Medical Management of Osteoporosis

Brunelli, Michael P.; Einhorn, Thomas A.

doi:10.1097/00003086-199803000-00005

Cited by 20 publications

(11 citation statements)

References 40 publications

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“…This is particularly important, as bone repair comprises two distinct processes of ossification, periosteal intramembranous bone formation followed by interfragmentary endochondral bone formation 41. Considering that each subsequent tissue is stiffer,42 the ultimate strain which can be withstood also decreases from very high strains in hematoma and granulation tissue (100%), decreasing to mature bone which can be damaged by as little as 2% strain 43,44.…”

Section: Discussionmentioning

confidence: 99%

Low‐magnitude high‐frequency mechanical signals accelerate and augment endochondral bone repair: Preliminary evidence of efficacy

Goodship

Lawes

Rubin

2008

Journal Orthopaedic Research

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Fracture healing can be enhanced by load bearing, but the specific components of the mechanical environment which can augment or accelerate the process remain unknown. The ability of low-magnitude, high-frequency mechanical signals, anabolic in bone tissue, are evaluated here for their ability to influence fracture healing. The potential for short duration (17 min), extremely low-magnitude (25 mm), high-frequency (30 Hz) interfragmentary displacements to enhance fracture healing was evaluated in a mid-diaphyseal, 3-mm osteotomy of the sheep tibia. In a pilot study of proof of concept and clinical relevance, healing in osteotomies stabilized with rigid external fixation (Control: n ¼ 4), were compared to the healing status of osteotomies with the same stiffness of fixation, but supplemented with daily mechanical loading (Experimental: n ¼ 4). These 25-mm displacements, induced by a ferroactive shape-memory alloy (''smart'' material) incorporated into the body of the external fixator, were less than 1% of the 3-mm fracture gap, and less than 6% of the 0.45-mm displacement measured at the site during ambulation (p < 0.001). At 10-weeks post-op, the callus in the Experimental group was 3.6-fold stiffer (p < 0.03), 2.5-fold stronger (p ¼ 0.05), and 29% larger (p < 0.01) than Controls. Bone mineral content was 52% greater in the Experimental group (p < 0.02), with a 2.6-fold increase in bone mineral content (BMC) in the region of the periosteum (p < 0.001). These data reinforce the critical role of mechanical factors in the enhancement of fracture healing, and emphasize that the signals need not be large to be influential and potentially clinically advantageous to the restoration of function. ß

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Section: Discussionmentioning

confidence: 99%

Low‐magnitude high‐frequency mechanical signals accelerate and augment endochondral bone repair: Preliminary evidence of efficacy

Goodship

Lawes

Rubin

2008

Journal Orthopaedic Research

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“…The use of fewer dairy products related to less chronic intake of calcium, protein, and vitamin D was also associated with an increased risk of hip fracture. 19 20 Decreased mobility protected against hip fracture, presumably by decreasing the risk of falling 21. Sensory handicaps (vision, hearing) were associated with an increased risk of fracture.…”

Section: Discussionmentioning

confidence: 99%

Benzodiazepines and hip fractures in elderly people: case-control study

Pierfitte

2001

BMJ

114

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“…Because degenerative spine conditions and osteoporosis are prevalent in the elderly population, and because bisphosphonates are first-line medications for the treatment of osteoporosis, 2 a significant percentage of the patients indicated for spine fusion will be currently taking alendronate. Osteoporosis affects more than 28 million patients in the United States, 3 and it is estimated that more than 41 million people will be at risk for osteoporosis by 2015. 4 Bisphosphonates are a class of antiresorptive drugs indicated in patients with osteoporosis, malignancies with propensity for skeletal metastasis, Paget disease of bone, and osteogenesis imperfecta.…”

mentioning

confidence: 99%

Alendronate Inhibits Spine Fusion in a Rat Model

Huang¹,

Khan²,

Sandhu³

et al. 2005

Spine

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Alendronate inhibits spine fusion in rats. Fusion masses in alendronate-treated animals appeared radiographically larger and denser than those in control animals despite lower fusion rates. Quantitative histomorphometry confirmed that alendronate inhibited bone graft resorption and incorporation. We recommend that patients undergoing spine arthrodesis should not take alendronate until fusion is achieved.

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Medical Management of Osteoporosis

Cited by 20 publications

References 40 publications

Low‐magnitude high‐frequency mechanical signals accelerate and augment endochondral bone repair: Preliminary evidence of efficacy

Low‐magnitude high‐frequency mechanical signals accelerate and augment endochondral bone repair: Preliminary evidence of efficacy

Benzodiazepines and hip fractures in elderly people: case-control study

Alendronate Inhibits Spine Fusion in a Rat Model

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