nach oben

Erschienen in:

18.07.2022 | Review

Gaps and alternative surgical and non-surgical approaches in the bone fragility management: an updated review

verfasst von: Umberto Tarantino, Ida Cariati, Chiara Greggi, Riccardo Iundusi, Elena Gasbarra, Giovanni Iolascon, Andreas Kurth, Kristina E. Akesson, Mary Bouxsein, Paolo Tranquilli Leali, Roberto Civinini, Francesco Falez, Maria Luisa Brandi

Erschienen in: Osteoporosis International | Ausgabe 12/2022

Einloggen, um Zugang zu erhalten

Abstract

Osteoporotic fractures are one of the major problems facing healthcare systems worldwide. Undoubtedly, fragility fractures of the hip represent a far greater burden in terms of morbidity, mortality, and healthcare costs than other fracture sites. However, despite the significant impact on the health and quality of life of older adults, there is a general lack of awareness of osteoporosis, which results in suboptimal care. In fact, most high-risk individuals are never identified and do not receive adequate treatment, leading to further fragility fractures and worsening health status. Furthermore, considering the substantial treatment gap and the proven cost-effectiveness of fracture prevention programs such as Fracture Liaison Services, urgent action is needed to ensure that all individuals at high risk of fragility fracture are adequately assessed and treated. Based on this evidence, the aim of our review was to (i) provide an overview and comparison of the burden and management of fragility fractures, highlighting the main gaps, and (ii) highlight the importance of using alternative approaches, both surgical and non-surgical, with the aim of implementing early prevention of osteoporotic fractures and improving the management of osteoporotic patients at imminent and/or very high risk of fracture.

Tarantino U, Iolascon G, Cianferotti L et al (2017) Clinical guidelines for the prevention and treatment of osteoporosis: summary statements and recommendations from the Italian Society for Orthopaedics and Traumatology. J Orthop Traumatol Off J Ital Soc Orthop Traumatol 18:3–36. https://doi.org/10.1007/s10195-017-0474-7CrossRef

Nuti R, Brandi ML, Checchia G et al (2019) Guidelines for the management of osteoporosis and fragility fractures. Intern Emerg Med 14:85–102. https://doi.org/10.1007/s11739-018-1874-2CrossRefPubMed

Wolf-Maier K, Cooper RS, Banegas JR et al (2003) Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 289:2363–2369. https://doi.org/10.1001/jama.289.18.2363CrossRefPubMed

Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 11:669–674. https://doi.org/10.1007/s001980070064CrossRef

Kanis JA, Odén A, McCloskey EV et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int a J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 23:2239–2256. https://doi.org/10.1007/s00198-012-1964-3CrossRef

Pisani P, Renna MD, Conversano F et al (2016) Major osteoporotic fragility fractures: risk factor updates and societal impact. World J Orthop 7:171–181. https://doi.org/10.5312/wjo.v7.i3.171CrossRefPubMedPubMedCentral

Jakobsen A, Laurberg P, Vestergaard P, Andersen S (2013) Clinical risk factors for osteoporosis are common among elderly people in Nuuk. Greenland Int J Circumpolar Health 72:19596. https://doi.org/10.3402/ijch.v72i0.19596CrossRefPubMed

Kanis JA, Oden A, Johnell O et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int J Establ Result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 12:417–427. https://doi.org/10.1007/s001980170112CrossRef

Warriner AH, Patkar NM, Curtis JR et al (2011) Which fractures are most attributable to osteoporosis? J Clin Epidemiol 64:46–53. https://doi.org/10.1016/j.jclinepi.2010.07.007CrossRefPubMedPubMedCentral

10.

Johansson H, Siggeirsdóttir K, Harvey NC et al (2017) Imminent risk of fracture after fracture. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 28:775–780. https://doi.org/10.1007/s00198-016-3868-0CrossRef

11.

van Geel TACM, van Helden S, Geusens PP et al (2009) Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis 68:99–102. https://doi.org/10.1136/ard.2008.092775CrossRefPubMed

12.

Kanis JA, Johansson H, Odén A et al (2018) Characteristics of recurrent fractures. Osteoporos Int J Establ Result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 29:1747–1757. https://doi.org/10.1007/s00198-018-4502-0CrossRef

13.

Kanis JA, Harvey NC, McCloskey E et al (2020) Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 31:1–12. https://doi.org/10.1007/s00198-019-05176-3CrossRef

14.

Rocha VM, Gaspar HA, Oliveira CF de (2018) Fracture risk assessment in home care patients using the FRAX® tool. Einstein (Sao Paulo) 16:eAO4236. https://doi.org/10.1590/S1679-45082018AO4236

15.

Bonaccorsi G, Messina C, Cervellati C et al (2018) Fracture risk assessment in postmenopausal women with diabetes: comparison between DeFRA and FRAX tools. Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol 34:404–408. https://doi.org/10.1080/09513590.2017.1407308CrossRef

16.

Borgström F, Karlsson L, Ortsäter G et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15:59. https://doi.org/10.1007/s11657-020-0706-yCrossRefPubMedPubMedCentral

17.

Svedbom A, Borgstöm F, Hernlund E et al (2018) Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures-results from the ICUROS. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 29:557–566. https://doi.org/10.1007/s00198-017-4317-4CrossRef

18.

Ito K (2020) Cost-effectiveness of screening for osteoporosis in older men with a history of falls. JAMA Netw open 3:e2027584. https://doi.org/10.1001/jamanetworkopen.2020.27584CrossRefPubMedPubMedCentral

19.

Svedbom A, Borgström F, Hernlund E et al (2018) Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from the ICUROS. Qual Life Res Int J Qual Life Asp Treat Care Rehabil 27:707–716. https://doi.org/10.1007/s11136-017-1748-5CrossRef

20.

Borgström F, Lekander I, Ivergård M et al (2013) The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)–quality of life during the first 4 months after fracture. Osteoporos Int J Establ Result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 24:811–823. https://doi.org/10.1007/s00198-012-2240-2CrossRef

21.

Roux C, Briot K (2017) Imminent fracture risk. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 28:1765–1769. https://doi.org/10.1007/s00198-017-3976-5CrossRef

22.

Bonafede M, Shi N, Barron R et al (2016) Predicting imminent risk for fracture in patients aged 50 or older with osteoporosis using US claims data. Arch Osteoporos 11:26. https://doi.org/10.1007/s11657-016-0280-5CrossRefPubMedPubMedCentral

23.

McKercher HG, Crilly RG, Kloseck M (2000) Osteoporosis management in long-term care. Survey of Ontario physicians. Can Fam Physician 46:2228–2235PubMedPubMedCentral

24.

Kaffashian S, Raina P, Oremus M et al (2011) The burden of osteoporotic fractures beyond acute care: the Canadian Multicentre Osteoporosis Study (CaMos). Age Ageing 40:602–607. https://doi.org/10.1093/ageing/afr085CrossRefPubMed

25.

Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136. https://doi.org/10.1007/s11657-013-0136-1CrossRefPubMedPubMedCentral

26.

Chau YT, Nashi N, Law LS-C et al (2020) Undertreatment of osteoporosis following hip fracture: a retrospective, observational study in Singapore. Arch Osteoporos 15:141. https://doi.org/10.1007/s11657-020-00816-2CrossRefPubMed

27.

Rodrigues AM, Eusébio M, Santos MJ et al (2018) The burden and undertreatment of fragility fractures among senior women. Arch Osteoporos 13:22. https://doi.org/10.1007/s11657-018-0430-zCrossRefPubMed

28.

Solomon DH, Johnston SS, Boytsov NN et al (2014) Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011. J bone Miner Res Off J Am Soc Bone Miner Res 29:1929–1937. https://doi.org/10.1002/jbmr.2202CrossRef

29.

Kim SC, Kim M-S, Sanfélix-Gimeno G et al (2015) Use of osteoporosis medications after hospitalization for hip fracture: a cross-national study. Am J Med 128:519–26.e1. https://doi.org/10.1016/j.amjmed.2015.01.014CrossRefPubMedPubMedCentral

30.

Inderjeeth CA, Chan K, Kwan K, Lai M (2012) Time to onset of efficacy in fracture reduction with current anti-osteoporosis treatments. J Bone Miner Metab 30:493–503. https://doi.org/10.1007/s00774-012-0349-1CrossRefPubMed

31.

Bone HG, Wagman RB, Brandi ML et al (2017) 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol 5:513–523. https://doi.org/10.1016/S2213-8587(17)30138-9CrossRefPubMed

32.

Bilezikian JP, Lin CJF, Brown JP et al (2019) Long-term denosumab treatment restores cortical bone loss and reduces fracture risk at the forearm and humerus: analyses from the FREEDOM Extension cross-over group. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 30:1855–1864. https://doi.org/10.1007/s00198-019-05020-8CrossRef

33.

Ferrari S, Butler PW, Kendler DL et al (2019) Further nonvertebral fracture reduction beyond 3 years for up to 10 years of denosumab treatment. J Clin Endocrinol Metab 104:3450–3461. https://doi.org/10.1210/jc.2019-00271CrossRefPubMed

34.

Grey A (2016) Intravenous zoledronate for osteoporosis: less might be more. Ther Adv Musculoskelet Dis 8:119–123. https://doi.org/10.1177/1759720X16650866CrossRefPubMedPubMedCentral

35.

Lyles KW, Colón-Emeric CS, Magaziner JS et al (2007) Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med 357:1799–1809. https://doi.org/10.1056/NEJMoa074941CrossRefPubMed

36.

Kendler DL, Marin F, Zerbini CAF et al (2018) Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet (London, England) 391:230–240. https://doi.org/10.1016/S0140-6736(17)32137-2CrossRef

37.

Leder BZ, O’Dea LSL, Zanchetta JR et al (2015) Effects of abaloparatide, a human parathyroid hormone-related peptide analog, on bone mineral density in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 100:697–706. https://doi.org/10.1210/jc.2014-3718CrossRefPubMed

38.

Miller PD, Hattersley G, Riis BJ et al (2016) Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis: a randomized clinical trial. JAMA 316:722–733. https://doi.org/10.1001/jama.2016.11136CrossRefPubMed

39.

Cosman F, Crittenden DB, Adachi JD et al (2016) Romosozumab treatment in postmenopausal women with osteoporosis. N Engl J Med 375:1532–1543. https://doi.org/10.1056/NEJMoa1607948CrossRefPubMed

40.

Lewiecki EM, Dinavahi RV, Lazaretti-Castro M et al (2019) One year of romosozumab followed by two years of denosumab maintains fracture risk reductions: results of the FRAME extension study. J bone Miner Res Off J Am Soc Bone Miner Res 34:419–428. https://doi.org/10.1002/jbmr.3622CrossRef

41.

Weycker D, Macarios D, Edelsberg J, Oster G (2007) Compliance with osteoporosis drug therapy and risk of fracture. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 18:271–277. https://doi.org/10.1007/s00198-006-0230-yCrossRef

42.

Andrade SE, Majumdar SR, Chan KA et al (2003) Low frequency of treatment of osteoporosis among postmenopausal women following a fracture. Arch Intern Med 163:2052–2057. https://doi.org/10.1001/archinte.163.17.2052CrossRefPubMed

43.

Caro JJ, Ishak KJ, Huybrechts KF et al (2004) The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 15:1003–1008. https://doi.org/10.1007/s00198-004-1652-zCrossRef

44.

McCombs JS, Thiebaud P, McLaughlin-Miley C, Shi J (2004) Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas 48:271–287. https://doi.org/10.1016/j.maturitas.2004.02.005CrossRefPubMed

45.

Recker RR, Gallagher R, MacCosbe PE (2005) Effect of dosing frequency on bisphosphonate medication adherence in a large longitudinal cohort of women. Mayo Clin Proc 80:856–861. https://doi.org/10.4065/80.7.856CrossRefPubMed

46.

Rabenda V, Vanoverloop J, Fabri V et al (2008) Low incidence of anti-osteoporosis treatment after hip fracture. J Bone Joint Surg Am 90:2142–2148. https://doi.org/10.2106/JBJS.G.00864CrossRefPubMed

47.

Panneman MJM, Lips P, Sen SS, Herings RMC (2004) Undertreatment with anti-osteoporotic drugs after hospitalization for fracture. Osteoporos Int J Establ Result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 15:120–124. https://doi.org/10.1007/s00198-003-1544-7CrossRef

48.

Ferrari S, Reginster J-Y, Brandi ML et al (2016) Unmet needs and current and future approaches for osteoporotic patients at high risk of hip fracture. Arch Osteoporos 11:37. https://doi.org/10.1007/s11657-016-0292-1CrossRefPubMedPubMedCentral

49.

Ding L-L, Wen F, Wang H et al (2020) Osteoporosis drugs for prevention of clinical fracture in white postmenopausal women: a network meta-analysis of survival data. Osteoporos Int J Establ Result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 31:961–971. https://doi.org/10.1007/s00198-019-05183-4CrossRef

50.

Reginster J-Y, Bianic F, Campbell R et al (2019) Abaloparatide for risk reduction of nonvertebral and vertebral fractures in postmenopausal women with osteoporosis: a network meta-analysis. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 30:1465–1473. https://doi.org/10.1007/s00198-019-04947-2CrossRef

51.

Cornelissen D, de Kunder S, Si L et al (2020) Interventions to improve adherence to anti-osteoporosis medications: an updated systematic review. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 31:1645–1669. https://doi.org/10.1007/s00198-020-05378-0CrossRef

52.

Hiligsmann M, Cornelissen D, Vrijens B et al (2019) Determinants, consequences and potential solutions to poor adherence to anti-osteoporosis treatment: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeleta. Osteoporos Int J Establ Result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 30:2155–2165. https://doi.org/10.1007/s00198-019-05104-5CrossRef

53.

Abrahamsen B (2010) Adverse effects of bisphosphonates. Calcif Tissue Int 86:421–435. https://doi.org/10.1007/s00223-010-9364-1CrossRefPubMed

54.

Papapetrou PD (2009) Bisphosphonate-associated adverse events. Hormones (Athens) 8:96–110. https://doi.org/10.14310/horm.2002.1226CrossRef

55.

Won Y, Lim J-R, Kim Y-H et al (2014) Atypical femoral fracture combined with osteonecrosis of jaw during osteoporosis treatment with bisphosphonate. J bone Metab 21:155–159CrossRefPubMedPubMedCentral

56.

Kharazmi M, Hallberg P, Michaëlsson K (2014) Gender related difference in the risk of bisphosphonate associated atypical femoral fracture and osteonecrosis of the jaw. Ann Rheum Dis 73:1594CrossRefPubMed

57.

Cummings SR, Ferrari S, Eastell R et al (2018) Vertebral fractures after discontinuation of denosumab: a post hoc analysis of the randomized placebo-controlled FREEDOM trial and its extension. J bone Miner Res Off J Am Soc Bone Miner Res 33:190–198. https://doi.org/10.1002/jbmr.3337CrossRef

58.

Lamy O, Stoll D, Aubry-Rozier B, Gonzalez Rodriguez E (2020) Correction to: Stopping denosumab. Curr Osteoporos Rep

59.

Langdahl BL, Hofbauer LC, Forfar JC (2021) Cardiovascular safety and sclerostin inhibition. J Clin Endocrinol Metab 106:1845–1853. https://doi.org/10.1210/clinem/dgab193CrossRefPubMed

60.

Marsh D, Akesson K, Beaton DE et al (2011) Coordinator-based systems for secondary prevention in fragility fracture patients. Osteoporos Int J Establ Result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 22:2051–2065. https://doi.org/10.1007/s00198-011-1642-xCrossRef

61.

Akesson K, Marsh D, Mitchell PJ et al (2013) Capture the fracture: a best practice framework and global campaign to break the fragility fracture cycle. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 24:2135–2152. https://doi.org/10.1007/s00198-013-2348-zCrossRef

62.

Ganda K, Puech M, Chen JS et al (2013) Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA 24:393–406. https://doi.org/10.1007/s00198-012-2090-yCrossRef

63.

Huntjens KMB, van Geel TACM, van den Bergh JPW et al (2014) Fracture liaison service: impact on subsequent nonvertebral fracture incidence and mortality. J Bone Joint Surg Am 96:e29. https://doi.org/10.2106/JBJS.L.00223CrossRefPubMed

64.

Wu C-H, Kao I-J, Hung W-C et al (2018) Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature. Osteoporos Int a J Establ as result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 29:1227–1242. https://doi.org/10.1007/s00198-018-4411-2CrossRef

65.

Wu C-H, Tu S-T, Chang Y-F et al (2018) Fracture liaison services improve outcomes of patients with osteoporosis-related fractures: a systematic literature review and meta-analysis. Bone 111:92–100. https://doi.org/10.1016/j.bone.2018.03.018CrossRefPubMed

66.

Majumdar SR, Lier DA, McAlister FA et al (2019) Cost-effectiveness of osteoporosis interventions to improve quality of care after upper extremity fracture: results from a randomized trial (C-STOP Trial). J bone Miner Res Off J Am Soc Bone Miner Res 34:1220–1228. https://doi.org/10.1002/jbmr.3699CrossRef

67.

Giannoudis PV, Schneider E (2006) Principles of fixation of osteoporotic fractures. J Bone Joint Surg Br 88:1272–1278. https://doi.org/10.1302/0301-620X.88B10.17683CrossRefPubMed

68.

Iolascon G, Resmini G, Tarantino U (2013) “Osteoporotic fragility fractures: medical and surgical approaches” II National Congress of the Italian Orthopedic Group for the Study of Severe Osteoporosis (GISOOS). Aging Clin Exp Res 25(Suppl 1):S1-2CrossRefPubMed

69.

Lems WF, Dreinhöfer KE, Bischoff-Ferrari H et al (2017) EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis 76:802–810. https://doi.org/10.1136/annrheumdis-2016-210289CrossRefPubMed

70.

Mak JCS, Cameron ID, March LM (2010) Evidence-based guidelines for the management of hip fractures in older persons: an update. Med J Aust 192:37–41. https://doi.org/10.5694/j.1326-5377.2010.tb03400.xCrossRefPubMed

71.

von Rüden C, Augat P (2016) Failure of fracture fixation in osteoporotic bone. Injury 47(Suppl 2):S3–S10. https://doi.org/10.1016/S0020-1383(16)47002-6CrossRef

72.

Moroni A, Hoang-Kim A, Lio V, Giannini S (2006) Current augmentation fixation techniques for the osteoporotic patient. Scand J Surg SJS Off organ Finnish Surg Soc Scand Surg Soc 95:103–109. https://doi.org/10.1177/145749690609500205CrossRef

73.

Vannucci L, Brandi ML (2016) Healing of the bone with anti-fracture drugs. Expert Opin Pharmacother 17:2267–2272. https://doi.org/10.1080/14656566.2016.1241765CrossRefPubMed

74.

Morris CD, Einhorn TA (2005) Bisphosphonates in orthopaedic surgery. J Bone Joint Surg Am 87:1609–1618. https://doi.org/10.2106/JBJS.D.03032CrossRefPubMed

75.

Türker M, Aslan A, Çırpar M et al (2016) Histological and biomechanical effects of zoledronate on fracture healing in an osteoporotic rat tibia model. Eklem Hastalik Cerrahisi 27:9–15. https://doi.org/10.5606/ehc.2016.03CrossRefPubMed

76.

Einhorn TA (2010) Can an anti-fracture agent heal fractures? Clin cases Miner bone Metab Off J Ital Soc Osteoporosis, Miner Metab Skelet Dis 7:11–14

77.

Alkhiary YM, Gerstenfeld LC, Krall E et al (2005) Enhancement of experimental fracture-healing by systemic administration of recombinant human parathyroid hormone (PTH 1–34). J Bone Joint Surg Am 87:731–741. https://doi.org/10.2106/JBJS.D.02115CrossRefPubMed

78.

Kakar S, Einhorn TA, Vora S et al (2007) Enhanced chondrogenesis and Wnt signaling in PTH-treated fractures. J bone Miner Res Off J Am Soc Bone Miner Res 22:1903–1912. https://doi.org/10.1359/jbmr.070724CrossRef

79.

Varga P, Hofmann-Fliri L, Blauth M, Windolf M (2016) Prophylactic augmentation of the osteoporotic proximal femur-mission impossible? Bonekey Rep 5:854. https://doi.org/10.1038/bonekey.2016.86CrossRefPubMedPubMedCentral

80.

Kanis JA, Cooper C, Rizzoli R, Reginster J-Y (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int J Establ Result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 30:3–44. https://doi.org/10.1007/s00198-018-4704-5CrossRef

81.

Stroncek JD, Shaul JL, Favell D et al (2019) In vitro injection of osteoporotic cadaveric femurs with a triphasic calcium-based implant confers immediate biomechanical integrity. J Orthop Res Off Publ Orthop Res Soc 37:908–915. https://doi.org/10.1002/jor.24239CrossRef

82.

Howe JG, Hill RS, Stroncek JD et al (2020) Treatment of bone loss in proximal femurs of postmenopausal osteoporotic women with AGN1 local osteo-enhancement procedure (LOEP) increases hip bone mineral density and hip strength: a long-term prospective cohort study. Osteoporos Int a J Establ as result Coop between Eur Found Osteoporos Natl Osteoporos Found USA 31:921–929. https://doi.org/10.1007/s00198-019-05230-0CrossRef

83.

Giannoudis PV, Einhorn TA, Marsh D (2007) Fracture healing: the diamond concept. Injury 38(Suppl 4):S3-6. https://doi.org/10.1016/s0020-1383(08)70003-2CrossRefPubMed

84.

Trost M, Schmoelz W, Wimmer D et al (2020) Local osteo-enhancement of osteoporotic vertebra with a triphasic bone implant material increases strength-a biomechanical study. Arch Orthop Trauma Surg 140:1395–1401. https://doi.org/10.1007/s00402-020-03382-xCrossRefPubMedPubMedCentral

85.

Tran TN, Warwas S, Haversath M et al (2014) Experimental and computational studies on the femoral fracture risk for advanced core decompression. Clin Biomech (Bristol, Avon) 29:412–417. https://doi.org/10.1016/j.clinbiomech.2014.02.001CrossRef

Titel: Gaps and alternative surgical and non-surgical approaches in the bone fragility management: an updated review
verfasst von: Umberto Tarantino
Ida Cariati
Chiara Greggi
Riccardo Iundusi
Elena Gasbarra
Giovanni Iolascon
Andreas Kurth
Kristina E. Akesson
Mary Bouxsein
Paolo Tranquilli Leali
Roberto Civinini
Francesco Falez
Maria Luisa Brandi
Publikationsdatum: 18.07.2022
Verlag: Springer London
Erschienen in: Osteoporosis International / Ausgabe 12/2022
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-022-06482-z

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Gaps and alternative surgical and non-surgical approaches in the bone fragility management: an updated review

Abstract

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

Update Orthopädie und Unfallchirurgie

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 12/2022

The association between peripheral arterial disease and risk for hip fractures in elderly men is not explained by low hip bone mineral density. Results from the MrOS Sweden study

Perceptions of fracture and fall risk and of the benefits and barriers to exercise in adults with diabetes

The imminent risk of a fracture—existing worldwide data: a systematic review and meta-analysis

Fractures and long-term mortality in cancer patients: a population-based cohort study

The potential mechanism of the microbiota-gut-bone axis in osteoporosis: a review

Adjusting conventional FRAX estimates of fracture probability according to the number of prior fractures

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

Update Orthopädie und Unfallchirurgie