Association Between Combat‐Related Traumatic Injury and Skeletal Health: Bone Mineral Density Loss Is Localized and Correlates With Altered Loading in Amputees: the Armed Services Trauma Rehabilitation Outcome (ADVANCE) Study
Authors' conclusion
Changes in bone health in CRTI appear to be mechanically driven rather than systemic and are only evident in those with lower limb amputation.
Study context
- Population
- Male adult UK military personnel with combat-related traumatic injury (CRTI) from the UK-Afghanistan War 2003 to 2014, and matched uninjured men153 lower limb amputees
- Participants
- 575 vs 562
- Exposure
- Combat-related traumatic injury vs uninjured
- CRTIn = 575
- Uninjuredn = 562reference
- Outcome
- BMD by DXA of the hips and lumbar spine
Methodological detailscross-sectional analysis of first phase of a cohort study, frequency-matched
- Cross-sectional analysis of first phase of a cohort study
- Frequency-matched
Main finding
As reported in the abstract
Femoral neck BMD (T-score)
- Femoral neck bone mineral density (BMD) was lower in CRTI than uninjured
- CRTI vs Uninjured: P = 0.000
Observational data: associations, not effects.
Further findings
Femoral neck BMD, subgroup: amputated limb of amputees
- Reduction significant only at femoral neck of the amputated limb of amputees
- P = 0.000
- Reduction greater for above knee than below knee amputees
- P < 0.001
Spine BMD and activity levels, amputees vs controls
- No differences in spine BMD or activity levels between amputees and controls
Original publication
Association Between Combat‐Related Traumatic Injury and Skeletal Health: Bone Mineral Density Loss Is Localized and Correlates With Altered Loading in Amputees: the Armed Services Trauma Rehabilitation Outcome (ADVANCE) Study. J Bone Miner Res. Published 17 May 2023. doi:10.
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