Current Role and Application of Teriparatide in Fracture Healing of Osteoporotic Patients: A Systematic Review

Kim, Sang-Min; Kang, Kyung-Chung; Kim, Ji Wan; Lim, Seung‐Jae; Hahn, Myung Hoon

doi:10.11005/jbm.2017.24.1.65

Cited by 36 publications

(29 citation statements)

References 46 publications

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“…[8][9][10] There has been previous reviews that suggest the role of TPTD as alternate to induce fracture healing. [11][12][13] However, to date, many clinical trials have been undertaken to elucidate the efficacy of TPTD for inducing fracture healing in several situations, such as atypical femoral fracture (AFF). [14][15][16] A better understanding of the role of TPTD with greater evidences on fractures healing could help clinician to make their decision.…”

Section: Introductionmentioning

confidence: 99%

Does Teriparatide Improve Fracture Union?: A Systematic Review

Yoon

Kim

2020

J Bone Metab

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We conducted an updated review of the evidence of teriparatide (TPTD) for fracture healing for the following questions. (1) Does it decrease fracture healing time?; (2) Can it be an alternative treatment for nonunion?; (3) Does it aid the union of atypical femoral fracture (AFF)? We searched PubMed, EMBASE, and Cochrane Library including "Fracture" AND "nonunion" AND "Teriparatide". In total, 57 publications met our inclusion criteria were summarized. This systemic review of the available literature revealed that TPTD works positively with regard to enhancing fracture healing time and union of AFF. There are also many case studies on the use of TPTD could be a potential new safe treatment for nonunion with no side effects. However, level 1 studies on the evidence of TPTD are still lacking so far. Over the last decade, a growing body of evidence has accumulated suggesting that TPTD can be an adjunct to enhance fracture healing or a therapeutic option to treat nonunion, but greater evidences from large volume prospective trials are needed.

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Section: Introductionmentioning

confidence: 99%

Does Teriparatide Improve Fracture Union?: A Systematic Review

Yoon

Kim

2020

J Bone Metab

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“…They reported that teriparatide yielded positive effects on radiographic bone healing in 6 studies, but was not associated with better radiographic outcome in 3 studies. They concluded that teriparatide provides selective advantages to fracture healing or functional recovery in management of osteoporotic fractures [13]. Bhandari et al performed a placebo-controlled phase 3 study to evaluate the effect of teriparatide on fracture healing.…”

Section: Discussionmentioning

confidence: 99%

“…Teriparatide, a parathyroid hormone (PTH) analogue, is a synthetic polypeptide hormone consisting of the 1–34 fragment of PTH, which is used in treatment of osteoporosis [12]. Recently, some reports have shown the ability of teriparatide to improve fracture healing [13, 14].…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of pathologic femoral shaft fracture associated with large arteriovenous malformations using a 3-dimensional external fixator and teriparatide: a case report

et al. 2019

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Background Arteriovenous malformations (AVMs) are rare congenital vascular lesions associated with early quiescence, late expansion, and, ultimately, infiltration and destruction of local soft tissue and bone. The extremities are a common location. Incidence of bony involvement by AVM has been reported as high as 31%. However, there are few reports on management of pathologic fracture associated with AVM. Teriparatide is a recombinant parathyroid hormone (PTH) analogue consisting of the 1–34 fragment of PTH. Recently, some reports have shown the ability of teriparatide to improve fracture healing. Here, we present a case of pathologic femoral shaft fracture associated with large AVMs that was treated successfully by external fixation and teriparatide. Case presentation A 68-year-old Japanese woman, previously diagnosed as having large AVMs, sustained a right femoral shaft fracture due to a fall. At the time of admission, she presented with massive swelling and venous varicosities of the right thigh. Plain radiography of the right thigh revealed femoral shaft fracture with bony erosion and calcification of soft tissue. We planned closed reduction and intramedullary nailing with a unilateral external fixator following embolization of the feeding artery. However, closed reduction using the fracture table was difficult. When we attempted open reduction, massive bleeding (1000 mL) after incision of subcutaneous tissue occurred. Finally, we carefully applied a Taylor Spatial Frame. Fracture displacement was corrected successfully and bony union was obtained with administration of teriparatide 15 months after the initial surgery. The patient is able to walk using 1 cane. Conclusion We present the first report of pathologic fracture associated with large AVMs that achieved bony union using a 3-dimensional external fixator and teriparatide.

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“…Postmenopausal women with a distal radial fracture in need of closed reduction, but not surgery, were assigned to 8 weeks of teriparatide; the median time to complete cortical bridging was analyzed, and the time to heal was shorter than placebo. 13,14 We administered 20 mg teriparatide, injected subcutaneously during 6 weeks after performing rTSA in acute proximal humeral fractures. All patients in this group obtained tuberosity union.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study showed that teriparatide, administered to the osteoporotic distal femur fracture, could accelerate initial callus formation, bridge callus formation, and consolidation. [13][14][15][16] From these cases, we evaluated the patient's range of motion and functional outcome. We found that there were significant differences between teriparatide and noteriparatide groups in external rotation (29.5 vs. 7.5 ; p ¼ 0.004), external rotation in 90 abduction (55 vs. 12.5 ; p < 0.020), forward flexion (120 vs. 105 ; p ¼ 0.002) range of motions, and ASES (84.5 vs. 74.6; p ¼ 0.019).…”

Section: Discussionmentioning

confidence: 99%

The role of teriparatide in tuberosity healing after reverse shoulder arthroplasty in complex proximal humeral fragility fracture

C้hernchujit

Prasetia

2018

J Orthop Surg (Hong Kong)

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Introduction: Tuberosity healing is known to be one of the factors that increase functional outcome in Reverse Total Shoulder Arthroplasty (rTSA). In fragility fractures, tuberosity healing is difficult to be achieved. The fragment stability and bone-forming agent application become strategies to overcome this problem. The purpose of this study was to evaluate the benefit of teriparatide application to promote tuberosity union in rTSA on four-part proximal humeral fractures to achieve better functional outcome. Methods: A retrospective study of a prospectively collected shoulder arthroplasty medical record was performed. Eleven patients were included in this analysis and consisted of two groups, teriparatide and no-teriparatide groups. Patients were evaluated on the range of motions and clinical outcome using the American Shoulder Elbow Surgeon (ASES) Shoulder Score and X-ray to determine tuberosity union. The group differences were analyzed by t-test or Mann-Whitney U test with SPSS version 20.0 for Windows. Results: The statistical analysis revealed no significant differences in mean age in both the groups. There were significant differences between teriparatide and no-teriparatide groups in external rotation (29.5 vs. 7.5 ; p ¼ 0.004), external rotation in 90 abduction (55 vs. 12.5 ; p < 0.020), forward flexion (120 vs. 105 ; p ¼ 0.002) range of motions, and ASES (84.5 vs. 74.6; p ¼ 0.019). We found clinical difference between teriparatide and no-teriparatide groups in time to achieve the initial callus (33 + 18.3 days vs. 150 + 42.4 days) and tuberosity consolidation (165.8 + 70.3 days vs. 315 + 106.1 days). Conclusions: Teriparatide administration supports tuberosity repair results in a high tuberosity healing rate with restoration of external rotation after rTSA in acute complex proximal humeral fractures.

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Current Role and Application of Teriparatide in Fracture Healing of Osteoporotic Patients: A Systematic Review

Cited by 36 publications

References 46 publications

Does Teriparatide Improve Fracture Union?: A Systematic Review

Does Teriparatide Improve Fracture Union?: A Systematic Review

Successful treatment of pathologic femoral shaft fracture associated with large arteriovenous malformations using a 3-dimensional external fixator and teriparatide: a case report

The role of teriparatide in tuberosity healing after reverse shoulder arthroplasty in complex proximal humeral fragility fracture

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