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Impact of osteoporo...
Impact of osteoporosis and osteoporosis medications on fracture healing : a narrative review
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- Chandran, M. (författare)
- Singapore General Hospital,Duke–NUS Medical School
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- Akesson, K. E. (författare)
- Lund University,Lunds universitet,Ortopedi,Forskargrupper vid Lunds universitet,Orthopedics,Lund University Research Groups,Skåne University Hospital
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- Javaid, M. K. (författare)
- University of Oxford
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- Harvey, N. (författare)
- University of Southampton,University Hospital Southampton
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- Blank, R. D. (författare)
- Medical College of Wisconsin
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- Brandi, M. L. (författare)
- University of Florence
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- Chevalley, T. (författare)
- Geneva University Hospital
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- Cinelli, P. (författare)
- University of Zurich,University Hospital of Zurich
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- Cooper, C. (författare)
- University of Southampton,University of Oxford,University Hospital Southampton
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- Lems, W. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Lyritis, G. P. (författare)
- Hellenic Osteoporosis Foundation
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- Makras, P. (författare)
- 251 Hellenic Air Force Hospital
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- Paccou, J. (författare)
- University of Lille
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- Pierroz, D. D. (författare)
- International Osteoporosis Foundation, Switzerland
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- Sosa, M. (författare)
- University of Las Palmas de Gran Canaria
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- Thomas, T. (författare)
- University of Lyon,Jean Monnet University
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- Silverman, S. (författare)
- University of California, Los Angeles
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- Engelska.
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Ingår i: Osteoporosis International. - 0937-941X.
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Summary: Antiresorptive medications do not negatively affect fracture healing in humans. Teriparatide may decrease time to fracture healing. Romosozumab has not shown a beneficial effect on human fracture healing. Background: Fracture healing is a complex process. Uncertainty exists over the influence of osteoporosis and the medications used to treat it on fracture healing. Methods: Narrative review authored by the members of the Fracture Working Group of the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF), on behalf of the IOF and the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT). Results: Fracture healing is a multistep process. Most fractures heal through a combination of intramembranous and endochondral ossification. Radiographic imaging is important for evaluating fracture healing and for detecting delayed or non-union. The presence of callus formation, bridging trabeculae, and a decrease in the size of the fracture line over time are indicative of healing. Imaging must be combined with clinical parameters and patient-reported outcomes. Animal data support a negative effect of osteoporosis on fracture healing; however, clinical data do not appear to corroborate with this. Evidence does not support a delay in the initiation of antiresorptive therapy following acute fragility fractures. There is no reason for suspension of osteoporosis medication at the time of fracture if the person is already on treatment. Teriparatide treatment may shorten fracture healing time at certain sites such as distal radius; however, it does not prevent non-union or influence union rate. The positive effect on fracture healing that romosozumab has demonstrated in animals has not been observed in humans. Conclusion: Overall, there appears to be no deleterious effect of osteoporosis medications on fracture healing. The benefit of treating osteoporosis and the urgent necessity to mitigate imminent refracture risk after a fracture should be given prime consideration. It is imperative that new radiological and biological markers of fracture healing be identified. It is also important to synthesize clinical and basic science methodologies to assess fracture healing, so that a convergence of the two frameworks can be achieved.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Nyckelord
- Fracture healing
- Osteoporosis
- Osteoporosis medication
- Union
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Chandran, M.
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Akesson, K. E.
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Javaid, M. K.
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Harvey, N.
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Blank, R. D.
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Brandi, M. L.
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Chevalley, T.
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Cinelli, P.
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Cooper, C.
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Lems, W.
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Lyritis, G. P.
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Makras, P.
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Paccou, J.
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Pierroz, D. D.
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Sosa, M.
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Thomas, T.
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Silverman, S.
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