Literatur

Einführung

Weiterführende Bücher und Artikel sind hier am Ende des Textes zu-sammengefasst. Die aufgeführten 35 Bücher der letzten 10 Jahre ent-halten überblicke über die verschiedenartigsten Aspekte der Osteo-porose. Ausführliche Referenzlisten sind aus den Büchern zu entneh-men.

Zusätzlich zu den vielen anderen Büchern über die Osteoporose,die hier nicht aufgeführt werden konnten, sind in der internationalenLiteratur bereits eine "astronomische" Zahl von wissenschaftlichenArtikeln über alle Aspekte der Osteoporose erschienen. Diese sind imInternet verfügbar. Zum Beispiel haben allein die beiden Schlüssel-wörter "osteoporosis therapy" über 1000 Zitate im Zeitraum "Januarbis Juli 2003" ergeben. Es ist daher unmöglich, alle Osteoporose-rele-vanten Art ikel in diesem praktisch orientierten Buch zu berücksichti-gen. Es wurde allerdings der Versuch unternommen, alle für die Text-aussage des Buches und für die klinische Arbeit wichtigen Arbeiten zuzitieren und vor allem neueste Publikationen zu berücksichtigen. Die-se Artikel sind nach den jeweiligen Kapiteln des Buches gelistet.

Literatur zum Thema

. Osteoporose" - eine kaum

mehr überschaubare Flut!

220 Literatur----- ----

Bücher über Osteoporose

1. Avioli L (2000) The osteoporotic syndrome. Aeademic Press, San Diego2. Avioli L,Krane S (1997) Metabolie bone disease and clinically related disorders.

Aeademic Press, San Diego3. Barlow D,Francis R, Miles A (2001) The effeetive management of osteoporosis.

Aeseulapius Medical Press , London, San Francisco, Sydney4. Bart! R (2001) Osteoporose - Prävention, Diagnostik, Therapie. Thieme, Stutt-

gart, New York5. Bart! R (2002) Osteoporose: Erfolgreich vorbeugen und gezielt behandeln. Süd-

west Verlag, München6. Bart! R, Frisch B (1993) Biopsy ofbone in internal medicine - An at!as and sour-

eebook. Kluwer Aeademic Publ ishers, Dordrecht, Boston, London7. Bart! R, Frisch B (2002) Bisphosphonates for bones: Guidelines for treatment in

all medical disciplines. Blackwell, Berlin8. Bilezikian J, Raisz L, Rodan G (1996) Principles of bone biology. Aeademic

Press, San Diego9. Cummings S,Cosman F,[amal S (2002) Osteoporosis: An evidenee-based guide

to prevention and therapy. American College of Physicians, Philadelphia10. Eastell R, Baumann M, Hoyle N, Wieezorek L (eds) (2001) Bone markers, bio-

ehemical and clinical perspeetives. Martin Dunitz, London11. Favus MJ (ed) (1999) Primer on the metabolie bone diseases and disorders of

mineral metabolism. Lippincott, Philadelphia12. Fleisch H (2000) Bisphosphonates in bone disease. 4thedn, Aeademie Press, San

Diego13. Frisch B, Bart! R (1998) Biopsy interpretation of bone and bone marrow. Ar-

nold, London14. Geusens P (ed) (1998) Osteoporosis in clinical praetice. Springer, Berlin, Heidel-

berg, New York,Tokio15. Henderson JE, Goltzman D (eds) (2000) The osteoporosis primer. Cambridge

University Press, Cambridge16. Heuek A (1997) Radiologie der Knochen- und Gelenkerkrankungen. Thierne,

Stuttgart17. Hodgson S (2003) Mayo Clinic on osteoporosis. Mayo Clinic, Rochester18. Hosking D,Ringe J (2000) Treatment of metabolie bone disease - management

strategy and drug therapy. Martin Dunitz, London19. Kleerekoper M,Siris E,MeClung M (eds) (1999) The bone and mineral manual.

Aeademic Press, London20. Mareus R, Feldman D, Kelsey J (eds) (1996) Osteoporosis. Aeademic Press, San

Diego21. Martin B, Burr D, Sharkey N (eds) (1998) Skeletal tissue meehanics. Springer,

Berlin, Heidelberg, New York,Tokio22. Meunier PI (1998) Osteoporosis: diagnosis and management. Martin Dunitz,

London23. MeIlwain H, Bruee D (1999) The osteoporosis eure. Avon Books, New York24. Mareus R (1996) Osteoporosis. Aeademic Press, San Diego25. Mundy G (1999) Bone remodelling and its disorders. 2nd edn , Martin Dunitz,

London26. Notelovitz M (1999) Osteoporosis: prevention, diagnosis and management. Pro-

fessional Communications, Caddo

literatur 221---------

27. Orwoll E (ed) (1999) Osteoporosis in men.Academic Press, San Diego28. Riggs B,Melton L (1995) Osteoporosis Etiology, Diagnosis and Management. 2nd

ed, Lippincott-Raven, Philadelphia29. Ringe J (2003) Osteoporose Dialog . Thieme, Stuttgart30. Ringe J, Meunier P (1996) Osteoporotic fractures in the elderly. Thieme, Stutt-

gart31. Rosen C, Glowack i J, Bilzikian J (eds) (1999) The aging skeleton. Academic

Press, San Diego32. Rubens R,Mundy G (eds) (2000) Cancer and the skeleton. Martin Dunitz, Lon-

don33. Seibel M, Stracke H (1997) Metabolische Osteopathien. Schattauer, Stuttgart34. Wolff J (1986) The law of bone remodelling. Springer, Berlin, Heidelberg, New

York, Tokio35. Woolf A (1994) Osteoporosis. Martin Dunitz, London

Ausgewählte Artikel aus Zeitschriften,geordnet nach Kapiteln

Einführung

1. Browner W,Pressman A, Nevitt M, Cummings S (1996) Mortality following frac-tures in older women. The Study of Osteoporotic Fractures. Arch Intern Med156:521-525

2. Hollon M, Larson E, Koepsell T, Downer A (2003) Direct-to-consumer marke-ting of osteoporosis drugs and bone densitometry. Ann Pharmacother 37:976-981

3. [ohnell 0 (2003) Economic implication of osteoporotic spine disease: cost to so-ciety. Eur Spine J 12:168-169

4. Kado D, Browner E, Palermo L et a!. (1999) Vertebral fractures and mortality inolder women: a prospective study. Arch Intern Med 159:1215-1220

5. Klift M, Laet C, Coebergh J et a!. (2003) Bone mineral density and the risk ofbreast cancer: the Rotterdam study. Bone 32:211-216

6. Levy P, Levy E, Audran M et a!. (2002) The cost of osteoporosis in men: theFrench situation. Bone 30:631-636

7. Lippuner K,von Overbeck J, Perrelet R et a!. (1997) Incidence and direct medi-cal costs ofhospitalisations due to osteoporotic fractures in Switzerland. Osteo-porosis Int 7:414-425

8. Philips S, Fox N, Iacobs J, Wright E (1988) The direct medical costs of os teopo-rosis of American women aged 45 and older. Bone 9:217-219

9. Richmond J,Aharonoff G, Zuckerman J, Koval K (2003) Mortality risk after hipfracture. J Orthop Trauma 17:2-5

10. Saw S-M, Hong C-Y,Lee J eta!. (2003) Awareness and health beliefs of women to-wards osteoporosis. Osteoporos Int 14:595-601

11. Schürch MA, Rizzoli R, Mermillod B et a!. (1996) A prospective study on soci-oeconomic aspects of fracture of the proximal femur. J Bone Miner Research11:1935-1942

222 Literatur----- ----

2 Biologie

1. Ahlborg H, [ohnell 0, Turner C et al. (2003) Bone loss and bone size after me-nopause. Engl J Med 349:327-334

2. Ammann P,Rizzoli R (2003) Bone strength and its determinants. 14 (SuPpI3):13- 18

3. Banse X (2002) When density fails to predict bone strength. Acta Orthop Scand73 (SUPpI303):2-53

4. Bauer D (2003) HMG CoA reductase inhibitors and the skeleton : a comprehen-sive review. Osteoporos Int 14:273-282

5. Boivin G, Meunier P (2003) The mineralisation of bone tissue: a forgotten di-mension in osteoporosis research. Osteoporos Int 14 (SuPpI3):l9-24

6. Bone C, Einhorm T (2003) Overview of osteoporosis: pathophysiology and de-terminants of bone strength. Eur Spine J 12:90-96

7. Bonewald L (2003) Osteocyte biology. Curr Opin Orthop 14:311-3168. Bouxsein M (2003) Bone quality: where do we go from here? Osteoporos Int

14:118-1279. Boyle W, Simonet W, Lacey D (2003) Osteoclast differentiation and activation.

Nature 423:337-34110 . Brumsen C, Papapoulos S, Lentjes E et al. (2002) A potential role for the mast

cell in the pathogenesis of idiopathic osteoporosis in men. Bone 31:556-56111. Buckalter J,Glimcher M, Cooper R, Recker R (1995)Bone biology: Part I: Struc-

ture, blood supply, cells, matrix and mineralisation. J Bone Joint Surg 77A:1256-1275

12. Burr D (2002) The contribution of the organic matrix to bone's material pro-perties. Bone 31:8-11

13. Currey J (2003) Perspective: How well are bones designed to resist fracture. JBone Miner Res 18:591-598

14. Donahue H (2000) Gap junctions and biophysical regulation ofbone cell diffe-rentiation. Bone 26:417-422

15. Flier J (2002) Is brain sympathetic to bone? Nature 420:619-62216. Frank G (2003) Role of estrogen and androgen in pubertal skeletal physiology.

Med Pediatr OncoI41 :217-22117. Harada S, Rodan G (2003) Control of osteoblast function and regulation of

bone mass. Nature 423:349-35518.Manolagas S (2000) Birth and death ofbone cells: Basic regulatory mechanis-

ms and implications for the pathogenensis and treatment of osteoporosis. En-docrine Reviews 21:115-137

19. Mukherjee A,Shalet S (2003) Growth hormone replacement therapy (GHRT) inchildren and adolescents: skeletal impact. Med Pediatr OncoI41:235-242

20.Onley R (2003) Regulation of bone mass by growth hormone. Med Pediatr On-coI41:228-234

21. Orwell E (2003) Men, bone and estrogen: unresolved issues. Osteoporos Int14:93-98

22. Reid R (2003) Bisphosphonates: new indications and methods of administrati-on. Curr Opin RheumatoI15 :458-463

23. Seaman E (2003) Reduced bone formation and increased bone resorption: ra-tional targets for the treatment of osteoporosis. Osteoporos Int 14 (Supp13):2-8

literatur 223---------24. Seeman E (2003) Perio steal bone formation - a neglected determinant ofbone

strength. N Engl JMed 349:320-32325.Takeda S, Elefteriou F, Levasseur R et al. (2002) Leptin regulates bone formati-

on via the sympathetic nervous system. CeIl111:305-31726. Turner C (2002) Biomechanics of bone: determinants of skeletal fragility and

bone quality.Osteoporos Int 13:97- 10427. Turner C (2002) Mechanotransduction in skeletal cells. Curr Opin Orthop

13:363-36728. Young M (2003) Bone matrix proteins: the ir function, regulation, and relation-

ship to osteoporosis. Osteoporos Int 14 (SupP13):35-4229. Zaidi M, Blair H, Moonga B et al. (2003) Osteoclastogenesis, bone resorption,

and osteoclast-based therapeutics. JBone Miner Res 18:599-60930. Zaidi M, Moonga B,Sun I et al. (2003) Understanding osteoclast formation and

function: implications for future therapies for osteoporosis. Curr Opin Orthop14:341-350

3 Definition

1. Ahlborg H, Iohnell 0, Turner C et al. (2003) Bone loss and bone size after me-nopause. Engl JMed 349:327-334

2. Bouxsein M (2003) Bone quality: where do we go from here? Osteoporos Int14:118-127

3. Chavassieux P,Arlot M, Reda C,Wei L,YatesA, Meunier P (1997)Histomorpho-metric assessment of the long-term effects of alendronate on bone quality andremodeling in patients with osteoporosis. JClin luvest 1000:1475-1480

4. Currey J (2003) Perspective: How weil are bones designed to resist fracture. JBone Miner Res 18:591-598

5. Epstein S, InzerilloA, Caminis J, Zaid i M (2003) Review: Disorders associatedwith acute rapid and severe bone loss. JBone Miner Res 18:2083-2094

6. Manolagas S (2000) Birth and death of bone cells: Basic regulatory mechanis-ms and implications for the pathogenensis and treatment of osteoporosis. En-docrine Reviews 21:115-137

7. Port L, Center J, Briffa K et al. (2003) Osteoporotic fracture: missed opportunityfor intervention. Osteoporos Int 14:780-784

8. Sherman P (2003) Osteoporosis and young women. Curr Opin Orthop 14:440-

4449. Stone K, Seeley D, Lui L et al. (2003) BMD at multiple sites and risk of fracture

of multiple types: long-term results from the study of osteoporotic fractures. JBone Miner Res 18:1947-1954

10. Turner C (2002) Biomechanics of bone: determinants of skeletal fragil ity andbone quality. Osteoporos Int 13:97-104

11. Van Staa T,Leufkens H, Cooper C (2002) Does a fracture at one site predict la-ter fractures at other sites ?A british cohort study. Osteoporos Int 13:624-629

12. Van Staa T, Leufkens H, Cooper C (2002) The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 13:777-787

13. Young M (2003) Bone matrix proteins: their function, regulation, and relation-ship to osteoporosis. Osteoporos Int 14 (SupP13):35-42

224 literatur----- ----

14. Zaidi M, Blair H, Moonga B et al. (2003) Osteoclastogenesis, bone resorption,and osteoclast-based therapeuties. JBone Miner Res 18:599-609

15. Zaidi M, Moonga B, Sun I et al. (2003) Understanding osteoclast formation andfunction: implications for future therapies for osteoporosis. Curr Opin Orthop14:341-350

4 Risikofaktoren

1. Ahlborg H, [ohnell 0, Turner C et al. (2003) Bone loss and bone size after me-nopause. Engl JMed 349:327-334

2. Ammann P, Rizzoli R (2003) Bone strength and its determinants. 14 (SuPpI3):13-18

3. Biolo G, Heer M, Narici M, Strollo F (2003) Mierogravity as a model of ageing.Curr Opin Clin Nutr Metab Care 6:3-7

4. Bone C, Einhorm T (2003) Overview of osteoporosis: pathophysiology and de-terminants of bone strength. Eur Spine J12:90-96

5. Chapurlat R, Bauer D,Nevitt M et al. (2003) Incidence and risk factors for a sec-ond hip fracture in elderly women. The study of osteoporotie fractures. Osteo -poros Int 14:130-136

6. Chapuy M, Arlot M, Duboeuf F et al. (1992)Vitamin D3 and calcium to preventhip fractures in elderly women. N Engl JMed 327:1637-1642

7. Charles P (1992) Calcium absorption and calcium bioavailability. J Intern Med231:161-168

8. Cohen A, Shane E (2003) Osteoporosis after solid organ and bone marrowtransplantation. Osteoporos Int 14:617-630

9. Cummings S (1996)Treatable and untreatable risk factors for hip fracture. Bone18:165-167

10. Cummings S, Black D, Rubin S (1989) Lifetime risks of hip , Colles ' or vertebralfracture and coronary heart disease among white postmenopausal women.Arch Intern Med 149:2445-2449

11. Ettinger M (2003) Aging bone and osteoporosis: strategies for preventing frac-tures in the elderly. Arch Intern Med 163:2237-2246

12. Fitzpatrick L, Heaney R (2003) Got sodai JBone Miner Res 18:1570-157113. Fleisch H (2001) Can bisphosphonates be given to patients with fracturesi J

Bone Miner Res 16:437-44014. Frank G (2003) Role of estrogen and androgen in pubertal skeletal phys iology.

Med Pediatr OncoI41:217-22115. Gerdhem P, Obrant K (2002) Effects of cigarette-smoking on bone mass as as-

sessed by dual -energy X-ray absorptiometry and ultrasound. Osteoporos Int13:933-936

16. Gerdhem P,Akesson K, Obrant K (2003) Effect of previous and present physiealactivity on bone mass in elderly women. Osteoporos. Int 14:208-212

17. Gourlay M, Riehy F,Reginster J(2003) Strategies for the prevention of hip frac -tures. Am JMed 115:309-317

18. Gregg E, Pereira M, Caspersen C (2000) Physieal activity, falls, and fracturesamong older adults: a review of the epidemiologie evidence. JAm Geriatr Soc48:883-893

literatur 225---------

19. Grisso J,Kelsey J,Strom B et al. (1991) Risk factors for falls as a cause of hip frac-ture in women. N Engl J Med 324:1326-1331

20. Haentjens P,Autier P,Collins J et al. (2003) Colles fracture, spine fracture, andsubsequent risk of hip fracture in men and women. J Bone Joint Surg 85A:1936-

194321. Hughes-Pulford M, Tjandrawinata R, Fitzgerald J et al. (1998) Effects of mic-

rogravity on osteoblast growth. Gravit Space Biol Bull11:51-6022. Kemmler W,Engelke K,Weineck Jet al. (2003) The Erlangen fitness osteoporo-

sis prevention study: a controlled exercise trial in early postmenopausal wom-en with low bone density-first-year results. Arch Phys Med Rehabil84:673-682

23. Klift M, Laet C, Coebergh J et al. (2003) Bone mineral density and the risk ofbreast cancer: the Rotterdam study. Bone 32:211-216

24. Krall E, Dawson-Hughes B (1991) Smoking and bone loss among postmeeno-pausal women. J Bone Miner Res 6:331-338

25. Kudlacek S, Freudenthaler 0 , Weissboeck H et al. (2003) Lactose intolerance: arisk factor for reduced bone mineral density and vertebral fractures? J Gastro-enteroI37:1014-1019

26. Ups P (2001) Vitamin D deficiency and secondary hyperparathyroidism in theelderly: consequences for bone loss and fractures and therapeutic implications.Endocrine Reviews 22:477-501

27. McGartiand C, Robson P, Murray L et al. (2003) Carbonated soft drink con-sumption and bone mineral density in adolescence: the Northern IrelandYoung Hearts Project. J Bone Miner Res 18:1563-1569

28. Perese E, Perese K (2003) Health problems of women with severe mental illness .J Am Acad Nurse Pract 15:212-219

29. Ralston S (2003) Genetic determinants of susceptibility to osteoporosis. CurrOpin PharmacoI3:286-290

30. Recker R, Hinders S,Davies K et al. (1996) Correcting calcium nutritional defi-ciency prevents spine fractures in elderly women. J Bone Miner. Res 11:1961-1966

31. Rehman 0, Lane N (2003) Effect of glucocorticoids on bone density. Med Pedi-atr OncoI41:212-216

32. Reid I, Ames R, Evans M, Gamble G, Sharpe S (1995)Long-term effect of calci-um supplementation on bone loss and fracture in postmenopausal women: arandomized controlled trial. Am J Med 98:331-335

33. Richmond J,Aharonoff G, Zuckerman J, Koval K (2003) Mortality risk after hipfracture. J Orthop Trauma 17:2-5

34. Richy F, Bousquet J, EherIich G et al. (2003) Inhaled corticosteroid effects onbone in asthmatic and COPD patients: a quantitative systematic study. Osteo-poros Int 14:179-190

35. Sambrook P,Kotowicz M, Nash P et al. (2003) Prevention and treatment of glu-cocorticoid-induced osteoporosis: a comparison of Kalzitriol, vitamin D pluscalcium and alendronate plus calcium. J None Miner Res 18:919-924

36. Schuh T, Lyles K (2003) Osteoporosis considerations in the frail elderly. CurrOpin RheumatoI15:481-486

37. Shabat S,Gepstein R, Mann G et al. (2003) The second hip fracture - an analysisof 84 elderly patients. J Orthop Trauma 17:613-617

38. Siebier T,Shalet S,Robson H. (2002) Effects of chemotherapy on bone metabol-ism and skeletal growth. Horm Res 58 (Supph):80-85

226 Literatur----- ----

39. Sinake M (2003) Critical appraisal of physical rehabilitation measures afterosteoporotic vertebral fracture. Osteoporos Int 14:773-77 9

40.Sirola J,Kröger H, Honkanen R et al. (2003) Smoking may impair the bone pro-tective effects of nutritional calcium: a population-based approach. JBone Mi-ner Res 18:1036-1042

41. Smith I, Dowsett M (2003) Aromatase inhibitors in breast cancer. N Engl J Med348:2431-2442

42.Smith S,Heer M (2002) Calcium and bone metabolism during space flight. Nu-trition 18:849-852

43.Sowers M, Crutchfield M, [annausch M et al. (1991) A prospective evaluation ofbone mineral changee in pregnancy. Obstet Gynecol77:841-845

44.Stone K, Seeley D, Lui L et al. (2003) BMD at multiple sites and risk of fractureof multiple types : long-term results from the study of osteoporotic fractures. JBone Miner Res 18:1947-1954

45. Van Staa T, Leufkens H, Cooper C (2002) Does a fracture at one site predict la-ter fractures at other sites? A british cohort study. Osteoporos Int 13:624-629

46. Van Staa T, Leufkens H, Cooper C (2002) The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 13:777-787

47. Verrotti A, Greco R Latini G et al. (2002) Increased bone turnover in prepuber-tal, pubertal and postpubertal patients receiving carbamazepine. Epilepsia43=1488-1492

48. Women's Health Initiative Group (2002) Risks and benefits of estrogen plusprogestin in healthy postmenopausal women. JAMA288:321-333

5 Diagnostik

1. Ahlborg H, Iohnell 0, Turner C et al. (2003) Bone loss and bone size after me-nopause. Engl J Med 349:327-334

2. Banse X (2002) When density fails to predict bone strength.Acta Orthop Scand73 (SuPpI3 03):2-53

3. Bart! R, Bart! C, Mutschier W (2003) Diagnostik und Therapie der Osteoporo-se: Strategie für eine effiziente Prävention von Folgefrakturen. Unfallchirurg106:526-541

4. Baur A, Stäbler A, Arbogast S et al. (2002) Acute osteoporotic and neoplasticvertebral compression fractures: fluid sign at MR imag ing. Radiology 225:730-

7355. Bone C, Einhorm T (2003) Overv iew of osteoporosis: pathophysiology and de-

terminants of bone strength. Eur Spine J 12:90-966. Damilakis J, Papadokostakis G, Perisinakis K et al. (2003) Can radial bone mi-

neral density and quantitative ultrasound measurements reduce the number ofwomen who need axial dens ity skeletal assessment? Osteoporos Int 14:688-693

7. Eddy D,[ohnston C, Cummings S et al. (1998) Osteoporosis: review of the evid-ence for prevention, diagnosis, treatment, and cost -effectiveness analysis.Osteoporos Int 8:7-80

8. Follin S,Black J,McDermott M (2003) Lack of diagnosis and treatment of osteo -porosis in men and women after hip fracture. Pharmacotherapy 23:190-198

9. Harper K, Weber T (1998) Secondary osteoporosis. Diagnostic cons iderations.Endocrinol Metab C!in North Am 27:325-348

literatur 227

10. lohneil 0, Oden A, De Laet C et al. (2002) Biochemieal markers and the assess-ment of fracture probability. Osteoporos Int 13:523-526

11. Iohnell 0, Karmus P,Obrant K et al. (2001) Management of the patient after anosteoporotie fracture: guidelines for orthopedie surgeons. Acta Orthop Scand72:325-330

12. Kanis J,Black D, Cooper C et al. (2002) A new approach to the development ofassessment guidelines for osteoporosis. Osteoporos Int 13:527-536

13. Kullenberg R,Falch J (2003) Prevalence of osteoporosis using bone mineral me-asurements at the calcaneus by dual X-ray and laser (DXL). Osteoporos Int14:823-827

14. Lane J,Gardner M,Lin J et al. (2003) The aging spine : new technologies and the-rapeuties for the osteoporotie spine. Eur Spine J 12:147-154

15. Marshall D, Iohnell 0, Wedel H et al. (1996) Meta-analysis ofhow weil measuresofbone mineral density prediet occurrence of osteoporotie fractures. Br Med J312:1254-1259

16. Mattson J,Cerutis D, Parrish L (2002) Osteoporosis: a review and its dental im-plication. Compend Contin Educ Dent 23:1001-1004

17. O'Gradaigh D,Debiram I, Love S et al. (2003) A prospective study of discordan-ce in diagnosis of osteoporosis using spine and proximal femur bone densito-metry. Osteoporos Int 14:13-18

18.Stone K, Seeley D, Lui L et al. (2003) BMD at multiple sites and risk of fractureof mult iple types: long-term results from the study of osteoporotie fractures. JBone Miner Res 18:1947-1954

19. Szulc P, Delmas P (2001) Biochemical markers of bone turnover in men. CalcifTissue Int 69:229-230

20.Taguchi A,Sanada M, Krall E et al. (2003) Relationship between dental panora-mie radiographie finding s and biochemieal markers of bone turnover. J BoneMiner Res 18:1689-1694

6 Prävention

1. Aharonoff G,Dennis M, Eishinawy A et al. (2003) Circumstances offalls causinghip fractures in the elderIy. J Orthop Trauma 17:22-26

2. Ammann P, Rizzoli R (2003) Bone strength and its determinants. 14(SuPpI3):13-18

3. Chapuy M, ArIot M, Duboeuf F et al. (1992)Vitamin D3 and calcium to preventhip fractures in elderIy women. N Engl J Med 327:1637-1642

4. CharIes P (1992) Calcium absorption and calcium bioavailablility. J Intern Med231:161-168

5· Dawson-Hughes B, Harris S, Krall E, Dallal G (1997) Effect of calcium and vit -amin D supplementation on bone density in men and women 65years of age orolder. N Engl J Med 337:1437-1443

6. Einhorn T,Bonnarens F, Burstein A (1986) The contributions of dietary proteinand mineral to the healing of experimental fractures: a biomechanieal study. JBone Joint Surg Am 68:1389-1395

7. Ettinger M (2003) Aging bone and osteoporosis: strategies for preventing frac -tures in the elderIy. Arch Intern Med 163:2237-2246

8. Fitzpatriek L,Heaney R (2003) Got soda? J Bone Miner Res 18:1570-1571

228 literatur----- ----9. Gerdhem P,Obrant K (2002) Effects of cigarette-srnoking on bone mass as as-

sessed by dual -energy X-ray absorptiometry and ultrasound. Osteoporos Int13:933-936

10. Gerdhem P,Akesson K, Obrant K (2003) Effect of previous and present physiealactivity on bone mass in elderly women. Osteoporos. Int14:208-212

11. Gourlay M, Riehy F,Reginster J (2003) Strategies for the prevention of hip frac-tures. Am J Med 115:309-317

12. Gregg E, Pereira M, Caspersen C (2000) Physieal activity, falls, and fracturesamong older adults: a review of the epidemiologie evidence. J Am Geriatr Soc

48:883-89313. Kannus P, Parkkari J,Niemi s et al. (2000) Prevention ofhip fracture in elderly

people with use of a hip protector. N Engl JMed 343:1506-151314. Katzman D (2003) Osteoporosis in anorexia nervosa: a brittle future? Curr

Drug Target CNS Neurol Disord 2:11-1515. Kemmler W,Engelke K,Weineck Jet al. (2003) The Erlangen fitness osteoporo-

sis prevention study: a controlled exercise trial in early postmenopausal wom -en with low bone density-first-year results .Arch Phys Med Rehabil84:673-682

16. Kudlacek S, Freudenthaler 0, Weissboeck H et al. (2003) Lactose intolerance: arisk factor for reduced bone mineral density and vertebral fractures? J Gastro-enteroI37:1014-1019

17. Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in theelderly: consequences for bone loss and fractures and therapeutie imp!ications.Endocrine Reviews 22:477-501

18. Lips P, Graafmans W, Ooms M, et al. (1996) Vitamin D supplementation andfracture incidence in elderly persons. A randomized placebo-controlled trial.Ann Intern. Med. 124:400-406

19. McGartiand C, Robson P, Murray L et al. (2003) Carbonated soft dr ink con-sumption and bone mineral dens ity in adolescence: the Northern IrelandYoung Hearts Project, J Bone Miner Res 18:1563-1569

zo.Melton L, Heaney R (2003) Osteoporosis: Too much medicine? Or too little!Bone 32:327-331

21. Ralston S (2003) Genetie determinants of susceptibility to osteoporosis. CurrOpin PharmacoI3:286-290

22. Recker R, Hinders S, Davies K et al. (1996) Correcting calcium nut ritional defi-ciency prevents spine fractures in elderly women. J Bone Miner. Res 11:1961-

196623. Rehman 0, Lane N (2003) Effect of glucocortieoids on bone density. Med Pedi-

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56. Taguchi A,Sanada M, Krall E et al. (2003) Relationship between dental panora-mie radiographie findings and biochemieal markers of bone turnover. J BoneMiner Res 18:1689-1694

57. Van Staa T, Leufkens H, Cooper C (2002) The epidemiology of cortieosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 13:777-787

58. Verrotti A, Greco R Latini G et al. (2002) Increased bone turnover in prepuber-tal, pubertal and postpubertal patients receiving carbamazepine. Epilepsia43:1488-1492

59. Wallach S, Cohen S, Reid D et al. (2000) Effects of risedronate treatment onbone dens ity and vertebral fracture in patients on cortieosteroid therapy. Cal-cif Tissue Int 67:277-285

60.Watts N, Harris S, Genant H et al. (1990) Intermittent cyclical etidronate treat-ment of postmenopausal osteoporosis. N Engl JMed 323:73-79

61. Weber T, Drezner M (2001) Effect of alendronate on bone mineral density inmale idiopathie osteoporosis. Metabolism 50:912-915

9 Frakturen

1. Aharonoff G,Dennis M, Eishinawy A et al. (2003) Circumstances of falls causinghip fractures in the elderly. JOrthop Trauma 17:22-26

2. Bachmann D (2003) Osteoporotie patient: what to do after fixing the fracture.Curr Opin Orthop 14:445-449

3. Bagger Y, Tank öL,Alexandersen P et al. (2003) Alendronate has a residual effecton bone mass in postmenopausal Danish women up to 7 years after treatmentwithdrawal. Bone 33=301-307

4. Bart! R (2003) Management der manifesten Osteoporose - eine neue Verant-wortung für den Unfallchirurgen! Unfallchirurg 106:525

5. Bart! R, Bart! C, Mutschier W (2003) Diagnostik und Therapie der Osteoporo-se: Strategie für eine effiziente Prävention von Folgefrakturen. Unfallchirurg106:526-541

238 Literatur----- ----

6. Bestehorn K, Raspe H, Götte S et al. (2002) Berücksichtigung der Osteoporosebei der Therapie nicht -vertebraler Frakturen - Pilotstudie zum FX-Register.(2002) Zeitschr. Rheumatol. 61 (Supp1.I):80

7. Bestehorn K, Zink A, Dreher R et al. (2002) Pharmakotherapie bei postmeno-pausaler Osteoporose. Analyse der Versorgungssituation. Z. ärztI. Fortbild.Qual.sich.96:699-704

8. Brody B, Dickey N, Ellenberg S et al. (2003) Is the use of placebo controls ethi-cally permissible in clinical trials of agents intended to reduce fractures inosteoporosisi J Bone Miner Res 18:1105-1109

9. Chapurlat R, Bauer D, Nevitt M et al. (2003) Incidence and risk factors for a sec-ond hip fracture in elderly women. The study of osteoporotic fractures. Osteo-poros Int 14:130-136

10 . Cho T, Gerstenfeld L, Barnes G, Einhorn T (2003) Cytokines and fracture hea-ling. Current Opinion in Orthopaedics 12:403-408

11. Cree M, [uby A, Carriere K (2003) Mortality and morbidity associated withosteoporosis drug treatment following hip fracture. Osteoporos. Int 14:722-727

12. Currey J (2003) Perspective: How weil are bones designed to resist fracture. JBone Miner Res 18:591-598

13. Ettinger M (2003) Aging bone and osteoporosis: strategies for preventing frac-tures in the elderly. Arch Intern Med 163:2237-2246

14. Feldstein A, Nichols G, Eimer P et al. (2003) Older women with fractures: pati-ents falling through the cracks of guideline - recommended osteoporosisscreening and treatment. J Bone Joint Surg 85A:2294-2302

15. Fleisch H (2001) Can bisphosphonates be given to patients with fractures? JBone Miner Res 16:437-440

16. Follin S,Black J,McDermott M (2003) Lack of diagnosis and treatment of osteo-porosis in men and women after hip fracture. Pharmacotherapy 23:190-198

17. Franck H, Boszczyk B, Bierschneider M, Jaksehe H (2003) Interdisciplinary ap-proach to balloon kyphoplasty in the treatment of osteoporotic vertebral com-pression fractures. Eur Spine J 12:163-167

18. Freedman K, Kaplan F, Bilker W et al. (2000) Treatment of osteoporosis: arephysicians missing an opportunity? J Bone Joint Surg 82A:l063-1070

19. Gardner M, Flik K, Mooar P et al. (2002) Improvement in the undertreatment ofosteoporosis following hip fracture. J Bone Joint Surgery 84:1342-1348

20.Götte S, Dittmar K (2001) Epidemiologie und Kosten der Osteoporose. Ortho-päde 30:402-404

21.Gourlay M, Richy F,Reginster J (2003) Strategies for the prevention ofhip frac-tures. Am J Med 115:309-317

22.Grados F,Depriester C, Cayrolle G et al. (2000) Leng-term observations of ver-tebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheuma-tology 39:1410-1414

23. Haentjens P, Autier P,Collins J et al. (2003) Colles fracture, spine fracture, andsubsequent risk ofhip fracture in men and women. J Bone Joint Surg 85A:1936-1943

24. Heinemann D (2000) Osteoporosis. An overview of the National OsteoporosisFoundation clinical practice guide. Geriatrics 55:31-36

25. [ohnell 0, Kannus P, Obrant K et al. (2001) Management of the patient after anosteoporotic fracture: guidelines for orthopedic surgeons. Acta Orthop Scand72:325-330

literatur 239---------

26. Juby A, De Geus-Wenceslau C (2002) Evaluation of osteoporosis treatment inseniors after hip fracture. Osteoporos Int 13:205-210

27. Kamel H, Hussain M, Tariq S et al. (2000) Failure to diagnose and treat osteo-porosis in elderly patients hospitalized with hip fracture.Amer J Med 109:326-328

28. Kanis J, Iohnell 0, Oden A et al. (2001) Ten year probabilities of osteoporoticfractures according to BMD and diagnostic thresholds. 12:989-995

29. Kannus P, Parkkari J, Niemi s et al. (2000) Prevention of hip fracture in elderlypeople with use of a hip protector. N Engl J Med 343=1506-1513

30. Kaufman J, Bolander M, Bunta A et al. (2003) Barriers and solutions to osteopo-rosis care in patients with a hip fracture. J Bone Joint Surg 85A:1837-1843

31. Kemmler W,Engelke K,Weineck Jet al. (2003) The Erlangen fitness osteoporo-sis prevention study: a controlled exercise trial in early postmenopausal wom-en with low bone density-first-year results. Arch Phys Med Rehabil84:673-682

32. Lane J,Gardner M,Lin J et al. (2003) The aging spine: new technologies and the-rapeutics for the osteoporotic spine. Eur Spine J 12:147-154

33. Martin A, Sornay-Rendu E, Chandler J et al. (2002) The impact of osteoporosison quality-of-life: theOFELYcohort. Bone 31:32-36

34. Namkung-Matthai H, Appleyard R, Iansen J et al. (2001) Osteoporosis inftuen -ces the early per iod of fracture healing in a rat osteoporotic model. Bone 28:80-86

35. Nguyen TV,Center JR, Sambrook PN et al. (2001) Risk factors for proximal hu-merus, forearm, and wrist fractures in elderly men and women: The DubboOsteoporosis Epidemiology Study.Am J EpidemioI153;6:587-95

36. Rao R, Singrakhia M (2003) Current concepts review: painful osteoporotic ver-tebral fracture. J Bone Joint Surg 85:2010-2022

37. Schuh T, Lyles K (2003) Osteoporosis considerations in the frail elderly. CurrOpin RheumatoI15:481-486

38. Schürch MA, Rizzoli R, Mermillod B et al. (1996) A prospective study on soci-oeconomic aspects of fracture of the proximal femur. J Bone Miner Research11:1935-1942

39. Scrammel B (1999) Alendronate prevents periprosthetic bone loss - 2 year re-sults . J Bone Mineral Res 14 (Supphj.ja;

40.Shabat S, Gepstein R, Mann G et al. (2003) The second hip fracture - an analy-sis of 84 elderly patients. J Orthop Trauma 17:613-617

41.Torgerson D,Dolan P (1998) Prescribing by general practitioners after an osteo-porotic fracture. Ann Rheum Dis 57:378-379

42. Van Staa T, Leufkens H, Cooper C (2002) Does a fracture at one site predict la-ter fractures at other sitesi A british cohort study. Osteoporos Int 13:624-629

Osteoporose kompakt

OSTEOPOROSE - Wie diagnostiziere ich richtig?

Diagnostisches Ziel~ Osteoporose ist eine klinische Diagnose, die Knochendichte-

messung stellt nur einen nützlichen Parameter!

Diagnostische Schlüsselfragen~ Wie hoch ist die Knochenmassel~ Liegen bereits Frakturen/Deformierungen vor?~ Sind die Veränderungen noch reversibel?~ Ist eine Osteomalazie ausgeschlossen?~ Welches Risikoprofilliegt vor?~ Liegt eine andere Krankheit zugrunde?

Krankengeschichte~ Familiäre Osteoporose-Belastung?~ Rücken- , Kreuz- und Gelenkschmerzen?~ Vorbestehende Frakturen?~ Östrogensubstitution bereits eingeleitet?~ Knochenschädigende Krankheiten/Medikamente?~ Erstellen eines Risikoprofils

Körperliche Untersuchung~ Körpergröße und deren Abnahme (>4 cm)~ Statik und Körperhaltung~ Bewegungseinschränkungen~ Rundrücken und andere WS-Deformierungen~ Muskeltonus und Muskelverspannungen~ "Steh- und Gehversuch", Refiexsituation~ Zeichen einer sekundären Osteoporose?

242 Osteoporose kompakt---- - ----

Laboruntersuchung (Blut).. Blutbild, BSG,GPT,Glukose, Kreatinin.. Ca,Ph,aP.. (Vitamin D, PTH, TSH, Testosteron)

Bildgebung (Knochendichtemessung).. Röntgen LWS in 2 Ebenen (BWS, HWS):Wirbeleinbrüche = "mani-

feste Osteoporose", Aortenkalkt.. DXA LWS und Hüfte: von der WHO vorgeschriebene Methode zur

Diagnosestellung einer Osteoporose (Standard) , sehr strahlenarm,gleichzeitige Messung von LWS und Hüfte.T-Werte >-1 SD Normalbefund

-1,0 bis -2,5 SD Osteopenie

Osteoporosekompakt 243---------

OSTEOPOROSE - Wie therapiere ich erfolgreich?

Therapeutisches Ziel~ Erreichen einer positiven Knochenbilanz~ Erhöhung der Knochenfestigkeit mit Reduktion des Frakturrisikos

Therapeutische Schlüsselfragen~ Reicht die Basistherapie aus?~ Welche Schmerztherapie ist sinnvoll?~ Ist eine Hormontherapie anzuraten?~ Wann ist Raloxifen vorteilhaft?~ Wann sind Bisphosphonate einzusetzen?~ Welches Bisphosphonat ist vorzuziehen?~ Sind Therapiekombinationen sinnvoll?~ Wie kontrolliere ich den Therapieerfolg?~ Welche Therapiedauer ist ausreichend?

Basistherapie~ So früh wie möglich und konsequent beginnen!~ Körperliche Aktivität und Wirbelsäulen-Gymnastik~ Stopp den Knochenräubern (Rauchen!)~ Die Sturzgefahr reduzieren!~ Insgesamt 1000 mg Kalzium/d und 1000 JEVitamin D/d

("lOooer-Regel")

Schmerztherapie~ Physikalische Therapie~ Peripher wirkende Analgetika~ Nichtsteroidale Antiphlogistika (Cox-z-Hernmer)~ Opioide kurzzeitig bei Frakturschmerz~ Aminobisphosphonate i.v, monatlich

Hormontherapie~ Östrogen/Gestagen (HRT) postmenopausal und nur bei Wechsel-

beschwerden! Kontraindikationen ausschließen und Aufklärungs-gespräch über Risiken! Viele Patientinnen brechen die HRT inner-halb von 3 Jahren ab!

~ Testosteron (i.m., Pflaster, Gel) bei Männern mit Mangel (vorherPSA bestimmen!)

244 Osteoporose kompakt---- - ----

Bisphosphonattherapie~ Alendronat 70 mg oder Risedronat 35mg als "Wochentablette".~ Alendronat 10 mg oder Risedronat 5 mg als "Tagestablette".~ Orale Bisphosphonate genau nach Vorschrift einnehmen.~ Bisphosphonate stets mit Vitamin D und Kalziumgabe!~ Kontraindikationen sind Schwangerschaft und Stillzeit.~ Bisphosphonate auch bei Männern mit Osteoporose.~ Bei oralen Einnahmeproblemen Aminobisphosphonat i.v, alle

3 Monate (noch keine Zulassung bei Osteoporose).

Raloxifentherapie~ Raloxifen 60 mg/d oral, bei postmenopausalen Frauen .~ Keine Einnahmeprobleme, gut verträglich, Patientin muss nicht

nüchtern sein!~ Raloxifen stets mit Vitamin D und Kalziumgabe!~ Zusatznutzen an Brust und kardiovaskulärem System.

Parathormontherapie~ Bei manifester Osteoporose postmenopausaler Frauen osteoana-

bole Therapie mit Teriparatid 20 Ilgsubkutan täglich möglich.

Andere Therapien~ Etidronat, Fluoride oder Kalzitonin sind nicht mehr zu empfehlen.~ Aktives Vitamin D nur bei Nieren- oder Leberkrankheiten.

Behandlungsstrategie~ Stufe 1: Basistherapie - der Patient ist gefordert: mit Bewegung,

Ernährung, Lebensstil, Kalzium und Vitamin D. DXA-Kontrollejährlich. Falls weiterer Abfall der Knochendichte:

~ Stufe 2: Medikamentöse Therapie - der Arzt ist gefordert: Raloxi-fen, Alendronat oder Risedronat: falls die Basistherapie nicht aus-reicht oder bereits eine Osteoporose vorliegt, konsequenter Einsatzeines der 3 A-klassifizierten Medikamente ("evidence based medi-eine"). DXA-Kontrolle jährlich. Therapiedauer 1-4 Jahre, je nachSchweregrad. Teriparatid als Alternative bei manifester Osteopo-rose zum Wiederaufbau der Knochenstruktur, auch anschließendan Raloxifentherapie. Therapiedauer bis zu 18 Monaten. Konse-quente medikamentöse Therapie vor allem nach operativer/kon-servativer Versorgung von Osteoporose-assoziierten Frakturen zurVerhütung von Folgefrakturen!

Sachverzeichnis

A

Abriebpartikel 194Afroamerikaner 41AIDS 169Aktivität, körperliche 42Akute-Phase-Reaktion 131Alendronat 132,133,186,198Alfakalzidol 117Aigodystrophie (Sudeck-Erkrankung)

32,188-191,216- Stadien 189,190Alkoholkonsum, exzessiver 45,46,90Alter 41,42Aluminium 170Alveole,alveoläre r Knochenschwund

54Amenorrhoe 44Analgetika 107Anamnese 51Anastrozol 183Anbauphase, frühe/späte 17Androgene 13, 18, 20Andropause 149Anorexia nervosa 44, 46Antazida, aluminiumhaltige 94Antiandrogene 184Antibiotika 94Antidepressiva 94Antikoagulanzien 94,166Antikonvulsiva 94Aortenanomalie 162Aortenkalk 64Apoptose 129,130 ,148,174Armspannweite 52Aromatase 18Aromatasehemmer 94,143,181,182

ARSBL ("acute, rapid andsevere bone 1055") 36

Arteriosklerose 39, 148Asthma bronchiale 172Astronaut 43ATAC-Studie 183Atrophie, Knochen 15>37Aufstehtest 47Augenentzündung 131Azathioprin 179

B

Baastrup-Zeichen 52Ballonierung 54Bandscheibenvorfall 51Barbiturate 94Bechterew-Erkrankung 51Beckengürtelfraktur 216Belastung, mechanische 21Belegzelle, endostale

("endosteallining cells") 15Bettruhe 42Bewegung 88, 89"biomechanical properties,

extrinsic/intrinsic" 30Biopsie 55,171,193- Beckenkamm 37,80- Indikation 80- Studie 24>33Bisphosphonate 125-137,159 ,160,190,

191- Applikation , intravenöse 135,136- Halbwertszeit 131- intravenöse Gabe, Onkologie 186- Kontra indikationen 131,132

246 Sachverzeichnis---------

- molekulare Struktur 127- Monitoring 136,137- Pharmakokinetik 126-131- Resorption 131- Resorptionsmarker 137- Substanzen 132-135- Therapiedauer 136- Therapieversager 136,137- Toxizität 131,132- Überblick 126- Wirkmechanismus 126-131Bisphosphonate, immunhistologischer

Nachweis 38Blutdruck 39,88BMD ("bone mineral density") 8,97BMI ("body-mass-index") 201BMP ("bone morphogenie protein")

7,13brauner Tumor 56Brustkrebs 141- Hypogonadismus 181-183- Risiko 143BSP("bone sialoprote in") 78Budesonid 177

c

Canaliculi 14Carbamazepin 94,172Cathepsin K 18Cholesterinspiegel 39,59Clodronat 135,183CML (chronische myeloische

Leukämie) 168Cola 90Colitis ulcerosa 167Colles-Fraktur 215Computertomographie (CT) 58- periphere quantitative (pQCT) 65,

66- quantitative (QCT) 65,66"Consensus Conference

on Osteoporosis" 25Coumestane 121COX-2-Hemmer 107,108Crohn-Erkrankung 167"cross-linking" 7, 29, 77

CTX 140Cushing-Erkrankung 166Cyclosporin A 179

D

Darmerkrankung, entzündliche 95Darmoperation 95,167Deckplatteneinbrüche 86Depression 44,45Dexamethason 93DHEA (Dehydroepiandrosteron)

123, 124DHS (dynamische Hüftschraube)

207,208Diabetes mellitus 95,167Diagnostik 49-80- Computertomographie (CT)

58,65,66- Knochenbiopsie (5. Biopsie)- Knochendichtemessung

(5. auchdort) 58-73- Labordiagnostik 73-80- Leitsymptome 49-54- Magnetresonanztomographie

(MRT) 58- Mikroradioskopie 57- Morphometrie 56,57- Röntgen, konventionelles 54-56- Skelettszintigraphie 57,58- Übersicht, Tabelle 50Dichte- Knochendiehte 27- Knochenmineraldichte (BMD)

8,97Diclofenac 106Dosisfindungsstudie 98Doxorubicin 185DVO(Dachverband Osteoporose) 64DXA-Methode ("dual energy X-ray

absorptiometry") 61-65- .full body DXA scanner" 62- Strahlenbelastung 64- Vorteile 65DXL (Dualröntgen und

Lasertechnologie) 68

E

Eiweiß 92Empfehlungsgrade 99"empty box" 54Endok rinologie 166, 167Endost 28"endosteallining cells"

(endostale Belegzelle) 15Entwicklungsländer 113Erbfaktoren 40,41Erbkrankheiten 167, 168Ermüdungsbruch 30, 44Ernährung, knochenfreundliche

82Ernährungsplan 111Essstörung 44Etidronat 134"evidence based rnedicine" 98-103,

158- "levels of evidence" 98Exemestan 183

F

Fallneigung 47,202"fast loosers" 174Fehlernährung 46Femur, proximales, Fraktur 206-209- Formen, Abbildung 207,208- Versorgung , Abbildung 207Femurnagel 209Ferse 68Fett 92Fibrinogen 142Fibromyalgie 51Fibulafraktur 216Finger 69FIT-Studie

("fracture intervention trial") 133FK506 179"Flash -Beam"-Technologie 64Fluoride 146,147- "slow-release" 147Fluorose 56- iatrogene 146Folsäure 86

Sachverzeichnis 247

Fraktur- Beckengürtel 216- Colles-Fraktur 215- Definition 30,31- Ermüdungsbruch 30, 44- Femur, proximales 206- 209- Fibula 216- Folgefrakturen, Prävention 204,

2°5- .fragility fractures" 12,30,200- Fußwurzelknochen 216- gesellschaftspolitische Bedeutung

199- Heilung 86- Humerusfraktur, subkapitale 216- Infraktion 31- Keilfraktur 212- Kompressio nsfraktur 31,212- Lokalisation 206-216- - Abbildung 200- .Jow trauma fracture" 30- "microcracks" 12- Mikrofraktur 12, 14, 29, 107, 210- Nachsorge, Richtlinien 205,206,

218- - Begleitformular für den Arztbrief,

Abbildung 217- Oberarm 216- Oberschenkelhals 3,45,199,205- pathologische 30- Problemfraktur 208- Radiusfraktur, distale 215- Rippen 216- Risikofaktoren 2, 59,200-2°3,208- Tibia, distale 216- Unterarm 215,216- vorausgegangene 42- Wirbelkörper 209-215Frakturregister 205Frakturschmerz, Therapie- akute Phase 1°7,108- chronische Phase 108,109Fruchtsäfte 84

248 Sachverzeichnis---- - ----G

Gammanagel 209"gap junction" 14Gastroenterologie 167gastrointestinale Beschwerden 131Gehtest 47Gelenkersatz, endoprothetischer

193-198Gemüse 82Gene 21,22- genetische Syndrome, Tabelle 40Genistein 123Geschlecht 41, 42Getreideprodukte 82Gewichtheber 89Glasschneidermodell 139Glukokortikoide 93GnRH ("Gonadotropin-Releasing-

Hormon") Analoge 181,184Gonarthrose 53Gorham-Stout-Syndrom 32,192,193Größenabnahme 52Gruen, Zonen der Prothesenlockerung

196

H

HAART 169Hämatologie 168,169hämolytische Syndrome, congenitale

169Haut 54Hautallergie 131Hemialloarthroplastik,

Oberschenkelhals 207- bipolare 209Hemiplegie 43HERS-Studie 120Herzinfarkt 51Herzinsuffizienz 166- chronische 95Herzklappe- Anomalie 162- Operation 166Herztransplantation 166Hilfsmittel, orthopädische 213

"hip axiallength" 57Histologie, histologische Paramenter

37Hitzewallung 142HIV-Infektion 169Hochleistungssportler 43Hodgkin-Erkrankung 184Hormone 14- Risikofaktoren 46,47- systemische 18-20Hormonersatztherapie (HRT) 117-125- Frauen 117-119- Risiken/Nebenwirkungen 119,120Hüfte 68Hüftkopferhaltende Verfahren,

Oberschenkelhalsfraktur 208Hüftprotektor 47Hüftschraube, dynamische (DHS)

207,208Humerusfraktur, subkapitale 216Hydroxylapatit 65,146- Kristalle 126Hydroxylprolin 78Hyperkalzämie 116,125Hyperkalzurie 31,117,162Hyperkortisolismus 166Hyperparathyreoidismus (HPT) 55,

56- primärer (pHPT) 166- sekundärer 201Hyperphosphaturie 31Hyperthyreoidismus 166Hypogonadismus 46,124,150,166- Brustkrebs 181-183- maligne Lymphome 184- Prostatakrebs 184Hypokalzämie 132Hypothalamus 22

Ibandronat 134,135,183,186,191-193,198

ICS ("inhalation corticosteroidtherapy") 177

Ifosfamid 185Immobilisation 43

Implantat-Mikrobewegung 195Inaktivitätsosteoporose

(Immobilisationsosteoporose)32,157,194

Infektionskrankheiten 169Infraktion 31Insulin 18"insulin-like growth factor" 144Involutionsosteoporose 33-35Iprifiavon 122ISCD ("International Society

of Clinical Densiometry") 62Isofiavone 121, 122Isoniazide 94

J

jamshidi-Nadel 80

K

Kaffee 90Kallusbildung, hyperplastische 162Kalzifizierung, ektop ische 116Kalzitonin 18,107,145,146,159Kalzitriol 117,158Kalzium 110-113- Aufnahme 112- Ausscheidung 78- gebundenes 112- kalziumreiche Kost 81-8 5- natürliches III- Präparate III- Quellen 83- Stoffwechsel 110- Tabletten 84- tägliche Mengen, Empfehlung,

Tabelle 82- Zufuhr, ungenügende 44Kalziumkarbonat IIIKalziumoxalatsteine 116Kardiologie 166Käse 82Kaukasier 41Keilfraktur, Wirbelkörper 212Keratokonus 162

Sachverzeichnis 249---------

Kindheit 81"kiss ing spine" 52Knochen- Biologie 5-24- kortikaler 10- spongiöser 10Knochenabbau, Parameter 77Knochenatrophie 15,37Knochenbewusstsein 3Knochendichte 27Knochendichtemessung 58-73- Auswahl der Knochen 67-69- Geräte 60-67- Indikation 58,59,69-72- Kinder 72, 73- Strahlenexposition 73Knochene rkrankung, adynamische

171Knochenmarködem 191Knochenmasse 8, 26, 69- maximale ("peak bone mass")

22-24Knochenmatrix 5,14Knochenmetastasen 51,125,172Knochenmineraldichte (BMD)

8,60,97Knochenneubildung, Parameter 76Knochenräuber 82,90-93Knochenschwund, periprothetischer

(5.auchProthesenlockerung)193-198

Knochenstoffwechsel, Parameterim Blut 170

Knochenszintigramm 106Knochenumbau- Einheiten

("bone remodeling units") 15-18- Marker 75-80- quantitative Parameter, Tabelle 11- Rate 10- Zyklus 15Knochenwachstum ("modeling")

10

Knochenzellen 12-15Knochenzement 214Knoten 9- Dichte, Reduzierung 29Koffein 90

250 Sachverzeichnis---- - ----

Kollagen 6- Typ I 13,162Kompakta 9Kompressionsfraktur 31,212Kontrazeptiva, orale 46Körpergewicht- ideales 93- niedriges 44Körperhaltung 52,87Korsett 213Kortikosteroide 42- ICS ("inhalation corticosteroid

therapy") 177- induzierte Osteoporose 174-178Kortison 18Kortisonempfindlichkeit 174Kosten 3Kreuzschmerz 49Kyphoplastik 108,213- Abbildung 214Kyphose 51

L

Laboruntersuchung 73-80- Knochenumbaumarker 75-80- "screening" 73- Übersicht, Tabelle 74Lactone 121Laktose 82Laktoseintoleranz 167Lebensqualität 98Leberzirrhose 90,117- primäre biliäre 167LEPS("lower extremity pain

syndrome") 146Leptin 22,147Letrozol 183Leukämie, chronische myeloische

(CML) 168Lignane 121, 122Lipidstoffwechsel 138Lithium 94Looser-Umbauzone 31"low trauma fracture" 30LRP5 22LSC("least significant change") 78

Lungenerkrankung, chronische 95Lungenfibrose , zystische 172Lungentransplantation 172Lymphom, malignes 184

M

Magenoperation 95,167Magnesium 84,85,117Magnetfeldtherapie 109Magnetresonanztomographie (MRT)

58Malabsorptionssyndrome 167Mammakarzinom, metastasiertes

55Marcumars' 143Marknagel 216Mastozytose 169Matrix, Knochen 5,14mechanosensorische Zelle 14Medikamente, Risikofaktoren 47,93,

94Menopause 82,117- männliche 152Metaanalyse 98Metakarpale 57Metalloproteinase 7Methotrexat 185"microcracks" 12Migration 195Mikroarchitektur 30Mikrofraktur 12, 14, 29, 107Mikroradioskopie 57Milch/Milchprodukte 82Mineralien 21Mineralisation 7,8, 21,30, 113Mineralstoffe 46, 84Mineralwasser 84Mitralklappenprolaps 162Mobilisierung 108"modeling" (Knochenwachstum) 10Morbus (siehe Syndrome/Morbus)MORE-Studie 140,215Morphometrie 56,57Mortalität- Oberschenkelhalsfraktur 3- Risiko 2

Muskelrelaxantien 42,106Muskeltrain ing 43Muskelzelle 14Myelom, multiples 55, 168

N

Nahrungsmittel, Einfluss aufKalziumstoffwechsel, Tabelle 91

Nandrolondecanoat 125Nasenspray 145Nekrose- avaskuläre 209- vaskuläre 150Nephrologie 169-171Nervenfasern, afferente 130Nervenzellen 22Neurologie 172Niereninsuffizienz 95- chronische 169Nierensteine 162- Bildung 113,116,117Nierentransplantation 170Nikotin 45NOF ("National Osteoporosis

Foundation") 71,218

o

Oberarmfraktur 216Oberschenkelhalsfraktur 3,45 ,199,

205Obst 82OFELY-Studie 200Onkologie 172Opioid 107Orchidektomie 184Orthese 213Osseointegration, Faktoren 194Osteoblasten 13Osteodystrophie, renale 170Osteogenesis imperfecta 162,163- Differentialdiagnose 161- Therapie 162,163- Typen 162Osteokalzin 13, 86

Sachverzeichnis 251---------

Osteoklasten 12,13Osteologie 4Osteomalazie 31,37,51,55,114Osteomyelitis 55Osteonektin 13Osteopathie- AIDS 169- diabetische 167Osteopenie 35- Definition 27Osteophyt 55Osteoporomalazie 37,167,201- medikamenteninduzierte

187,188Osteoporose- Definition 25-28- Einteilung

fokale 31- - generalisierte 31,32

Histologie 37,38idiopathische junger Erwachsener

33- - idiopathische juvenile 32, 33,

159-161- - Inaktivitätsosteoporose

(Immobilisationsosteoporose)32,157,194

- - Involutionsosteoporose 33-35- - manifeste (schwere) 35- - postmenopausale 32,33- - präklinische 35- - regionale 31- - Schweregrad 35-37- - sekundäre 164-166- - systemische 31- - transiente (transitorische)

32,15°,191,192- beim Kind 154-163- - Ätiologie 154- - Definition 155-159- - Therapie 158,159- kortikosteroidinduzierte 174-178- Lokalisation 28, 29- beim Mann 149-154- - Prävention 153

Risikofaktoren 150- - spezifische Merkmale 152- - Therapie 153,154

252 Sachverzeichnis---- - ----

- Risiko- - Erkrankungen, Tabelle 164,165- - Medikamente, Tabelle 173- sekundäre 44- Stadiensystem, klinisches 36- Studien, Probleme der

Interpretation 103,104- Transplantationsosteoporose 179,

180- tumortherapieinduzierte 180,181Osteoporose-Bäuchlein 52Osteoprotegerin (OPG) 21Osteoprotektion 186Osteozyten 13Osterix 21Östrogen, pflanzliches

(Phytoöstrogen) 90,121 -123Östrogenagonist 138Östrogenrezeptor 13,122,138- SERMs(selektive Östrogenrezeptor-

modulatoren) 123,137-143Oxalsäure 116

p

Paget-Erkrankung 55,125,197Pamidronat 135,186Pankreas- Insuffizienz 167- Tumor 51Paralyse 43Paraplegie 43Parathormon 18,92,143-145- "parathormon-related proteins"

172

"patient's value" 98"peak bone mass"

(maximale Knochenmasse) 22-24Perforation, Knochenbälkchen 29"phantom bone" (Gorham-Stout-

Syndrom) 32,192,193Phenytoin 94Phosphate 92Phytomenadion 117Phytoöstrogen 90,121-123"picture frame" 54piezoelektrischer Effekt 109

Polyarthritis, primäre chronische(PcP) 94> 173

Polycythaemia vera (PV) 168Prävention 81-95Prednison 93PREVOS Studie 148Problemfraktur 208Propranolol 22Prostaglandine 20- Prostagiandin E 176Prostata- Hypertrophie 124- Karzinom 124, 184Prothesendesign 195Prothesenlockerung- aseptische 194- Behandlungsstrategie 196- Diagnostik 195,196- Faktoren 194- septische 195- Therapie 197,198- Zonen,Gruen 196Protonen-ATPase 102,130PSA (prostataspezifische Antigen) 124Pseudarthrosenbildung 209Pulmologie 172

Q

QUI ("quantitative ultrasound index")66,67

R

Rachitis 3,114"radiolucent lines" 195Radius 69Radiusfraktur, distale 215Raloxifen 137-143,151,181 ,186,198- klinische Sicherheit 142, 143- physiologische Effekte auf Knochen

138,139- Studienlage 139-141- Wirkmechanismus 139- Zusatznutzen, Brust und kardio-

vaskuläres System 141

RANK/RANKL-Osteoprotegerin-System 13

Rasse 41Rauchen 45,89,90Regel.roooer-Regel 116,177.remodellng" 11- "bone remodeling units"

(Knochenumbaueinheiten) 15-18Reparaturmechanismus 30Resorptionsphase 16Rezeptor- ß2-adrenerge 22- Östrogen 13,122,138- - SERMs (selektive Östrogen-

rezeptormodulatoren)123,137-143

Rheumatologie 173Rippenfraktur 216Risedronat 133,134,186,198Risikofaktoren 39-47Röntgen, konventionelles 54-56Rückenschmerz 49-53- akuter 52rückenschonendes Verhalten 86"ruffled border" 12"rugger-jersey-spine" 56Ruhephase 16,17

s

Salz 91Sandwich-Wirbel 56Sarkopenie 149Schallgeschwindigkeit 66Schallschwächung 66Scheitel-Sohlen-Abstand 52Schilddrüsenhormone 18,93Schmerz 51- Osteoporoseschmerz 52- Vernichtungsschmerz 52Schmerzambulanz 106Schmerzsyndrom. komplexes regio-

nales (CRPS,Sudeck-Erkrankung)32,188-191,216

- Stadien 189,190Schmerztherapie 105-109- Frakturschmerz 107-109

Sachverzeichnis 253

- Prinzipien 105- Stufenschema (WHO) 106Schutzreflex 47Schwangerschaft 42, 82Schwerelosigkeit 43Schwerkraft 43Schwimmer 89Screeningmethode 67- laborchemisches 73SERMs (selekt ive Östrogenrezeptor-

modulatoren) 123,137-143Serumlipide 142Sexualhormone 18, 20"Singh-Index" 57Skandinavier 41Skelett 5- appendikuläres 9, 10- axiales 9Skelettläsion. paraneoplastische 172Skelettszintigraphie 57,58Skleren- blaue 162- Ruptur 162Skoliose 51SMP ("sympathetically maintained

pain") 189"society's value" 98Softdrinks 91Sojaprodukte 123Sonnenbad 85Sonnenexposition 114Spickdrahtosteosynthese 216"spine deformity index" 57Spondylarthrose 54Spondylitis 55Spondylophyt 64Spongiosa 9Sport, übermäßiger 43,44Sportarten 88Spurenelemente 117Stabilität, Knochen 201Statine 147,148Steroide- anabole 125- Kortikosteroide 42,174-178Stilbene 121Stillzeit 42, 82Stolpersteine 47

254 Sachverzeichnis---- - ----STRATOS Studie 148"stress-shielding" 195Strontium 144,148Studien, randomisierte kontrollierte

(ReT) 98,100,101Sturzneigung 47,202SXA("single energy X-ray

absorptiometry") 65"sympathetic reflex dystrophy"

(Sudeck-Erkrankung) 32,188-191,216

- Stadien 189,190Syndrome/Morbus- Bechterew-Erkrankung 51- Crohn-Erkrankung 167- Cushing-Erkrankung 166- Gorham-Stout-Syndrom 32,192,

193- Hodgkin-Erkrankung 184- Klinefelter-Syndrom 124- Paget-Erkrankung 55,125,197- Sudeck-Erkrankung 32,188-191,

216

T

Tacrolimus 179Tamoxifen 137,138,181Tannenbaumphänomen 52Taubheit 162Teenager 81Telopeptide 77Tennis 88Teriparatid 144,145,154Testosteron 46, 89, 124- Ersatztherapie 149,153- Mangel 151,153Tetrazykiine 148Teufelskreis 1Therapie 97-148- antiresorptive Substanzen 97- Behandlungskonzept 104, 105- Behandlungsstrategie 104,105- Bisphosphonate (5.auchdort)

125-137, 159, 160, 186, 190, 191- Dosisfindungsstudie 98- "evidence based medicine " 98-103

- Fluoride 146,147- Hormonersatztherapie 117-125- Kalzitonin 145,146- Kalzium (5.auchdort) 110-113- Magnetfeldtherapie 109- osteoanabole Substanzen 97, 98- Parathormon (5.auchdort)

143- 145- Raloxifen (5.auchdort) 137-143,

151,181,186,198- Schmerztherapie (5.auchdort)

105-109- Vitamin D 113-117Thrombospondin-z 7Tibia, distale , Fraktur 216Tibolon 119Totalendoprothese 209Tragende Säule 54Trajektionslinien 9Tramadol 106transkriptionale Regulation 21,22Transplantationsosteoporose 179,180"T-score" 27"turnover, highllow" 15,75,174

u

Übersäuerung 92, 93Ultraschallmessung, quantitative

66Umschaltphase 17Unterarmfraktur 215,216Untersuchung, körperliche 51

v

"vanishing bone disease"(Gorham-Stout-Syndrom)32,192 ,193

VDS ("vertebral deformation score")56

Vererbung 40, 41Vertebroplastik 108,213- Abbildung 214Vertikalisierung 54V-H+-ATPase 18

Vitamine 21- fettlösliche 116- Vitamin A 86,117- Vitamin B12 86- Vitamin C 85- Vitamin D 85,113-117- - aktives 116,117- - empfohlene Tagesmenge 113- - Intoxikation 116- - Stoffwechselwege 114- - - Beeinflussung 187,188- - Synthese , Haut 114- - im Wachstum 115- Vitamin K 86,117Volkskrankheit 1, 2Vorsorgeprogramm 81Vorsorgeuntersuchung 39VTE (venöse thrombembolische

Ereignisse) 142

w

Wachstumsfaktoren 147Wachstumshormone 18,158Wadenkrampf 143"watch and wait"-Strategie 159WHI ("Women's Health Initiative

Study") 119,120WH0 (Weltgesundheitsorganisation)- Definition Osteoporose 25- Schmerztherapie, Stufenschema

106

Wirbelkörperfraktur 209-215- bikonkave 210- Formen und Schweregrade,

Abbildung 210- Häufigkeit,Abbildung 211- Keilfraktur 212- Kompressionsfraktur 212- Symptome 212Wirbels äule 67Wirbelsäulengymnastik 109Witwenbuckel 53Wolffsches Gesetz 88,195

Sachverzeichnis 255

z

Zähne 54- Anomalie 162Zementlinien 8Zoledronat 135,183,186,192,193,198"Z-score" 65Zucker 90,91Zwei-Phasen-Komponente 7Zytokine 20,21- postinflammatorische 194Zytostatika 94

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