engineering models. Clin Orthop Relat Res Aug 437:219–228CrossRef
25.
Zurück zum Zitat Keyak JH, Lang TF (2012) Finite element modeling of proximal femoral load capacity under fall loading. Trans Orthop Res Soc 37:0189 Keyak JH, Lang TF (2012) Finite element modeling of proximal femoral load capacity under fall loading. Trans Orthop Res Soc 37:0189
26.
Zurück zum Zitat Carpenter RD, LeBlanc AD, Evans HJ, Sibonga JD, Lang T (2010) Long-term changes in the density and structure of the human hip and spine after long-duration spaceflight. Acta Astronaut 67:71–81CrossRef Carpenter RD, LeBlanc AD, Evans HJ, Sibonga JD, Lang T (2010) Long-term changes in the density and structure of the human hip and spine after long-duration spaceflight. Acta Astronaut 67:71–81CrossRef
27.
Zurück zum Zitat Amin S, Kopperdhal DL, Melton LJ 3rd, Achenbach SJ, Therneau TM, Riggs BL, Keaveny TM, Khosla S (2011) Association of hip strength estimates by finite-element analysis with fractures in women and men. J Bone Miner Res 26(7):1593–1600PubMedCrossRef Amin S, Kopperdhal DL, Melton LJ 3rd, Achenbach SJ, Therneau TM, Riggs BL, Keaveny TM, Khosla S (2011) Association of hip strength estimates by finite-element analysis with fractures in women and men. J Bone Miner Res 26(7):1593–1600PubMedCrossRef
28.
Zurück zum Zitat Frost HM (1982) Mechanical determinants of bone remodeling. Metab Bone Dis Relat Res 4(4):217–229PubMedCrossRef Frost HM (1982) Mechanical determinants of bone remodeling. Metab Bone Dis Relat Res 4(4):217–229PubMedCrossRef
29.
Zurück zum Zitat Scheuring RA, Mathers CH, Jones JA, Wear ML (2009) Musculoskeletal injuries and minor trauma in space: incidence and injury mechanisms in U.S. astronauts. Aviat Space Environ Med 80(2):117–124PubMedCrossRef Scheuring RA, Mathers CH, Jones JA, Wear ML (2009) Musculoskeletal injuries and minor trauma in space: incidence and injury mechanisms in U.S. astronauts. Aviat Space Environ Med 80(2):117–124PubMedCrossRef
30.
Zurück zum Zitat Johnston SL, Campbell MR, Scheuring R, Feiveson AH (1994) Risk of herniated nucleus pulposus among U.S. astronauts. Aviat Space Environ Med 81(6):566–574CrossRef Johnston SL, Campbell MR, Scheuring R, Feiveson AH (1994) Risk of herniated nucleus pulposus among U.S. astronauts. Aviat Space Environ Med 81(6):566–574CrossRef
31.
Zurück zum Zitat LeBlanc AD, Evans HJ, Schneider VS, Wendt RE 3rd, Hedrick TD (1994) Changes in intervertebral disc cross-sectional area with bed rest and space flight. Spine 19(7):812–817PubMedCrossRef LeBlanc AD, Evans HJ, Schneider VS, Wendt RE 3rd, Hedrick TD (1994) Changes in intervertebral disc cross-sectional area with bed rest and space flight. Spine 19(7):812–817PubMedCrossRef
32.
Zurück zum Zitat Mader TH, Gibson CR, Pass AF, Kramer LA, Lee AG, Fogarty J, Tarver WJ, Dervay JP, Hamilton DR, Sargsyan A, Phillips JL, Tran D, Lipsky W, Choi J, Stern C, Kuyumjian R, Polk JD (2011) Optic disc edema, globe flattening, choroidal folds, and hyperopic shifts observed in astronauts after long-duration space flight. Ophthalmology 118(10):2058–2069PubMedCrossRef Mader TH, Gibson CR, Pass AF, Kramer LA, Lee AG, Fogarty J, Tarver WJ, Dervay JP, Hamilton DR, Sargsyan A, Phillips JL, Tran D, Lipsky W, Choi J, Stern C, Kuyumjian R, Polk JD (2011) Optic disc edema, globe flattening, choroidal folds, and hyperopic shifts observed in astronauts after long-duration space flight. Ophthalmology 118(10):2058–2069PubMedCrossRef
33.
Zurück zum Zitat Pietrzyk RA, Jones JA, Sams CF, Whitson PA (2007) Renal stone formation among astronauts. Aviat Space Environ Med 78(4 Suppl):A9–A13PubMed Pietrzyk RA, Jones JA, Sams CF, Whitson PA (2007) Renal stone formation among astronauts. Aviat Space Environ Med 78(4 Suppl):A9–A13PubMed
34.
Zurück zum Zitat Whitson PA, Pietrzyk RA, Jones JA, Nelman-Gonzalez M, Hudson EK, Sams CF (2009) Effect of potassium citrate therapy on the risk of renal stone formation during spaceflight. J Urol 182(5):2490–2496PubMedCrossRef Whitson PA, Pietrzyk RA, Jones JA, Nelman-Gonzalez M, Hudson EK, Sams CF (2009) Effect of potassium citrate therapy on the risk of renal stone formation during spaceflight. J Urol 182(5):2490–2496PubMedCrossRef
35.
Zurück zum Zitat LeBlanc AD, Spector ER, Evans HJ, Sibonga JD (2007) Skeletal responses to space flight and the bed rest analog: a review. J Musculoskelet Neuronal Interact 7(1):33–47PubMed LeBlanc AD, Spector ER, Evans HJ, Sibonga JD (2007) Skeletal responses to space flight and the bed rest analog: a review. J Musculoskelet Neuronal Interact 7(1):33–47PubMed
36.
Zurück zum Zitat Okada A, Ohshima H, Itoh Y, Yasui T, Tozawa K, Kohri K (2008) Risk of renal stone formation induced by long-term bed rest could be decreased by premedication with bisphosphonate and increased by resistive exercise. Int J Urol 15(7):630–635PubMedCrossRef Okada A, Ohshima H, Itoh Y, Yasui T, Tozawa K, Kohri K (2008) Risk of renal stone formation induced by long-term bed rest could be decreased by premedication with bisphosphonate and increased by resistive exercise. Int J Urol 15(7):630–635PubMedCrossRef
37.
Zurück zum Zitat Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B (2012) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw—2009 update. Aust Endod J 35(3):119–130CrossRef Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B (2012) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw—2009 update. Aust Endod J 35(3):119–130CrossRef
38.
Zurück zum Zitat Abrahamsen B, Einhorn TA (2012) Beyond a reasonable doubt? Bisphosphonates and atypical femur fractures. Bone 50(5):1196–1200PubMedCrossRef Abrahamsen B, Einhorn TA (2012) Beyond a reasonable doubt? Bisphosphonates and atypical femur fractures. Bone 50(5):1196–1200PubMedCrossRef
39.
Zurück zum Zitat Feldstein AC, Black D, Perrin N, Rosales AG, Friess D, Boardman D, Dell R, Santora A, Chandler JM, Rix MM, Orwoll E (2012) Incidence and demography of femur fractures with and without atypical fractures. J Bone Miner Res 27(5):977–986.37PubMedCrossRef Feldstein AC, Black D, Perrin N, Rosales AG, Friess D, Boardman D, Dell R, Santora A, Chandler JM, Rix MM, Orwoll E (2012) Incidence and demography of femur fractures with and without atypical fractures. J Bone Miner Res 27(5):977–986.37PubMedCrossRef
40.
Zurück zum Zitat Lewiecki EM (2011) Safety and tolerability of denosumab for the treatment of postmenopausal osteoporosis. Drug Health Patient Safety 3:79–91CrossRef Lewiecki EM (2011) Safety and tolerability of denosumab for the treatment of postmenopausal osteoporosis. Drug Health Patient Safety 3:79–91CrossRef
41.
Zurück zum Zitat Akhtar NH, Afzal MZ, Ahmed AA (2011) Osteonecrosis of jaw with the use of denosumab. J Cancer Res Ther 7(4):499–500PubMedCrossRef Akhtar NH, Afzal MZ, Ahmed AA (2011) Osteonecrosis of jaw with the use of denosumab. J Cancer Res Ther 7(4):499–500PubMedCrossRef
Metadaten
Titel
Bisphosphonates as a supplement to exercise to protect bone during long-duration spaceflight
verfasst von
A. LeBlanc
T. Matsumoto
J. Jones
J. Shapiro
T. Lang
L. Shackelford
S. M. Smith
H. Evans
E. Spector
R. Ploutz-Snyder
J. Sibonga
J. Keyak
T. Nakamura
K. Kohri
H. Ohshima
Publikationsdatum
01.07.2013
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 7/2013
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-012-2243-z

Weitere Artikel der Ausgabe 7/2013

Osteoporosis International 7/2013 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.