Bone, Joint, and Muscle Infections in Children

Bone, Joint, and Muscle Infections in Children

Article Featured on AAOS

Children can develop infections in their bones, joints, or muscles. Often referred to as “deep” infections, the technical names for these conditions are:

  • Osteomyelitis (bone infection)
  • Septic arthritis (joint infection)
  • Pyomyositis (muscle infection)

This article covers the most common types of deep infections in children and includes the ways doctors identify and treat them.

Cause

Infections are usually caused by bacteria that are present in our normal living environment. The most common bacteria causing bone, joint, or muscle infections in children is Staphylococcus aureus (often referred to as “Staph” infections).

Bacteria can get into the body in a variety of ways. They circulate through the bloodstream until they reach a bone, joint, or muscle. Bacteria then leave the bloodstream and multiply in the bone, joint, or muscle tissues.

Description

Deep infections most often occur in the joints and at the ends of long bones where they meet to form joints. These include the hip, knee, and ankle joints of the leg, and the shoulder, elbow, and wrist joints of the arm.

The large muscle groups of the thigh, groin, and pelvis are the most common locations for deep muscle infections.

The reason infections occur in these areas is due to the way blood flows to these locations. There is a strong blood flow to the ends of bone near growth centers (called growth plates), the lining of the joints, and the large muscle groups. This allows bacteria to easily find their way to these areas.

The blood supply to the spine, pelvis, and heel is similar to that of the long bones, and infections often develop in these areas, as well.

Infections pose special risks to young children for a number of reasons:

  • Children under the age of three are easily infected. Their immune systems are not fully developed and they tend to fall down a lot, opening the skin to infection.
  • Infections spread quickly through a young child’s circulation system and bone structure.
  • Damage to bones and joints caused by infection can harm a child’s growth and lead to physical dysfunction. Infection of child’s hip joint is a surgical emergency.

Symptoms and Signs

Children who have infections of their bones, joints, or muscles often have the following:

  • Fever
  • Pain
  • Limited movement of the infected area — your child may limp or refuse to walk if the infection involves the legs or back
  • Infants may be irritable and lethargic, refuse to eat, or vomit

Many children who have bone, joint, or muscle infections have had recent injuries. The symptoms of infection are often masked by those of the injury. Because parents assume the injury will get better over time, it may take them longer to notice the infection.

It is important to bring your child to a doctor immediately if symptoms are not quickly resolving at home.

Doctor Examination

Medical History and Physical Examination

Make sure to tell your child’s doctor the circumstances surrounding the symptoms, such as when the symptoms began, and whether there was a prior infection or injury.

After discussing your child’s symptoms and medical history, your doctor will examine the painful area. He or she may ask your child to move the affected area to see whether movement increases the pain.

Tests

Other tests that may help your doctor confirm a diagnosis and plan your child’s treatment include:

  • Blood tests and tissue cultures. Tests on your child’s blood, as well as fluid and/or tissue from the infected area, can help identify the bacteria or other organism causing the infection. This information about the infection helps your doctor determine the most effective ways to treat it.
  • Imaging tests. Tests, such as x-rays, magnetic resonance imaging (MRI) scans, and ultrasound, provide your child’s doctor with pictures of the bones, muscles, and soft tissues in the affected area. Your doctor will look for swelling around bones and muscles, or fluid within the joints that are infected. This information helps your doctor when making the decision whether to treat the infection with antibiotics alone or to perform surgery to help resolve it.

Treatment

Antibiotic Treatment

Prescribing antibiotics is the mainstay of treatment for infections.

  • Intravenous. At first, your child will need to stay at the hospital to receive antibiotics through the veins (intravenous or IV). How long your child will stay in the hospital will depend on how severe the infection is. Most children with bone, joint, or muscle infections are in the hospital for 1 to 2 weeks.
  • Oral. For many children, the antibiotic is eventually changed to a form that can be taken by mouth (oral) and given at home.
  • PICC line. Some children can continue to receive an antibiotic by vein at home through a special intravenous device called a PICC (pronounced “pick”) line. This is a peripherally introduced central catheter (PICC).

The amount of time on antibiotics that is needed to resolve an infection varies from child to child but, in general, is 4 to 6 weeks for a bone infection and 3 to 4 weeks for joint or muscle infections.

It is very important to have your child take all of the antibiotics he or she is given, in exactly the way they are prescribed.

Surgical Treatment

In mild infections, antibiotics alone may resolve the condition. Many children, however, will need surgery to remove infected material (pus) from the area of infection. This will reduce pressure and inflammation and improve blood flow, which will make it easier for the antibiotics to reach the infected area. For most children, one surgical procedure is enough, but more severe infections may require two or more surgeries to help resolve the infection.

Infected biceps muscle

An infection in the biceps muscle has caused pus to accumulate in this child’s upper arm. During surgery, the pus will be drained so that antibiotics can effectively reach and resolve the infection.
Courtesy of Children’s Medical Center of Dallas

Outcome

Most children will completely recover from deep infections after proper treatment. They are not likely to develop the same infection again. In most cases, children have no further problems and return to all of their activities.

In general, children do better when the infection is recognized early. There is a greater chance for full recovery when the infection is quickly recognized and treated. The later the diagnosis is made, the more likely it is that the infection will cause greater damage to the bones, muscles and other tissues that are involved.

Some problems can occur in children who have serious and prolonged infections. These include blood clots, growth arrests, deformed bones, fractures through bone that is weakened from infection, bone death (called necrosis), and joint stiffness. However, these problems are rare.

Methicillin Resistant Staphylococcus Aureus (MRSA)

In many communities, deep infections are more frequently being caused by a particular type of bacteria known as MRSA. This bacteria is more able to resist antibiotics that previously worked well to treat these infections.

Currently, there are several antibiotics that work very well against MRSA and are tolerated very well by the children who are treated.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

25 Foods for Strong Bones

25 Foods for Strong Bones

Your bones require specific nutrients to stay strong and healthy. Calcium and vitamin D are the two big ones most people recognize, but magnesium, protein, omega-3 fatty acids, and vitamins A, C, and K are also essential for bone health.

Here are 25 foods that will supply you with those essential nutrients when included in a balanced diet.

Read more

Best Exercises for Bone Health With RA

Best Exercises for Bone Health With RA

Article Featured on WebMD

If you take corticosteroids for your RA, it’s a good idea to step up your exercise to help keep your bones strong. You will also strengthen the muscles that support your joints, so you’ll move better. You will also improve your heart health, energy level, mood, balance, and coordination.The best exercises for building bone are weight-bearing exercises, such as these:

Walking

It’s simple, free, and you can do it anywhere. A regular walking program strengthens your hip bones, ankles, and knees. To get the most benefits, walk for at least 30 minutes, 5 days a week. You can break that up into three 10-minute strolls, if you like.

Strength Training

You can use exercises with free weights, weight machines, or elastic exercise bands. Do it at a gym or at home with handheld weights, resistance bands, or even soup cans from your cupboard. Aim to do your exercises 2 to 3 days per week. A physical therapist or certified fitness trainer who has experience working with people with RA can get you started.

Yoga

It eases stiffness and tension, and some poses also help your bones. Talk to your physical therapist or find an instructor who has taught people with arthritis. Once you know the postures, you can practice at home.

Stationary Bikes and Elliptical Machines

Does RA affect your back and hips? You may want to try a recumbent bike, in which you sit down with your legs stretched in front of you. It may feel better than an upright bike.

Elliptical trainers give you a good workout and are easy on your knees.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Fast food linked to poorer bone development in early years

Fast food linked to poorer bone development in early years

Article Featured on Medical News Today
Living in a neighborhood where there is greater access to fast food outlets may affect bone development in early childhood, according to the first study to investigate links between neighborhood food environment and bone mass in the first 6 years of life.
The researchers say exposure of mothers and children to more healthy food environments might optimize childhood bone development.

Reporting their findings in the journal Osteoporosis International, researchers from the University of Southampton in the UK also conclude:

“If confirmed in future studies, action to reduce access to fast-food outlets could have benefits for childhood development and long-term bone health.”

The team also found that having more healthy specialty stores in the neighborhood is linked to higher bone mass in young children.

For their study, the researchers used data on 1,107 children that was collected in the Southampton Women’s Survey, a research project that aims to learn about the dietary and lifestyle factors that influence the health of women and their children.

They compared the bone mineral density and bone mineral content of children at birth, and then at age 4 or 6, to the number of supermarkets, healthy specialty stores and fast food outlets in their neighborhood.

‘Improving food environment could benefit bone development’

The analysis showed that a higher number of fast food outlets in the neighborhood was tied to lower bone mineral density and bone mineral content in newborns. However, this link was not significant at age 4 and 6.

In contrast, the researchers note that having more healthy specialty stores in the neighborhood – such as greengrocers selling fresh fruit and vegetables – was tied to higher bone mineral density at age 4 and 6.

Coauthor Cyrus Cooper, professor of rheumatology and director of the Medical Research Council Lifecourse Epidemiology Unit at Southampton, where the study took place, says:

These findings suggest that the exposure of mothers and children to more healthy food environments might optimize childhood bone development through its influence on the quality of the maternal diet and dietary choices during childhood.”

He explains if the findings are confirmed with more extensive research, then they would suggest that improving the food environment could benefit children’s bone development.

Initiatives to improve the food environment have already begun in some parts of the UK, where local planning regulations do not allow fast food outlets within 400 meters of schools.

October 20th is World Osteoporosis Day, whose message this year is “serve up bone strength,” to emphasize the role that a healthy diet plays in bone health.

Research shows that a balanced diet containing adequate amounts of fruits, vegetables, protein, calcium and vitamin D helps develop healthy bones throughout life.

According to a 2014 report from the American Academy of Pediatrics, attaining substantial bone mass in early life is thought to be the “most important modifiable determinant of lifelong skeletal health.”

Earlier this year, Medical News Today also learned of a study published in Nature Communications that found early antibiotic use may affect child development by promoting weight gain, increased bone growth and altered gut bacteria.

What is a hairline fracture?

What are the symptoms of a hairline fracture?

What is a hairline fracture?

A hairline fracture, also known as a stress fracture, is a small crack or severe bruise within a bone. This injury is most common in athletes, especially athletes of sports that involve running and jumping. People with osteoporosis can also develop hairline fractures.

Read more

16 Ways You May Be Hurting Your Joints

16 Ways You May Be Hurting Your Joints

Your joints link bones together so you can bend your knees, wiggle your hips, and move your body. Learn how you might be preventing your joints from working their best.

Carry Extra Weight

Your joints, which link your bones together, are sensitive to heavy loads. Every pound on your frame puts 4 pounds of stress on your knees. It also strains your back, hips, and feet. That causes wear and tear that can lead to damage, aches, and pain. Being overweight also triggers inflammation. That can make all your joints, including in your hands, stiff, painful, and swollen.

Text Too Much

‘Texting thumb’ is a real thing. Your tendons can get irritated and lock your thumb in a curled position. All that looking down at your phone is just as bad for your neck and shoulders, too. Every inch your head drops forward raises the load on your muscles. If you bend your neck so far that your chin touches your chest, it’s as if your neck has to support the weight of 5 heads instead of just one.

Steep Price of High Heels

They might look fab, but the higher they rise, the more your weight tips forward. Your thigh muscles have to work harder to keep your knee straight, which can cause pain. When heels go up, so does the twisting force in your knees. If you wear them every day, you boost your odds for osteoarthritis. That’s when the bones and the cushioning between the bones break down.

Wear the Wrong Shoes

Worn-out shoes don’t support your feet and ankles enough. That’ll throw your knees, hips, and back out of whack. Also, make sure your sneakers are right for your sport. High tops for basketball, for example, can protect your ankles from sprains. But don’t go overboard. Too much cushion or arch support means your foot can’t move naturally, which could keep you in a cycle of pain.

Crack Your Knuckles

That satisfying pop comes from tiny bubbles bursting in the fluid around your joints. Or from ligaments snapping against bone. Despite what annoyed adults might have warned you, it doesn’t cause arthritis. Still, it might be smart to stop. One study showed that this habit may cause your hands to swell and weaken your grip.

Lug a Big Bag

Whether it’s a purse, backpack, or messenger bag, packing too much can cause neck and shoulder pain. Heavy weight on one shoulder throws off your balance and your walk. If you tend to carry things only on one side, the constant pull overstretches your muscles and tires out your joints. If you do that every day, your body’s going to let you know loud and clear.

Use Wrong Muscles for the Job

When you put too much load on little muscles, your joints pay the price. If you need to open a heavy door, push with your shoulder instead of your fingers. When you lift something off the floor, bend at your knees and push up with your strong leg muscles. When you carry something, hold it close to you in the palms of your hands instead of stressing your fingers.

Sleep on Your Stomach

It might help with snoring, but not so much with the rest of your body. Lying on your tummy pushes your head back, which compresses your spine. Your head also will face in one direction for longer stretches than if you sleep on your back. All that puts pressure on other joints and muscles.

Skip Stretching

You don’t need to be a yogi, but regular stretching can help strengthen your muscles and tendons. It also can make them more flexible. That allows your joints to move more easily and helps the muscles around them work better. That’s key to healthy and stable joints.

Skimp on Strength Training

Once you turn 40, your bones start to get a little thinner and more likely to break. If you build muscle with strength training, it slows bone loss and triggers new growth. So you not only get stronger muscles, but denser bones, too. Together, they stabilize your joints so you’re less likely to get hurt.

Smoke and Chew Tobacco

Here’s another reason to quit: Your joints will thank you. Nicotine from cigarettes and chewing tobacco cuts down on blood flow to your bones and to the cushioning discs in your back. It limits how much bone-building calcium your body can take in. It also breaks down estrogen, a hormone you need for bone health. And it slows new growth that thickens bones. All that makes your joints weaker and your hips more likely to break.

Don’t Get Quality ZZZs

You may wonder how poor sleep can affect your joints. One study found that people with arthritis felt more pain after restless nights. That made them take a closer look. One theory is that when you don’t sleep well, it triggers inflammation in your body. That might lead to joint problems over time. More research is needed, but in the meantime, it sure won’t hurt to get good shut-eye.

Slouch and Slump

Your body’s at its best when you work with it, not against it. That’s why posture matters. When you slump in your chair, it puts more stress on your muscles and joints and tires them out. It’s like always jamming on your car brakes when you could just ease down on the pedal instead. So keep your back straight and those shoulders back and down.

Ignore Pain

When you work out, you might think you just need to power through it. After all, no pain, no gain, right? It’s true that some muscle soreness is OK. But not if it lasts for days or if your muscles are swollen or too sore to move or to touch. Joint pain isn’t normal, so pay attention to it. If you think you overdid it, ease up on your exercises. If the pain won’t go away, check with your doctor.

Too Much Computer Time

It can literally be a pain in your neck — and your elbows, wrists, back, and shoulders. The problem isn’t just bad posture, but that you hold it for too long. That overworks your muscles. It also puts pressure on the discs in your back. If you’re in a soft chair, prop up your arms with cushions to take the load off your shoulders and your neck. Be sure to get up and move every hour.

Repeat Poor Form

When you run, bike, or play tennis, you use the same motions over and over. But if your form is bad, you’ll stress your body in all the wrong places. If you overload your muscles, it puts more pressure on your joints, and you can end up with an injury like tennis elbow.

 


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Bone health: Tips to keep your bones healthy

Bone health: Tips to keep your bones healthy

Protecting your bone health is easier than you think. Understand how diet, physical activity and other lifestyle factors can affect your bone mass.

By Mayo Clinic Staff

Bones play many roles in the body — providing structure, protecting organs, anchoring muscles and storing calcium. While it’s important to build strong and healthy bones during childhood and adolescence, you can take steps during adulthood to protect bone health, too.

Why is bone health important?

Your bones are continuously changing — new bone is made and old bone is broken down. When you’re young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. Most people reach their peak bone mass around age 30. After that, bone remodeling continues, but you lose slightly more bone mass than you gain.

How likely you are to develop osteoporosis — a condition that causes bones to become weak and brittle — depends on how much bone mass you attain by the time you reach age 30 and how rapidly you lose it after that. The higher your peak bone mass, the more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age.

What affects bone health?

A number of factors can affect bone health. For example:

  • The amount of calcium in your diet. A diet low in calcium contributes to diminished bone density, early bone loss and an increased risk of fractures.
  • Physical activity. People who are physically inactive have a higher risk of osteoporosis than do their more-active counterparts.
  • Tobacco and alcohol use. Research suggests that tobacco use contributes to weak bones. Similarly, regularly having more than one alcoholic drink a day for women or two alcoholic drinks a day for men may increase the risk of osteoporosis.
  • Gender. You’re at greater risk of osteoporosis if you’re a woman, because women have less bone tissue than do men.
  • Size. You’re at risk if you are extremely thin (with a body mass index of 19 or less) or have a small body frame because you might have less bone mass to draw from as you age.
  • Age. Your bones become thinner and weaker as you age.
  • Race and family history. You’re at greatest risk of osteoporosis if you’re white or of Asian descent. In addition, having a parent or sibling who has osteoporosis puts you at greater risk — especially if you also have a family history of fractures.
  • Hormone levels. Too much thyroid hormone can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. Prolonged absence of menstruation (amenorrhea) before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass.
  • Eating disorders and other conditions. People who have anorexia or bulimia are at risk of bone loss. In addition, stomach surgery (gastrectomy), weight-loss surgery, and conditions such as Crohn’s disease, celiac disease and Cushing’s disease can affect your body’s ability to absorb calcium.
  • Certain medications. Long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone and dexamethasone, is damaging to bone. Other drugs that might increase the risk of osteoporosis include aromatase inhibitors to treat breast cancer, selective serotonin reuptake inhibitors, methotrexate, some anti-seizure medications, such as phenytoin (Dilantin) and phenobarbital, and proton pump inhibitors.

What can I do to keep my bones healthy?

You can take a few simple steps to prevent or slow bone loss. For example:

  • Include plenty of calcium in your diet. For adults ages 19 to 50 and men ages 51 to 70, the Recommended Dietary Allowance (RDA) is 1,000 milligrams (mg) of calcium a day. The recommendation increases to 1,200 mg a day for women after age 50 and for men after age 70.

    Good sources of calcium include dairy products, almonds, broccoli, kale, canned salmon with bones, sardines and soy products, such as tofu. If you find it difficult to get enough calcium from your diet, ask your doctor about supplements.

  • Pay attention to vitamin D. Your body needs vitamin D to absorb calcium. For adults ages 19 to 70, the RDA of vitamin D is 600 international units (IUs) a day. The recommendation increases to 800 IUs a day for adults age 71 and older.

    Good sources of vitamin D include oily fish, such as salmon, trout, whitefish and tuna. Additionally, mushrooms, eggs and fortified foods, such as milk and cereals, are good sources of vitamin D. Sunlight also contributes to the body’s production of vitamin D. If you’re worried about getting enough vitamin D, ask your doctor about supplements.

  • Include physical activity in your daily routine. Weight-bearing exercises, such as walking, jogging, and climbing stairs, can help you build strong bones and slow bone loss.
  • Avoid substance abuse. Don’t smoke. If you are a woman, avoid drinking more than one alcoholic drink each day. If you are a man, avoid drinking more than two alcoholic drinks a day.

Enlist your doctor’s help

If you’re concerned about your bone health or your risk factors for osteoporosis, including a recent bone fracture, consult your doctor. He or she might recommend a bone density test. The results will help your doctor gauge your bone density and determine your rate of bone loss. By evaluating this information and your risk factors, your doctor can assess whether you might be a candidate for medication to help slow bone loss.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Coaxing' stem cells to form new bone tissue

‘Coaxing’ stem cells to form new bone tissue

By Maria Cohut

| Article Featured on Medical News Today

New research has identified a possible way to manipulate certain stem cells to generate new bone tissue. The results of this investigation could vastly improve the outcome for people with skeletal injuries or conditions such as osteoporosis.

A new study looks at how to encourage stem cells to form new bone tissue rather than other types of tissue.

Stem cells are undifferentiated cells that have the potential to specialize and undertake any function.

Much recent research has focused on how best to use stem cells for therapeutic purposes. Researchers are particularly interested in how to manipulate them to create new tissue that can successfully replace damaged sets of cells or those that are no longer functional.

In a new study from the Johns Hopkins University School of Medicine in Baltimore, MD, Dr. Aaron James and his team have looked into the mechanisms that allow certain types of stem cell, which are known as “perivascular stem cells,” to form new bone tissue.

These stem cells tend to turn into either fat tissue or bone tissue. To date, it has been unclear what, exactly, determines their fate.

“Our bones have a limited pool of stem cells to draw from to create new bone. If we could coax these cells toward a bone cell fate and away from fat, it would be a great advancement in our ability to promote bone health and healing.”

Dr. Aaron James

The investigators conducted their research in a rat model as well as in human cell cultures, and they report their findings in the journal Scientific Reports.

The protein that drives cell fate

Previous studies that Dr. James conducted have suggested that a particular signaling protein called WISP-1 is likely to drive the fate of perivascular stem cells by “telling” them whether to form fat or bone tissue.

In the current study, the researchers sought to prove WISP-1’s role in determining stem cell fate by genetically modifying a set of human stem cells to stop them from producing this protein.

When they compared gene activity in the engineered stem cells with gene activity in cells that still produced WISP-1, the researchers confirmed that the protein played an important role. In the cells without WISP-1, four of the genes responsible for fat formation had a 50–200 percent higher level of activity than they did in the cells continuing to produce WISP-1.

This also indicated that the correct dosage of this signaling protein could drive the stem cells to form bone tissue instead of fat tissue.

As expected, when the researchers then modified stem cells to increase WISP-1 production, they noticed that three of the genes that stimulate bone tissue growth became twice as active compared with those in stem cells with normal levels of the signaling protein.

At the same time, the activity of genes that stimulated the growth of fat tissue — such as peroxisome proliferator-activated receptor gamma (PPARG) — was 42 percent lower in stem cells with a WISP-1 boost, and this decrease occurred in favor of genes that determine bone tissue growth.

Stem cell intervention shows promise

In the next stage of the study, the scientists used a rat model to determine whether WISP-1 could boost bone healing in spinal fusion, a type of medical intervention that requires joining two or more vertebrae (spine bones) to form a single bone.

The therapeutic use of spinal fusion is to improve back pain or spinal stability in the context of various conditions that affect the spine, such as scoliosis.

Usually, “Such a procedure requires a massive amount of new bone cells,” explains Dr. James. “If we could direct bone cell creation at the site of the fusion, we could help patients recover more quickly and reduce the risk of complications,” he notes.

In the current study, the researchers injected human stem cells that had active WISP-1 into rats. They did this between the vertebrae that were due to become joined as part of the fusion procedure.

After 4 weeks, Dr. James and his team found that the animals still displayed high levels of WISP-1 in their spinal tissue. Moreover, new bone tissue was already forming in the right places, allowing the vertebrae to become “welded.”

Conversely, rats that had received the same surgical intervention but without the WISP-1 boost did not present any vertebral fusion during this same period.

“We hope our findings will advance the development of cellular therapies to promote bone formation after surgeries like this one and for other skeletal injuries and diseases, such as broken bones and osteoporosis,” Dr. James declares.

In the future, the research team also aims to find out whether reducing WISP-1 levels in stem cells could lead them to form fat tissue, which could help promote faster wound healing.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Eating for Your Bones

Eating for Your Bones

Article Featured on US News | By Lisa Esposito

SKELETONS IN A SCIENCE classroom are dangling structures of solid rods, disks and plates – simple building materials. But the living bones supporting your body are much more dynamic. “People think bone is some kind of inert substance,” says Dr. Michael Greger, founder of NutritionFacts.org. “But, actually, we’re remodeling our bone all the time. It’s a living, breathing organ that bleeds.” As your body continually breaks down and replenishes bone, you should feed it well.

Calcium from cow’s milk for strong bones has long been the conventional dietary wisdom. “When people think of calcium-rich foods, they think of dairy products,” says Carrie Dennett, a Seattle-based registered dietitian nutritionist. “But it’s good to look beyond these obvious sources.”

Eating canned sardines and canned salmon – as long as they still have their bones – is good for your bones, Dennett says. Dark, leafy green vegetables and other types of produce, including collard greens, broccoli rabe, turnip greens and kale, also promote bone health, she says. In addition to their antioxidant properties, fruits and vegetables contain nutrients like potassium, which help conserve calcium in the body.

“Not a big prune fan? Well, your bones like them,” Greger says. An evidence review published in the April 2017 issue of the journal Nutrients concluded that dried plums, e.g., prunes, guard against bone loss in women after menopause. That’s important because of older women’s increased risk of osteoporosis, falls and fractures as their bone mineral density decreases. Prunes help maintain bone-building cells called osteoblasts, Greger explains.

Almonds, on the other hand, help suppress osteoclasts, cells that break down bone tissue, according to a study from the University of Toronto published in the journal Metabolism: Clinical and Experimental, in July 2011.

“Soy is one food that’s been put to the test and found to significantly improve bone function,” Greger says. In a comparison study, menopausal women who were randomly assigned to consume two glasses of soy milk daily showed increased bone mass after two years, he says. However, women in the control group, who received hormonal replacement treatment via skin patches, lost significant bone density in that time.

“You do see lower bone fracture rates in women who eat more soy,” Greger says. He recommends whole soy foods like edamame or tempeh, a traditional soy product from Indonesia.

Along with bone mass, older adults worry about losing muscle, Dennett points out. “We want to stay strong and stay healthy,” she says. “We need to keep our muscle for that.” Protein, which is essential for muscle health, has gotten a bad rap because of the lingering myth that it leaches calcium from the bones. “That’s not necessarily true,” she says. “Somebody would have to be getting excessive amounts. But getting an adequate amount of protein is good for both muscle and bone.” Balanced diets include healthy sources of lean protein.

The acid-alkaline diet– based on the premise of helping your body control its pH through diet –is often touted as beneficial for bone health, but it’s not, Dennett says. The reality is our body has other mechanisms for regulating acid-base balance in the body, including our rate of breathing,” she says. “So we don’t need to eat an ‘alkaline’ diet to prevent the body from pulling minerals from our bones to maintain blood pH.”

Bones need vitamins as well as minerals like calcium. Dark-green leafy vegetables are a good source of vitamin K, which promotes healthy bones, Greger says. However, he adds, avoid veggies such as spinach, beet greens and Swiss chard, because they contain substances called oxalates, which can bind up calcium. Low-oxalate vegetables (such as cabbage and cucumbers) are probably the most absorbable whole-food source of calcium – more so than cow’s milk, he adds.

Vitamin D plays an important role. One sign of vitamin D deficiency is softening of the bones, which is a precursor to osteoporosis, Dennett says. “Vitamin D is pretty much the only supplement I almost universally recommend to my patients,” she adds. “Most of us don’t get enough vitamin D from diet … and if we’re doing our due diligence by protecting our skin from the sun, then we’re probably not making enough natural vitamin D.”

To create a truly bone-friendly meal, try this, Greger suggests: “Trail mix: prunes and nuts, or maybe a nut-stuffed prune. Washed down with soy milk and then maybe with some dark-green leafy vegetables for dessert.”

As appealing as that may or may not sound, you could also turn to any of several top-ranked diets to boost your bone health. Plant-based diets such as the Mediterranean, Flexitarian and Ornish diets will meet all your leafy-green needs. Balanced eating plans including the DASH, MIND and Mayo Clinic diets provide plenty of healthy sources for all the fruits and veggies, fish, soy products, minerals and vitamins you require to keep bones strong.

Best Plant-Based Diets

RANKDIET NAME
#1Mediterranean Diet
#2The Flexitarian Diet
#3Ornish Diet
#4Vegetarian Diet
#5The Traditional Asian Diet
#6Dr. Weil’s Anti-Inflammatory Diet
#7Nutritarian Diet
#8The Engine 2 Diet
#9Vegan Diet
#10Eco-Atkins Diet

DIET Ranking information as of January 3rd, 2018


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

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