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Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_6 | Pages 18 - 18
1 Feb 2016
Fabiane S Ward K Williams F
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Background and aims:

T2D is postulated to be an important aetiological factor for lumbar disc degeneration (LDD), which itself has a well documented relationship with low back pain. Obesity increases risk of both T2D, low back pain and LDD. Connective tissue modification has been reported in hyperglycaemia, but the epidemiology of LDD in T2D has not been described to date.

Methods and results:

A population sample of unselected same-sex adult twin pairs was studied who had attended a spine MR study and completed general health questionnaires defining T2D by self-report. LDD had been coded as the sum of five lumbar discs coded (0–3) for each of height, signal intensity, disc bulge and anterior osteophytes. Risk factors for LDD included age, body-mass index (BMI), sex, alcohol consumption and smoking.

Mean age of the 1011 participants = 54 years (sd=8), mean BMI=25 kg/m2 (sd=4), 95% female. The prevalence of T2D was 6%. Twins with T2D had increased BMI (27 vs 25 kg/m2, p<0.001) and were older (59 vs 54 years, p<0.001). LDD score in T2D was significantly higher in diabetic cases than controls (14.9 vs 13.1, p=0.04) in univariable analysis. In multivariable analysis inclusion of age and BMI abrogated the effect of T2D.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVII | Pages 45 - 45
1 Jun 2012
Chettier R Nelson L Ogilvie J Macina R Ward K
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Introduction

Several disorders have been associated with genetic variants. Copy number variations (CNVs) are documented micro DNA insertions and deletions that may be ten times more frequent than point mutations. We undertook a genome-wide scan to find CNVs associated with adolescent idiopathic scoliosis (AIS).

Methods

879 white individuals with AIS severe spine curvatures and 1486 white controls were evaluated for CNVs with the Affymetrix 6.0 HUSNP array. After implementation of quality filters, data were quantile normalised. Copy number analysis was done with Helix Tree (Golden Helix, Bozeman, MT, USA). The copy number segments were measured with the Golden Helix's univariate segmentation algorithm. Statistically different segments were extracted with mean Log2 ratio intensity for that segment to highlight deletions, neutrals, and duplications. We then undertook association analysis on those segments. A p value of less than 10–7 was regarded as significant.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_III | Pages 47 - 47
1 Feb 2012
Kiely P Ward K Chan S Bellemore M Little D
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Background

Distraction Osteogenesis can be complicated by regenerate insufficiency resulting in prolonged implant usage or regenerate failure with malalignment or fracture. Experimental evidence has demonstrated that bisphosphonates may mediate improved local limb BMD and regenerate strength.

Methods

A prospective series of 14 patients over 5 years. One cohort (Group A) of these cases presented with established regenerate insufficiency leading to consideration for surgical intervention. Patients received a therapeutic regime of intravenous bisphosphonate A further cohort (Group B) of 7 patients was commenced on bisphosphonate therapy at an earlier stage, prior to the regenerate maturation phase.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 435 - 435
1 Aug 2008
Ward K Nelson L Ogilvie J Braun J
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Purpose: Adolescent idiopathic scoliosis (AIS) is know to occur in families and research has shown that in populations or predominantly Northern European origin, 97% of AIS patients are related to families with AIS. It affects 1–2% of the population and results in deformities treated by bracing and surgery. Brace prescription is empirical and surgery is reserved for late cases and brace failures. Identifying the genetic markers for AIS would allow creation of a diagnostic gene-based test that may also have prognostic value for differentiating progressive and non-progressive curves.

Methods: A 21 million name data base of the original European pioneers in Utah was assembled including 3 million descendents and 18 million ancestors. 500 DNA samples from affected and first degree unaffected relatives were collected and genotypes determined with capillary electrophoresis using 763 autosomal markers and gene chip scanning for 116 000 SNPs. Disease haplotypes were also scanned with a 500K SNP chip to further narrow the position of each loci.

Results: Two markers were identified with LOD scores of 7.0 and 7.3. p-values from SNP scanning were highly significant. More detailed descriptions of these genotypes will be presented.

Conclusion: Two genetic markers were identified, one of which was present in 95% of patients with AIS greater than 40°. In our population, no one with AIS less than 40° had these markers. A genotype test for AIS may be possible that would offer both diagnostic and prognostic value. Further characterization of the genes and their mutations could give information concerning the molecular pathway that lead to disease expression.