Aging Clinical and Experimental Research

, Volume 25, Supplement 1, pp 105–108

Fracture healing in elderly patients: new challenges for antiosteoporotic drugs

  • Umberto Tarantino
  • Luca Saturnino
  • Alessandro Scialdoni
  • Maurizio Feola
  • Federico Maria Liuni
  • Valerio Tempesta
  • Pietro Pistillo
Short Communication

Abstract

Osteoporosis is a major public health concern, characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fracture. Fracture repair progresses through different pathways, striking a balance between bone formation and bone remodeling mechanisms. Conventionally, fracture repair is divided into defined stages, each characterized by a specific set of cellular and molecular events. In postmenopausal women and elderly patients, bone healing rates are conditioned by cellular and molecular alterations to bone tissue that result in a progressive deterioration of fracture healing ability. In addition, in elderly patients, comorbidities and drugs therapies may also affect fracture healing. For this reason, pharmacological research is now focused on the possible use of antiosteoporotic drugs to promote bone healing in frail patients.

Keywords

Osteoporosis Antiosteoporotic drugs Fracture healing Strontium ranelate 

References

  1. 1.
    Schindeler A, McDonald MM, Bokko P, Little DG (2008) Bone remodeling during fracture repair: the cellular picture. Semin Cell Dev Biol 19:459–466PubMedCrossRefGoogle Scholar
  2. 2.
    Jagodzinski M, Krettek C (2007) Effect of mechanical stability on fracture healing an update. Injury 38(Suppl 1):S3–S10PubMedCrossRefGoogle Scholar
  3. 3.
    Giannoudis P, Tzioupis C, Almalki T, Buckley R (2007) Fracture-healing in osteoporotic fractures: is it really different? A basic science perspective. Injury 38(Suppl 1):S90–S99PubMedCrossRefGoogle Scholar
  4. 4.
    Beil FT, Barvencik F, Gebauer M, Seitz S, Rueger JM, Ignatius A, Pogoda P, Schinke T, Amling M (2010) Effects of estrogen on fracture-healing in mice. J Trauma 69:1259–1265PubMedCrossRefGoogle Scholar
  5. 5.
    Dalle Carbonare L, Valenti MT, Zanatta M, Donatelli L, Lo Cascio V (2009) Circulating mesenchymal stem cells with abnormal osteogenic differentiation in patients with osteoporosis. Arthritis Rheum 60:3356–3365PubMedCrossRefGoogle Scholar
  6. 6.
    Lencel P, Magne D (2011) Inflammaging: the driving force in osteoporosis? Med Hypotheses 76:317–321PubMedCrossRefGoogle Scholar
  7. 7.
    Montagnani A, Gonnelli S, Alessandri M, Nuti R (2011) Osteoporosis and risk of fracture in patients with diabetes: an update. Aging Clin Exp Res. 23:84–90PubMedGoogle Scholar
  8. 8.
    Bastos MF, Brilhante FV, Bezerra JP, Silva CA, Duarte PM (2010) Trabecular bone area and bone-healing in spontaneously hypertensive rats: a histometric study. Brazil Oral Res. 24:170–176CrossRefGoogle Scholar
  9. 9.
    Tarantino U, Cerocchi I, Celi M, Scialdoni A, Saturnino L, Gasbarra E (2009) Pharmacological agents and bone-healing. Clin Cases Miner Bone Metab. 6:144–148PubMedGoogle Scholar
  10. 10.
    Goldhahn J, Féron JM, Kanis J, Papapoulos S, Reginster JY, Rizzoli R, Dere W, Mitlak B, Tsouderos Y, Boonen S (2012) Implications for fracture-healing of current and new osteoporosis treatments: an ESCEO consensus paper. Calcif Tissue Int 90(5):343–353PubMedCrossRefGoogle Scholar
  11. 11.
    Goldhahn J, Little D, Mitchell P, Fazzalari NL, Reid IR, Aspenberg P, Marsh D (2010) Evidence for anti-osteoporosis therapy in acute fracture situations Recommendations of a multidisciplinary workshop of the International Society for Fracture Repair. Bone 46:267–271PubMedCrossRefGoogle Scholar
  12. 12.
    Aspenberg P, Genant HK, Johansson T, Nino AJ, See K, Krohn K, García-Hernández PA, Recknor CP, Einhorn TA, Dalsky GP, Mitlak BH, Fierlinger A, Lakshmanan MC (2010) Teriparatide for acceleration of fracture-repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radial fractures. J Bone Miner Res 25:404–414PubMedCrossRefGoogle Scholar
  13. 13.
    Li YF, Luo E, Feng G, Zhu SS, Li JH, Hu J (2010) Systemic treatment with strontium ranelate promotes tibial fracture healing in ovariectomized rats. Osteoporos Int 21:1889–1897PubMedCrossRefGoogle Scholar
  14. 14.
    Habermann B, Kafchitsas K et al (2010) Strontium ranelate enhances callus strength more than PTH 1-34 in an osteoporotic rat model of fracture-healing. Calcif Tissue Int 86:82–89PubMedCrossRefGoogle Scholar
  15. 15.
    Maïmoun L, Brennan TC, Badoud I, Dubois-Ferriere V, Rizzoli R, Ammann P (2010) Strontium ranelate improves implant osseointegration. Bone 46(5):1436–1441PubMedCrossRefGoogle Scholar
  16. 16.
    Li Y, Feng G, Gao Y, Luo E, Liu X, Hu J (2010) Strontium ranelate treatment enhances hydroxyapatite-coated titanium screws fixation in osteoporotic rats. J Orthop Res 28(5):578–582PubMedGoogle Scholar
  17. 17.
    Habermann B, Kafchitsas K, Olender G, Augat P, Kurth A (2011) Effects of anti-osteoporosis medications on fracture healing. Curr Osteoporos Rep 9:149–155CrossRefGoogle Scholar
  18. 18.
    Brandi ML (2012) Drugs for bone healing. Expert Opin Investig Drugs 21:1169–1176PubMedCrossRefGoogle Scholar
  19. 19.
    Alegre DN, Ribeiro C, Sousa C, Correia J, Silva L, de Almeida L (2012) Possible benefits of strontium ranelate in complicated long bone fractures. Rheumatol Int 32:439–443PubMedCrossRefGoogle Scholar
  20. 20.
    Tarantino U, Celi M, Saturnino L, Scialdoni A, Cerocchi I (2010) Strontium ranelate and bone healing: report of two cases. Clin Cases Miner Bone Metab. 7:65–68PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Umberto Tarantino
    • 1
  • Luca Saturnino
    • 1
  • Alessandro Scialdoni
    • 1
  • Maurizio Feola
    • 1
  • Federico Maria Liuni
    • 1
  • Valerio Tempesta
    • 1
  • Pietro Pistillo
    • 1
  1. 1.Department of Orthopedic and TraumatologyUniversity of Rome “Tor Vergata”, Policlinico Tor Vergata FoundationRomeItaly

Personalised recommendations