The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration

Tsuchie, Hiroyuki; Miyakoshi, Naohisa; Iba, Kousuke; Kasukawa, Yuji; Nozaka, Koji; Dohke, Takayuki; Kosukegawa, Ima; Aizawa, Toshiaki; Maekawa, Shigeto; Abe, Hidekazu; Takeshima, Masaaki; Tomite, Takanori; Segawa, Toyohito; Ouchi, Kentaro; Kinoshita, Hayato; Suzuki, Manabu; Yamashita, Toshihiko; Shimada, Yasuhiro

doi:10.1007/s00198-018-4658-7

Cited by 31 publications

(15 citation statements)

References 24 publications

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“…Daily administration of teriparatide enhances bone healing more than weekly administration in complete AFF patients [23]. However, our patients were over 80 years old and their cognitive functions were declined; therefore, they could not self-administer teriparatide daily.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Periprosthetic Atypical Femoral Fractures in Patients on Long-Term Bisphosphonate Treatment

Miura

Kijima

Tani

et al. 2019

Case Reports in Surgery

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The current definition of atypical femoral fractures (AFFs) excludes periprosthetic fractures. However, a few cases of bisphosphonates (BPs) -associated periprosthetic atypical femoral fractures (PAFFs) have been reported in the literature. Here, we report two rare cases of PAFFs that fulfilled the major criteria for AFFs in patients with prolonged use of BPs. Both cases progressed to a complete fracture with minor trauma from an incomplete fracture at the distal tip of the well-fixed femoral stem. The femoral stem effect on lateral femoral cortical bone, together with the decreased bone elastic resistance induced by BPs, was considered the cause of onset. In each case, we performed open reduction and internal fixation using a locking plate with cable grip and postoperatively prescribed teriparatide and low-intensity pulsed ultrasound (LIPUS). Both cases had a good clinical course. However, as conservative treatment was not effective in these cases, treatment such as non-weight-bearing exercises during hospitalization or prophylactic surgery may be necessary. Further studies are needed to determine the optimal treatment strategy.

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Section: Discussionmentioning

confidence: 99%

Two Cases of Periprosthetic Atypical Femoral Fractures in Patients on Long-Term Bisphosphonate Treatment

Miura

Kijima

Tani

et al. 2019

Case Reports in Surgery

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“…There are several studies that TPTD treatment can aid fracture healing in patients with AFF. [57][58][59][60] One retrospective study compared 2 groups, AFFs were treated TPTD (n=21) and not-TPTD (n=24) groups. All TPTD group showed faster healing time (5.4±1.5 vs. 8.6±4.7 months; P=0.012), and low frequency of delayed healing or nonunion (P=0.012).…”

Section: Does Tptd Aid the Union Of Aff?mentioning

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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“…However, the benefit of teriparatide in fracture healing remains controversial [ 24 ]. There has been recent increased interest in the effect of teriparatide on accelerating fracture healing [ 25 ]. Hip fractures are frequent injuries in patients with osteoporosis and are a serious burden for the individuals and their families, as well as the healthcare system [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Teriparatide in Improving Fracture Healing in Hip Fractures: A Systematic Review and Meta-Analysis

Han

Wen

Zhao

et al. 2020

BioMed Research International

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Background. This systematic review and meta-analysis assessed the role of teriparatide in improving hip fracture healing and function to provide a clinical guide. Methods. The systematic literature review identified randomized controlled trials (RCTs) and controlled studies evaluating teriparatide for elderly hip fractures. A meta-analysis was performed using RevMan version 5.3. Results. This study included two RCTs and four retrospective studies comprising 607 patients, with 269 and 338 patients in the teriparatide and control groups, respectively. The quality of these six studies was moderate. Compared to the control group, teriparatide reduced the time to union (weighted mean difference WMD=−1.95; 95% confidence interval (CI): -3.23–-0.68; P=0.003) but did not improve the rate of fracture union at 3 months (odds ratio OR=1.46; 95% CI: 0.50–4.24; P=0.49) or 6 months (OR=0.89; 95% CI: 0.44–1.81; P=0.75). In addition, teriparatide did not decrease the complications, need for reoperation, mortality, rate of deformity after fracture healing, and subsequent fracture or improve hip function. Conclusions. The current limited evidence did not support that teriparatide improves fracture healing in hip fractures, due to study heterogeneity and various sources of biases. Further high-quality, large-sample trials are needed. This trial is registered with PROSPERO with registration number CRD42020152205.

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The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration

Abstract: Daily teriparatide injections enhance bone union more than weekly injections in complete AFF patients.

Cited by 31 publications

References 24 publications

Two Cases of Periprosthetic Atypical Femoral Fractures in Patients on Long-Term Bisphosphonate Treatment

Two Cases of Periprosthetic Atypical Femoral Fractures in Patients on Long-Term Bisphosphonate Treatment

Does Teriparatide Improve Fracture Union?: A Systematic Review

The Efficacy of Teriparatide in Improving Fracture Healing in Hip Fractures: A Systematic Review and Meta-Analysis

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