Advancements in Osteoporosis Imaging, Screening, and Study of Disease Etiology
AbstractPurpose of ReviewThe purpose of this review is to inform researchers and clinicians with the most recent imaging techniques that are employed (1) to opportunistically screen for osteoporosis and (2) to provide a better understanding into the disease etiology of osteoporosis.Recent FindingsPhantomless calibration techniques for computed tomography (CT) may pave the way for better opportunistic osteoporosis screening and the retroactive analysis of imaging data. Additionally, hardware advances are enabling new applications of dual-energy CT and cone-beam CT to the study of bone. Advances in MRI sequences are also imp...
Source: Current Osteoporosis Reports - July 22, 2021 Category: Orthopaedics Source Type: research

Correction to: Gut Microbiota in Bone Health and Diabetes
A Correction to this paper has been published:https://doi.org/10.1007/s11914-021-00694-8 (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - July 22, 2021 Category: Orthopaedics Source Type: research

Bringing Mechanical Context to Image-Based Measurements of Bone Integrity
AbstractPurpose of ReviewImage-based measurements of bone integrity are used to estimate failure properties and clinical fracture risk. This paper (1) reviews recent imaging studies that have enhanced our understanding of the mechanical pathways to bone fracture and (2) discusses the influence that inter-individual differences in image-based measurements may have on the clinical assessment of fracture riskRecent FindingsIncreased tissue mineralization is associated with improved bone strength but reduced fracture toughness. Trabecular architecture that is important for fatigue resistance is less important for bone strength...
Source: Current Osteoporosis Reports - July 16, 2021 Category: Orthopaedics Source Type: research

Part I: Which Child with a Chronic Disease Needs Bone Health Monitoring?
AbstractPurpose of the ReviewUnderlying conditions which adversely affect skeletal strength are one of the most common reasons for consultations in pediatric bone health clinics. The diseases most frequently linked to fragility fractures include leukemia and other cancers, inflammatory disorders, neuromuscular disease, and those treated with osteotoxic drugs (particularly glucocorticoids). The decision to treat a child with secondary osteoporosis is challenged by the fact that fractures are frequent in childhood, even in the absence of risk factors. Furthermore, some children have the potential for medication-unassisted re...
Source: Current Osteoporosis Reports - July 10, 2021 Category: Orthopaedics Source Type: research

The Diminishing Returns of Mechanical Loading and Potential Mechanisms that Desensitize Osteocytes
AbstractAdaptation to mechanical loading is critical to maintaining bone mass and offers therapeutic potential to preventing age-related bone loss and osteoporosis. However, increasing the duration of loading is met with “diminishing returns” as the anabolic response quickly becomes saturated. As a result, the anabolic response to daily activities and repetitive bouts of loading is limited by the underlying mechanisms that desensitize and render bone unresponsive at the cellular level. Osteocytes are the primary cells that respond to skeletal loading and facilitate the overall anabolic response. Although many o...
Source: Current Osteoporosis Reports - July 3, 2021 Category: Orthopaedics Source Type: research

Bisphosphonates, Bone and Joint Pain
AbstractPurpose of ReviewBisphosphonates (BPs) have an established role in a number of diseases including osteoporosis, but the role of BPs for treating symptomatic conditions other than bone metastases is less clear. We review recent data on the efficacy of BPs in the treatment of symptomatic bone and joint pain with osteoarthritis (OA) as an example.Recent FindingsAlthough controversial, BPs have been reported to improve pain ratings, imaging features, and inflammatory markers in patients with arthritis, more specifically OA. It is possible that their effects in periarticular bone strongly influence the complex inflammat...
Source: Current Osteoporosis Reports - July 3, 2021 Category: Orthopaedics Source Type: research

Updates in Management of Bone Metastatic Disease in Primary Solid Tumors with Systemic Therapies
AbstractPurpose of ReviewThe purpose of this review is to highlight novel and impactful discoveries in systemic treatment of bone metastatic disease in solid tumors published within the past 5 years.Recent FindingsMajor developments in systemic treatment of bone metastatic disease in solid tumors include evidence that decreasing frequency of dosing zoledronic acid in metastatic breast and prostate cancer maintains efficacy in preventing skeletal-related events while decreasing costs. The landmark findings on the use of Radium-223 to treat metastatic prostate cancer were reported in 2013. Recently, it has been found that no...
Source: Current Osteoporosis Reports - June 30, 2021 Category: Orthopaedics Source Type: research

Finite Element Analysis of Fracture Fixation
AbstractPurpose of ReviewFracture fixation aims to provide stability and promote healing, but remains challenging in unstable and osteoporotic fractures with increased risk of construct failure and nonunion. The first part of this article reviews the clinical motivation behind finite element analysis of fracture fixation, its strengths and weaknesses, how models are developed and validated, and how outputs are typically interpreted. The second part reviews recent modeling studies of the femur and proximal humerus, areas with particular relevance to fragility fractures.Recent FindingsThere is some consensus in the literatur...
Source: Current Osteoporosis Reports - June 29, 2021 Category: Orthopaedics Source Type: research

Bone Health in Pediatric Patients with IBD: What Is New?
AbstractPurpose of the ReviewPatients with inflammatory bowel disease (IBD) have increased bone fragility, demonstrated by increased fracture risk, and often have low bone density and altered bone geometry, but the underlying pathophysiology remains poorly understood.Recent FindingsChildren and adolescents with IBD appear to have decreased bone formation, at diagnosis, which frequently improves with treatment of their underlying IBD. There is a growing body of evidence regarding how the immune system interacts with bone metabolism. There are likely multi-factorial etiologies that contribute to suboptimal bone accrual and s...
Source: Current Osteoporosis Reports - June 22, 2021 Category: Orthopaedics Source Type: research

Part 2: When Should Bisphosphonates Be Used in Children with Chronic Illness Osteoporosis?
AbstractPurpose of ReviewPart 1 of this review on secondary osteoporosis of childhood was devoted to understanding which children should undergo bone health monitoring, when to label a child with osteoporosis in this setting, and how best to monitor in order to identify early, rather than late, signs of bone fragility. In Part 2 of this review, we discuss the next critical step in deciding which children require bisphosphonate therapy. This involves distinguishing which children have the potential to undergo “medication-unassisted” recovery from secondary osteoporosis, obviating the need for bisphosphonate admi...
Source: Current Osteoporosis Reports - June 19, 2021 Category: Orthopaedics Source Type: research

Using “-omics” Data to Inform Genome-wide Association Studies (GWASs) in the Osteoporosis Field
AbstractPurpose of ReviewOsteoporosis constitutes a major societal health problem. Genome-wide association studies (GWASs) have identified over 1100 loci influencing bone mineral density (BMD); however, few of the causal genes have been identified. Here, we review approaches that use “-omics” data and genetic- and systems genetics–based analytical strategies to facilitate causal gene discovery.Recent FindingsThe bone field is beginning to adopt approaches that are commonplace in other disease disciplines. The slower progress has been due in part to the lack of large-scale “omics” data on bone ...
Source: Current Osteoporosis Reports - June 14, 2021 Category: Orthopaedics Source Type: research

Energy Metabolism of Osteocytes
AbstractPurpose of ReviewIn this review, we provide a recent update on bioenergetic pathways in osteocytes and identify potential future areas of research interest. Studies have identified a role for regulation of bone formation and bone resorption through osteocyte mechanosensing and osteocyte secreted factors. Nevertheless, there is a paucity of studies on the bioenergetics and energy metabolism of osteocytes, which are required for the regulation of bone remodeling.Recent FindingsOsteocytes are cells of the osteoblast lineage embedded in bone. The osteocyte lacunocanalicular network within the skeletal matrix is exposed...
Source: Current Osteoporosis Reports - June 12, 2021 Category: Orthopaedics Source Type: research

Potential Role of Perilacunar Remodeling in the Progression of Osteoporosis and Implications on Age-Related Decline in Fracture Resistance of Bone
AbstractPurpose of ReviewWe took an interdisciplinary view to examine the potential contribution of perilacunar/canalicular remodeling to declines in bone fracture resistance related to age or progression of osteoporosis.Recent FindingsPerilacunar remodeling is most prominent as a result of lactation; recent advances further elucidate the molecular players involved and their effect on bone material properties. Of these, vitamin D and calcitonin could be active during aging or osteoporosis. Menopause-related hormonal changes or osteoporosis therapies affect bone material properties and mechanical behavior. However, investig...
Source: Current Osteoporosis Reports - June 12, 2021 Category: Orthopaedics Source Type: research

The Role of Fall Biomechanics in the Cause and Prevention of Bone Fractures in Older Adults
AbstractPurpose of ReviewAdults over age 65 experience the highest rates of bone fracture, and 90% of fractures in older adults are caused by falls from standing height or lower. Advances in fracture prevention rely on our ability to prevent falls, reduce the severity of falls, and enhance the resistance of bone to trauma. To help guide these efforts, we need improved understanding on the types of falls that cause fractures.Recent FindingsIn this review, we describe recent evidence on how the mechanics of falls in older adults influence the risk for fractures to the hip, wrist, vertebrae, and humerus. We discuss how fractu...
Source: Current Osteoporosis Reports - June 9, 2021 Category: Orthopaedics Source Type: research

Genetic Determinants of Paget ’s Disease of Bone
AbstractPurpose of ReviewTo provide an overview of the role of genes and loci that predispose to Paget ’s disease of bone and related disorders.Recent FindingsStudies over the past ten years have seen major advances in knowledge on the role of genetic factors in Paget ’s disease of bone (PDB). Genome wide association studies have identified six loci that predispose to the disease whereas family based studies have identified a further eight genes that cause PDB. This brings the total number of genes and loci implicated in PDB to fourteen. Emerging evidence has s hown that a number of these genes also predispose ...
Source: Current Osteoporosis Reports - May 14, 2021 Category: Orthopaedics Source Type: research

Burosumab for Pediatric X-Linked Hypophosphatemia
AbstractPurpose of ReviewX-Linked hypophosphatemia (XLH) is the most common genetic cause of rickets. This review describes advances in the management of XLH using burosumab which was FDA approved for treating children with XLH in 2018.Recent FindingsElevated FGF23 in XLH leads to systemic hypophosphatemia and several musculoskeletal manifestations, including rachitic bone deformities, impaired growth, dental abscesses, insufficiency fractures, osteoarthritis, and enthesopathy, with lifelong consequences for physical function and quality of life. Burosumab treatment has demonstrated clinical improvement of rickets and grow...
Source: Current Osteoporosis Reports - May 10, 2021 Category: Orthopaedics Source Type: research

The Polygenic and Monogenic Basis of Paediatric Fractures
AbstractPurpose of ReviewFractures are frequently encountered in paediatric practice. Although recurrent fractures in children usually unveil a monogenic syndrome, paediatric fracture risk could be shaped by the individual genetic background influencing the acquisition of bone mineral density, and therefore, the skeletal fragility as shown in adults. Here, we examine paediatric fractures from the perspective of monogenic and complex trait genetics.Recent FindingsLarge-scale genome-wide studies in children have identified ~44 genetic loci associated with fracture or bone traits whereas ~35 monogenic diseases characterized b...
Source: Current Osteoporosis Reports - May 4, 2021 Category: Orthopaedics Source Type: research

Clinical Importance of Bone Matrix Damage Mechanisms for Fracture Prevention
AbstractPurpose of ReviewBone matrix exhibits great complexity in its composition, structure and mechanics. Here, we provide a review of recent research articles and appraise the evidence that bone matrix quality is clinically important and possibly targetable for fracture prevention.Recent FindingsDeformation of mineralised collagen fibrils determines bone fracture mechanics. Slipping and separation at the mineral-fibril and fibril-fibril interfaces, respectively, are the structural mechanisms for plastic deformation and microcrack nucleation. Existing technologies for assessing bone tissue in vivo cannot measure matrix s...
Source: Current Osteoporosis Reports - April 20, 2021 Category: Orthopaedics Source Type: research

The Gut Microbiome: a New Frontier in Musculoskeletal Research
AbstractPurpose of the reviewThe human gut harbors a complex community of microbes that influence many processes regulating musculoskeletal development and homeostasis. This review gives an update on the current knowledge surrounding the impact of the gut microbiota on musculoskeletal health, with an emphasis on research conducted over the last three years.Recent findingsThe gut microbiota and their metabolites are associated with sarcopenia, osteoporosis, osteoarthritis, and rheumatoid arthritis. The field is moving fast from describing simple correlations to pursue establishing causation through clinical trials.SummaryTh...
Source: Current Osteoporosis Reports - April 17, 2021 Category: Orthopaedics Source Type: research

Do Interactions of Vitamin D 3 and BMP Signaling Hold Implications in the Pathogenesis of Fibrodysplasia Ossificans Progressiva?
AbstractPurpose of ReviewFibrodysplasia ossificans progressiva (FOP) is a debilitating rare disease known for episodic endochondral heterotopic ossification (HO) caused by gain-of-function mutations inACVR1/ALK2. However, disease severity varies among patients with identical mutations suggesting disease-modifying factors, including diet, may have therapeutic implications. The roles of vitamin D3 in calcium metabolism and chondrogenesis are known, but its effects on BMP signaling and chondrogenesis are less studied. This review attempts to assess the possibility of vitamin D ’s effects in FOP by exploring relevant int...
Source: Current Osteoporosis Reports - April 14, 2021 Category: Orthopaedics Source Type: research

MicroRNAs and Their Roles in Breast Cancer Bone Metastasis
AbstractBone metastasis occurs in advanced stages of breast cancer, worsening the quality of life and increasing the mortality of patients. Current treatments for bone metastasis are only palliative, and efficient therapeutic targets need to be still identified. MicroRNAs (miRNAs) are a large class of small non-coding RNAs that regulate gene expression within cells. Interestingly, the expression of certain miRNAs has been associated with several stages of bone metastasis progression, highlighting the importance of these small RNAs during the course of the metastatic disease. In this review, we aim to summarise the most rec...
Source: Current Osteoporosis Reports - April 8, 2021 Category: Orthopaedics Source Type: research

Current Analysis of Skeletal Phenotypes in Down Syndrome
AbstractPurposeDown syndrome (DS) is caused by trisomy 21 (Ts21) and results in skeletal deficits including shortened stature, low bone mineral density, and a predisposition to early onset osteoporosis. Ts21 causes significant alterations in skeletal development, morphology of the appendicular skeleton, bone homeostasis, age-related bone loss, and bone strength. However, the genetic or cellular origins of DS skeletal phenotypes remain unclear.Recent FindingsNew studies reveal a sexual dimorphism in characteristics and onset of skeletal deficits that differ between DS and typically developing individuals. Age-related bone l...
Source: Current Osteoporosis Reports - April 8, 2021 Category: Orthopaedics Source Type: research

Role of Osteocytes in Cancer Progression in the Bone and the Associated Skeletal Disease
AbstractPurpose of ReviewThe goal of this manuscript is to review the current knowledge on the role of osteocytes in cancer in the bone, discuss the potential of osteocytes as a therapeutic target, and propose future research needed to understand the crosstalk between cancer cells and osteocytes in the tumor niche.Recent FindingsNumerous studies have established that cancer cells manipulate osteocytes to facilitate invasion and tumor progression in bone. Moreover, cancer cells dysregulate osteocyte function to disrupt physiological bone remodeling, leading to the development of bone disease. Targeting osteocytes and their ...
Source: Current Osteoporosis Reports - April 5, 2021 Category: Orthopaedics Source Type: research

Skeletal Functions of Voltage Sensitive Calcium Channels
AbstractSummaryVoltage-sensitive calcium channels (VSCCs) are ubiquitous multimeric protein complexes that are necessary for the regulation of numerous physiological processes. VSCCs regulate calcium influx and various intracellular processes including muscle contraction, neurotransmission, hormone secretion, and gene transcription, with function specificity defined by the channel ’s subunits and tissue location.The functions of VSCCs in bone are often overlooked since bone is not considered an electrically excitable tissue. However, skeletal homeostasis and adaptation relies heavily on VSCCs. Inhibition or deletion ...
Source: Current Osteoporosis Reports - March 15, 2021 Category: Orthopaedics Source Type: research

Targeting Histone Modifications in Bone and Lung Metastatic Cancers
AbstractPurpose of ReviewBreast cancer frequently metastasizes to the bone and lung, but the ability to treat metastatic tumor cells remains a pressing clinical challenge. Histone deacetylases (HDACs) and histone acetyltransferases (HATs) have emerged as promising targets since these enzymes are aberrantly expressed in numerous cancers and regulate the expression of genes that drive tumorigenesis and metastasis. This review focuses on the abnormal expression of histone-modifying enzymes in cancers that have a high tropism for the bone and lung and explores the clinical use of histone deacetylase inhibitors for the treatmen...
Source: Current Osteoporosis Reports - March 15, 2021 Category: Orthopaedics Source Type: research

Osteogenesis Imperfecta —Who Needs Rodding Surgery?
AbstractPurpose of ReviewThe purpose of this review is to precise the indications for intramedullary rodding of long bones in osteogenesis imperfecta, the classic treatment for fractures and deformities in this condition.Recent FindingsThe use of plates and screws alone is not recommended, but its use in conjunction with rodding is becoming more popular as demonstrated in recent literature. The different types of rods are reviewed and their advantages/disadvantages exposed. There is a clear advantage for telescopic rods in terms of incidence of revision surgery but complications are still to be expected.SummaryAn interdisc...
Source: Current Osteoporosis Reports - March 1, 2021 Category: Orthopaedics Source Type: research

Extracellular Vesicles and Bone-Associated Cancer
AbstractPurpose of ReviewIn this review, we describe the biology of extracellular vesicles (EV) and how they contribute to bone-associated cancers.Recent FindingsCrosstalk between tumor and bone has been demonstrated to promote tumor and metastatic progression. In addition to direct cell-to-cell contact and soluble factors, such as cytokines, EVs mediate crosstalk between tumor and bone. EVs are composed of a heterogenous group of membrane-delineated vesicles of varying size range, mechanisms of formation, and content. These include apoptotic bodies, microvesicles, large oncosomes, and exosomes. EVs derived from primary tu...
Source: Current Osteoporosis Reports - February 27, 2021 Category: Orthopaedics Source Type: research

Biomechanical Basis of Predicting and Preventing Lower Limb Stress Fractures During Arduous Training
AbstractPurpose of ReviewStress fractures at weight-bearing sites, particularly the tibia, are common in military recruits and athletes. This review presents recent findings from human imaging and biomechanics studies aimed at predicting and preventing stress fractures.Recent FindingsPeripheral quantitative computed tomography (pQCT) provides evidence that cortical bone geometry (tibial width and area) is associated with tibial stress fracture risk during weight-bearing exercise. The contribution of bone trabecular microarchitecture, cortical porosity, and bone material properties in the pathophysiology of stress fractures...
Source: Current Osteoporosis Reports - February 26, 2021 Category: Orthopaedics Source Type: research

Preventing Bone Stress Injuries in Runners with Optimal Workload
AbstractBone stress injuries (BSIs) occur at inopportune times to invariably interrupt training. All BSIs in runners occur due to an “error” in workload wherein the interaction between the number and magnitude of bone tissue loading cycles exceeds the ability of the tissue to resist the repetitive loads. There is not a single optimal bone workload, rather a range which is influenced by the prevailing scenario. In prepubertal athletes, optimal bone workload consists of low-repetitions of fast, high-magnitude, multidirectional loads introduced a few times per day to induce bone adaptation. Premature sports specia...
Source: Current Osteoporosis Reports - February 26, 2021 Category: Orthopaedics Source Type: research

Anabolic Agents for Postmenopausal Osteoporosis: How Do You Choose?
AbstractPurpose of ReviewThere are now three anabolic agents available for the treatment of postmenopausal women at high risk for fracture. The purpose of this review is to supply a rationale to aid in determining which agent should be used in which clinical settings.Recent FindingsStudies over the last decade have shown that anabolic agents produce faster and larger effects against fracture than antiresorptive agents. Furthermore, trials evaluating anabolic antiresorptive treatment sequences have shown that anabolic first treatment strategies produce the greatest benefits to bone density, particularly in the hip region. H...
Source: Current Osteoporosis Reports - February 26, 2021 Category: Orthopaedics Source Type: research

Denosumab Treatment for Giant Cell Tumors, Aneurysmal Bone Cysts, and Fibrous Dysplasia —Risks and Benefits
AbstractPurpose of ReviewThis review summarizes current understanding of the role of denosumab, an inhibitor of receptor activator of nuclear kappa-B ligand (RANKL), in the management of 3 skeletal neoplasms: giant cell tumors, aneurysmal bone cysts, and fibrous dysplasia.Recent FindingsA growing body of literature supports denosumab use in giant cell tumors, a neoplasm in which RANKL plays a clear pathogenic role. Comparatively less data is available in aneurysmal bone cysts and fibrous dysplasia; however, the pathogenic similarity of these disorders to giant cell tumors, as well as encouraging preliminary data, suggests ...
Source: Current Osteoporosis Reports - February 22, 2021 Category: Orthopaedics Source Type: research

Applications of Lipidomics to Age-Related Musculoskeletal Disorders
AbstractPurpose of ReviewThe goal of this review is to highlight the need for new biomarkers for the diagnosis and treatment of musculoskeletal disorders, especially osteoporosis and sarcopenia. These conditions are characterized by loss of bone and muscle mass, respectively, leading to functional deterioration and the development of disabilities. Advances in high-resolution lipidomics platforms are being used to help identify new lipid biomarkers for these diseases.Recent FindingsIt is now well established that bone and muscle have important endocrine functions, including the release of bioactive factors in response to me...
Source: Current Osteoporosis Reports - February 16, 2021 Category: Orthopaedics Source Type: research

The Genetics of Atypical Femur Fractures —a Systematic Review
AbstractPurpose of ReviewAtypical femur fractures (AFFs) are rare subtrochanteric or diaphyseal fractures regarded as side effects of bisphosphonates (BPs), possibly with a genetic background. Here, we summarize the most recent knowledge about genetics of AFFs.Recent FindingsAFF has been reported in 57 patients with seven different monogenic bone disorders including hypophosphatasia and osteogenesis imperfecta; 56.1% had never used BPs, while 17.5% were diagnosed with the disorder only after the AFF. Gene mutation finding in familial and sporadic cases identified possible AFF-related variants in theGGPS1 andATRAID genes re...
Source: Current Osteoporosis Reports - February 15, 2021 Category: Orthopaedics Source Type: research

Dietary Patterns and Pediatric Bone
AbstractPurpose of ReviewMuch of what we know about dietary patterns (DPs) and bone is derived from cross-sectional studies in adults. Given, establishing healthy bones during childhood serves as a blueprint for adult bone, it is important to better understand the role of DPs on pediatric bone. The purpose of this review is to determine if DPs influence bone strength in children.Recent FindingsThe majority of studies investigating the role of DPs on pediatric bone are cross-sectional in design and examine data-derived “a posterori” DPs. Overall, the DPs characterized by high intakes of fruits and vegetables dem...
Source: Current Osteoporosis Reports - February 11, 2021 Category: Orthopaedics Source Type: research

Single Cell Omics for Musculoskeletal Research
This article summarizes talks given during a workshop on “Single Cell Omics” at the 2020 annual meeting of the Orthopedic Research Society. Studies that applied scRNA-seq, ATAC-seq, and CyTOF mass cytometry to cartilage development and osteoarthritis are reviewed. This body of work shows how these cutting-edge tools can advance our understanding of th e cellular heterogeneity and trajectories of lineage specification during development and disease. (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - February 9, 2021 Category: Orthopaedics Source Type: research

Osteoarthritis: Insights Offered by the Study of Bone Mass Genetics
We examined whether those genetically predisposed to elevated BMD are at increased risk of developing OA, using our high bone mass (HBM) cohort. HBM individuals were found to have a greater prevalence of OA compared with family controls and greater development of radiographic features of OA over 8 years, with predominantly osteophytic OA. Initial Mendelian randomisation analysis provided additional support for a causal effect of increased BMD on increased OA risk. In contrast, more recent investigation estimates this relationship to be bi-directional. However, both these findings could be explained instead by shared biolog...
Source: Current Osteoporosis Reports - February 4, 2021 Category: Orthopaedics Source Type: research

Orthodontic Tooth Movement Studied by Finite Element Analysis: an Update. What Can We Learn from These Simulations?
AbstractPurpose of ReviewTo produce an updated overview of the use of finite element (FE) analysis for analyzing orthodontic tooth movement (OTM). Different levels of simulation complexity, including material properties and level of morphological representation of the alveolar complex, will be presented and evaluated, and the limitations will be discussed.Recent FindingsComplex formulations of the PDL have been proposed, which might be able to correctly predict the behavior of the PDL both when chewing forces and orthodontic forces are simulated in FE models. The recent findings do not corroborate the simplified view of th...
Source: Current Osteoporosis Reports - February 4, 2021 Category: Orthopaedics Source Type: research

Bisphosphonate Drug Holidays in Primary Care: When and What to Do Next?
AbstractPurpose of ReviewThis review describes the rational for bisphosphonate holidays, summaries key evidence to support the concept, and provides a roadmap to help clinicians initiate, monitor, and discontinue a bisphosphonate drug holiday.Recent FindingsRandomized trials and data from large observational studies are available to determine the short and long-term bisphosphonate benefits (prevention of fracture) and harms (principally atypical femoral fractures and osteonecrosis of the jaw). Mounting evidence points towards a causal relationship between bisphosphonate use and AFF and ONJ, particularly with>  5&...
Source: Current Osteoporosis Reports - February 2, 2021 Category: Orthopaedics Source Type: research

Understanding Early-Stage Posttraumatic Osteoarthritis for Future Prospects of Diagnosis: from Knee to Temporomandibular Joint
AbstractPurpose of ReviewMany mechanical load-bearing joints of the body are prone to posttraumatic osteoarthritis (PTOA), including the knee joint and temporomandibular joint (TMJ). Early detection of PTOA can be beneficial in prevention or alleviating further progression of the disease.Recent FindingsVarious mouse models, similar to those used in development of novel diagnosis strategies for early stages of OA, have been proposed to study early PTOA. While many studies have focused on OA and PTOA in the knee joint, early diagnostic methods for OA and PTOA of the TMJ are still not well established. Previously, we showed t...
Source: Current Osteoporosis Reports - February 1, 2021 Category: Orthopaedics Source Type: research

Approaches to Fracture Risk Assessment and Prevention
AbstractPurpose of ReviewTo critically assess recent evidence concerning osteoporosis fracture risk.Recent FindingsRobust instruments exist for predicting factures incorporating well-documented risk factors especially prior fracture whose magnitude varies with site, occurrence time, and age. Stratifying time-since-prior fracture has resulted in the concept of imminent fracture risk and increased focus on secondary fracture prevention. Secondary fracture prevention recommendations include fracture liaison service, pharmacologic and non-pharmacologic multidisciplinary intervention, and communicating that fractures in older a...
Source: Current Osteoporosis Reports - February 1, 2021 Category: Orthopaedics Source Type: research

Gut Microbiota in Bone Health and Diabetes
AbstractPurpose of ReviewPatients with diabetes mellitus (DM) are at increased risk of developing osteopathogenesis and skeletal fragility. The role of the gut microbiota in both DM and osteopathy is not fully explored and may be involved in the pathology of both diseases.Recent FindingsGut microbiota alterations have been observed in DM and osteopathogenic disorders as compared with healthy controls, such as significantly lower abundance ofPrevotella and higher abundance ofLactobacillus, with a diminished bacterial diversity. Other overlapping gastro-intestinal features include the loss of intestinal barrier function with...
Source: Current Osteoporosis Reports - February 1, 2021 Category: Orthopaedics Source Type: research

Cell Sources for Human In vitro Bone Models
AbstractPurpose of ReviewOne aim in bone tissue engineering is to develop human cell-based, 3D in vitro bone models to study bone physiology and pathology. Due to the heterogeneity of cells among patients, patient ’s own cells are needed to be obtained, ideally, from one single cell source. This review attempts to identify the appropriate cell sources for development of such models.Recent FindingsBone marrow and peripheral blood are considered as suitable sources for extraction of osteoblast/osteocyte and osteoclast progenitor cells. Recent studies on these cell sources have shown no significant differences between i...
Source: Current Osteoporosis Reports - January 15, 2021 Category: Orthopaedics Source Type: research

Type 2 Diabetes Mellitus and Vertebral Fracture Risk
AbstractPurpose of ReviewThe purpose of this review is to summarize the recently published evidence concerning vertebral fracture risk in individuals with diabetes mellitus.Recent FindingsVertebral fracture risk is increased in individuals with T2DM. The presence of vertebral fractures in T2DM is associated with increased non-vertebral fracture risk and mortality. TBS could be helpful to estimate vertebral fracture risk in individuals with T2DM. An increased amount of bone marrow fat has been implicated in bone fragility in T2DM. Results from two recent studies show that both teriparatide and denosumab are effective in red...
Source: Current Osteoporosis Reports - January 12, 2021 Category: Orthopaedics Source Type: research

Ex vivo Bone Models and Their Potential in Preclinical Evaluation
AbstractPurpose of ReviewNovel therapies for damaged and diseased bone are being developed in a preclinical testing process consisting of in vitro cell experiments followed by in vivo animal studies. The in vitro results are often not representative of the results observed in vivo. This could be caused by the complexity of the natural bone environment that is missing in vitro. Ex vivo bone explant cultures provide a model in which cells are preserved in their native three-dimensional environment. Herein, it is aimed to review the current status of bone explant culture models in relation to their potential in complementing ...
Source: Current Osteoporosis Reports - January 11, 2021 Category: Orthopaedics Source Type: research

Nutritional Supplements and Skeletal Health
AbstractPurpose of ReviewNutrition influences skeletal health throughout the lifespan, from the impact of maternal intakes during development, through the development of peak bone mass, to the rate of bone loss during aging. However, there are limited data available on the effects of nutritional supplements on bone density, let alone fracture risk. This review will assess the current literature, focusing on human studies, and emphasizing nutrients where bone density or fracture data are available.Recent FindingsCalcium and vitamin D supplements, in combination, reduce fracture risk, particularly in populations with low int...
Source: Current Osteoporosis Reports - January 9, 2021 Category: Orthopaedics Source Type: research

Closing the Osteoporosis Care Gap
AbstractPurpose of ReviewThis review outlines the scope of the problem in osteoporosis care and secondary fracture prevention and describes fracture prevention strategies, with a focus on the frail elderly.Recent FindingsDespite heightened awareness among patients and clinicians alike and the availability of efficacious anti-osteoporosis medications, osteoporosis is still underdiagnosed and undertreated. However, the introduction of systematic risk assessment and secondary fracture prevention programmes has gained momentum, and evidence of success is accumulating.SummaryWe possess today the knowledge required to close the ...
Source: Current Osteoporosis Reports - January 9, 2021 Category: Orthopaedics Source Type: research

New Advances in Osteocyte Mechanotransduction
AbstractPurpose of ReviewSkeletal adaptation to mechanical loading plays a critical role in bone growth and the maintenance of bone homeostasis. Osteocytes are postulated to serve as a hub orchestrating bone remodeling. The recent findings on the molecular mechanisms by which osteocytes sense mechanical loads and the downstream bone-forming factors are reviewed.Recent FindingsCalcium channels have been implicated in mechanotransduction in bone cells for a long time. Efforts have been made to identify a specific calcium channel mediating the skeletal response to mechanical loads. Recent studies have revealed that Piezo1, a ...
Source: Current Osteoporosis Reports - January 9, 2021 Category: Orthopaedics Source Type: research

Therapies for Preventing Bone Loss with Glucocorticoid Treatment
AbstractPurpose of ReviewWe aim to critically review recent recommendations regarding preventative strategies for glucocorticoid-induced osteoporosis and provide a summary of key evidence regarding available interventions.Recent FindingsLifestyle optimization remains the hallmark of bone health preservation. Early initiation of anti-osteoporotic agents in the setting of glucocorticoid exposure is essential, guided by appropriate risk stratification. Recommendations for calcium and vitamin D intake optimization are well-supported across all risk strata. Bisphosphonates are the mainstay of pharmacological therapy. Newer agen...
Source: Current Osteoporosis Reports - January 7, 2021 Category: Orthopaedics Source Type: research

Romosozumab: a Review of Efficacy, Safety, and Cardiovascular Risk
AbstractPurpose of ReviewAuthors review the safety and efficacy of romosozumab for the treatment of osteoporosis as demonstrated in three phase III clinical trials and offer insights into the potential cardiovascular risk associated with its use.Recent FindingsIncidence of new vertebral fracture is dramatically reduced with 12  months of romosozumab use in comparison to both placebo and active bisphosphonate control groups in patients with postmenopausal osteoporosis. Significant non-vertebral anti-fracture benefit was also demonstrated in patients with more severe osteoporosis. Numerical increases in cardiovascular e...
Source: Current Osteoporosis Reports - January 7, 2021 Category: Orthopaedics Source Type: research

Connexin Gap Junctions and Hemichannels Link Oxidative Stress to Skeletal Physiology and Pathology
AbstractPurpose of ReviewThe goal of this review is to provide an overview of the impact and underlying mechanism of oxidative stress on connexin channel function, and their roles in skeletal aging, estrogen deficiency, and glucocorticoid excess associated bone loss.Recent FindingsConnexin hemichannel opening is increased under oxidative stress conditions, which confers a cell protective role against oxidative stress-induced cell death. Oxidative stress acts as a key contributor to aging, estrogen deficiency, and glucocorticoid excess-induced osteoporosis and impairs osteocytic network and connexin gap junction communicati...
Source: Current Osteoporosis Reports - January 6, 2021 Category: Orthopaedics Source Type: research