Supervisors info:
Λυρίτης Γεώργιος, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Κασσή Ευανθία, Αναπληρωτής Καθηγήτρια, Ιατρική, ΕΚΠΑ
Τριανταφυλλόπουλος Ιωάννης, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Summary:
Aminobisphosphonates are pharmaceutical agents that have been used for many years to treat osteoporosis, multiple myeloma, Paget's disease, metastatic bone disease, and a variety of other diseases in which bone mineral density is reduced. Given that aminobisphosphonates inhibit bone resorption, an important stage in fracture healing process, they have been extensively studied in preclinical models for their activity. In animal models, treatment with aminobisphosphonates is associated with a larger callus formation in fracture area and delay in remodeling from primary woven bone to lamellar bone, but there is no delay in formation of the fracture callus. In humans, all existing evidence suggest that initiating treatment with aminobisphosphonates, after upper and lower limb fractures, does not appear to have a significant effect on fracture healing. Rarely, patients with long-term use of aminobisphosphonates may develop “atypical fractures” and delay in their healing. Therefore, this clinical condition is not fully understood and many questions remain unanswered. Similarly, there are few studies about the benefits of stopping a long-term treatment with them, if a fracture occurs. Although most studies support that chronic aminobisphosphonate therapy may lead to fracture healing delay, this is not fully documented. On the other hand, there are studies that are in complete disagreement with them. All of the above suggest that there is a need of more detailed future research, into larger patient populations and different types of fractures, with sufficient data on the type, dosage, way and duration of administration of aminobisphosphonates, and the control methods of fracture healing, in order to have a safe final conclusion on the effect of their long-term administration in this highly complex process.
Keywords:
Fracture, Fracture healing, Bisphosphonates, Pseudarthrosis, Osteoporosis
