Current Osteoporosis Reports

, Volume 12, Issue 1, pp 33–40

Local Strategies to Prevent and Treat Osteoporosis

Regenerative Biology and Medicine in Osteoporosis (EM Schwartz and RE Guldberg, Section Editors)

DOI: 10.1007/s11914-014-0191-6

Cite this article as:
Torstrick, F.B. & Guldberg, R.E. Curr Osteoporos Rep (2014) 12: 33. doi:10.1007/s11914-014-0191-6

Abstract

Despite advances in systemic osteoporosis therapeutic outcomes, management of fragility fractures and implant fixation in osteoporotic bone remain difficult clinical challenges. Low initial bone density and a prolonged healing response can lead to fracture nonunion and aseptic implant loosening. Local treatment strategies could be used to prevent fracture, accelerate healing, and increase implant fixation by locally stimulating anabolic pathways or inhibiting catabolic pathways. Local strategies under investigation include direct drug release from injectable materials or implant surface coatings. Common locally delivered drugs include bisphosphonates, parathyroid hormone, and bone morphogenetic proteins, yet additional compounds targeting novel pathways in bone biology are also being actively explored. Mechanical stimulation via low intensity pulsed ultrasound, alone or in combination with drug therapy, may also prove effective to promote local bone healing and implant fixation within osteoporotic bone.

Keywords

OsteoporosisLocal deliveryHydroxyapatiteBisphosphonateLIPUS

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.The George W. Woodruff School of Mechanical Engineering, Parker H. Petit Institute for Bioengineering and BioscienceGeorgia Institute of TechnologyAtlantaUSA