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

The Use of Platelet-Rich Plasma (PRP) for the Management of Non-union Fractures
AbstractPurpose of ReviewThe treatment of non-union fractures represents a significant challenge for orthopaedic surgeons. In recent years, biologic agents have been investigated and utilised to support and improve bone healing. Among these agents, platelet-rich plasma (PRP) is an emerging strategy that is gaining popularity. The aim of this review is to evaluate the current literature regarding the application and clinical effectiveness of PRP injections, specifically for the treatment of non-union fractures.Recent FindingsThe majority of published studies reported that PRP accelerated fracture healing; however, this evid...
Source: Current Osteoporosis Reports - January 4, 2021 Category: Orthopaedics Source Type: research

Enchondromatosis and Growth Plate Development
AbstractPurpose of reviewEnchondroma is a common cartilage benign tumor that develops from dysregulation of chondrocyte terminal differentiation during growth plate development. Here we provide an overview of recent progress in understanding causative mutations for enchondroma, dysregulated signaling and metabolic pathways in enchondroma, and the progression from enchondroma to malignant chondrosarcoma.Recent findingsSeveral signaling pathways that regulate chondrocyte differentiation are dysregulated in enchondromas. Somatic mutations in the metabolic enzymes isocitrate dehydrogenase 1 and 2 (IDH1/2) are the most common f...
Source: Current Osteoporosis Reports - December 11, 2020 Category: Orthopaedics Source Type: research

Trabecular Architecture and Mechanical Heterogeneity Effects on Vertebral Body Strength
AbstractPurpose of ReviewWe aimed to synthesize the recent work on the intra-vertebral heterogeneity in density, trabecular architecture and mechanical properties, its implications for fracture risk, its association with degeneration of the intervertebral discs, and its implications for implant design.Recent FindingsAs compared to the peripheral regions of the centrum, the central region of the vertebral body exhibits lower density and more sparse microstructure. As compared to the anterior region, the posterior region shows higher density. These variations are more pronounced in vertebrae from older persons and in those a...
Source: Current Osteoporosis Reports - November 20, 2020 Category: Orthopaedics Source Type: research

Ethnic Differences in Bone Microarchitecture
AbstractPurpose of the ReviewThe aim of this review is to briefly introduce updates in global fracture epidemiology and then to highlight recent contributions to understanding ethnic differences in bone density, geometry and microarchitecture and consider how these might contribute to differences in fracture risk. The review focuses on studies using peripheral quantitative computed tomography techniques.Recent FindingsRecent studies have contributed to our understanding of the differences in fracture incidence both between countries, as well as between ethnic groups living within the same country. In terms of understanding...
Source: Current Osteoporosis Reports - November 17, 2020 Category: Orthopaedics Source Type: research

Osteocytes and Diabetes: Altered Function of Diabetic Osteocytes
This article gives an overview of events occurring in diabetic osteocytes. In particular, mechanical responses seem to be seriously affected in these conditions, suggesting that mechanical sensibility could be a target for future research in the field. (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - November 13, 2020 Category: Orthopaedics Source Type: research

Glucose-Lowering Drugs and Fracture Risk —a Systematic Review
AbstractPurpose of ReviewDiabetes mellitus (DM) is associated with increased fracture risk. The aim of this systematic review was to examine the effects of different classes of glucose-lowering drugs on fracture risk in patients with type 2 DM. The heterogeneity of the included studies did not allow formal statistical analyses.Recent FindingsSixty studies were included in the review. Metformin, dipeptidylpeptidase-IV inhibitors, glucagon-like peptide-1 receptor agonists, and sodium –glucose cotransporter 2-inhibitors do not appear to increase fracture risk. Results for insulin and sulphonylureas were more disparate, ...
Source: Current Osteoporosis Reports - November 9, 2020 Category: Orthopaedics Source Type: research

Correction to: Do Bisphosphonates Alleviate Pain in Children? A Systematic Review
In a previous version of this publication, the author Mercedes Rodriguez Celin ’s name was listed as M.R. Celin. (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - October 29, 2020 Category: Orthopaedics Source Type: research

Biological Response to Nanosurface Modification on Metallic Biomaterials
AbstractPurpose of reviewNew biomaterials for biomedical applications have been developed over the past few years. This work summarizes the current cell lines investigations regarding nanosurface modifications to improve biocompatibility and osseointegration.Recent findingsMaterial surfaces presenting biomimetic morphology that provides nanoscale architectures have been shown to alter cell/biomaterial interactions. Topographical and biofunctional surface modifications present a positive effect between material and host response.SummaryNanoscale surfaces on titanium have the potential to provide a successful interface for i...
Source: Current Osteoporosis Reports - October 21, 2020 Category: Orthopaedics Source Type: research

Play During Growth: the Effect of Sports on Bone Adaptation
AbstractPurpose of ReviewThe development of exercise interventions for bone health requires an understanding of normative growth trends. Here, we summarize changes in bone during growth and the effect of participating in sports on structural and compositional measures in different bones in males and females.Recent FindingsGrowing females and males have similar normalized density and bone area fraction until age 16, after which males continue increasing at a faster rate than females. All metrics for both sexes tend to plateau or decline in the early 20s. Areal BMD measures indicate significant heterogeneity in adaptation to...
Source: Current Osteoporosis Reports - October 21, 2020 Category: Orthopaedics Source Type: research

When the Nervous System Turns Skeletal Muscles into Bones: How to Solve the Conundrum of Neurogenic Heterotopic Ossification
AbstractPurpose of ReviewNeurogenic heterotopic ossification (NHO) is the abnormal formation of extra-skeletal bones in periarticular muscles after damage to the central nervous system (CNS) such as spinal cord injury (SCI), traumatic brain injury (TBI), stroke, or cerebral anoxia. The purpose of this review is to summarize recent developments in the understanding of NHO pathophysiology and pathogenesis. Recent animal models of NHO and recent findings investigating the communication between CNS injury, tissue inflammation, and upcoming NHO therapeutics are discussed.Recent FindingsAnimal models of NHO following TBI or SCI ...
Source: Current Osteoporosis Reports - October 21, 2020 Category: Orthopaedics Source Type: research

Biomechanical Properties of Metastatically Involved Osteolytic Bone
AbstractPurpose of ReviewSkeletal metastasis involves the uncoupling of physiologic bone remodeling resulting in abnormal bone turnover and radical changes in bony architecture, density, and quality. Bone strength assessment and fracture risk prediction are critical in clinical treatment decision-making. This review focuses on bone tissue and structural mechanisms altered by osteolytic metastasis and the resulting changes to its material and mechanical behavior.Recent FindingsBoth organic and mineral phases of bone tissue are altered by osteolytic metastatic disease, with diminished bone quality evident at multiple length-...
Source: Current Osteoporosis Reports - October 19, 2020 Category: Orthopaedics Source Type: research

Exercise and Diet: Uncovering Prospective Mediators of Skeletal Fragility in Bone and Marrow Adipose Tissue
AbstractPurpose of ReviewTo highlight recent basic, translational, and clinical works demonstrating exercise and diet regulation of marrow adipose tissue (MAT) and bone and how this informs current understanding of the relationship between marrow adiposity and musculoskeletal health.Recent FindingsMarrow adipocytes accumulate in the bone in the setting of not only hypercaloric intake (calorie excess; e.g., diet-induced obesity) but also with hypocaloric intake (calorie restriction; e.g., anorexia), despite the fact that these states affect bone differently. With hypercaloric intake, bone quantity is largely unaffected, whe...
Source: Current Osteoporosis Reports - October 17, 2020 Category: Orthopaedics Source Type: research

A Review on Recent Advances in the Constitutive Modeling of Bone Tissue
AbstractPurpose of ReviewImage-based finite element analysis (FEA) to predict and understand the biomechanical response has become an essential methodology in musculoskeletal research. An important part of such simulation models is the constitutive material model of which recent advances are summarized in this review.Recent FindingsThe review shows that existing models from other fields were introduced, such as cohesion zone (cortical bone) or phase-field models (trabecular bone). Some progress has been made in describing cortical bone involving physical mechanisms such as microcracks. Problems with validations at differen...
Source: Current Osteoporosis Reports - October 17, 2020 Category: Orthopaedics Source Type: research

Failures of Endochondral Ossification in the Mucopolysaccharidoses
AbstractPurpose of ReviewThe mucopolysaccharidoses (MPS) are a group of inherited lysosomal storage disorders characterized by abnormal accumulation of glycosaminoglycans (GAGs) in cells and tissues. MPS patients frequently exhibit failures of endochondral ossification during postnatal growth leading to skeletal deformity and short stature. In this review, we outline the current understanding of the cellular and molecular mechanisms underlying failures of endochondral ossification in MPS and discuss associated treatment challenges and opportunities.Recent FindingsStudies in MPS patients and animal models have demonstrated ...
Source: Current Osteoporosis Reports - October 16, 2020 Category: Orthopaedics Source Type: research

Understanding Bone Disease in Patients with Diabetic Kidney Disease: a Narrative Review
AbstractPurpose of ReviewBoth diabetes and kidney disease associate with the development of bone disease and an increased risk of fragility fractures. The etiologies of bone disease in patients with diabetic kidney disease (DKD) are multiple and complex. This review explores the association between DKD and bone disease and discusses how the presence of both diabetes and kidney disease may impair bone quality and increase fracture risk. Diagnostic tools as well as future research areas are also discussed.Recent FindingsPatients with DKD have an increased risk of fragility fracture, most pronounced in patients with type 1 di...
Source: Current Osteoporosis Reports - October 13, 2020 Category: Orthopaedics Source Type: research

Sex Differences in Cancer Cachexia
AbstractPurpose of ReviewCachexia, a feature of cancer and other chronic diseases, is marked by progressive weight loss and skeletal muscle wasting. This review aims to highlight the sex differences in manifestations of cancer cachexia in patients, rodent models, and our current understanding of the potential mechanisms accounting for these differences.Recent FindingsMale cancer patients generally have higher prevalence of cachexia, greater weight loss or muscle wasting, and worse outcomes compared with female cancer patients. Knowledge is increasing about sex differences in muscle fiber type and function, mitochondrial me...
Source: Current Osteoporosis Reports - October 12, 2020 Category: Orthopaedics Source Type: research

3D Analysis of Tooth Movement Using 3D Technology
AbstractPurpose of Review3D cone beam imaging (CBCT) has allowed clinicians to better understand the anatomical variations of cranial anatomy. One crucial aspect of this technology plays is the understanding of alveolar bone morphology and remodeling. Variations in cortical bone thickness between individuals have been reported. No published study has analyzed the relationship between cortical bone thickness and rate of tooth movement. The aim of this study is to begin answering the question: is there an association between rate of tooth movement and cortical bone thickness?Recent FindingsTwenty-three patients underwent ext...
Source: Current Osteoporosis Reports - October 10, 2020 Category: Orthopaedics Source Type: research

Markers for Identification of Postnatal Skeletal Stem Cells In Vivo
AbstractPurpose of ReviewThe adult skeleton contains stem cells involved in growth, homeostasis, and healing. Mesenchymal or skeletal stem cells are proposed to provide precursors to osteoblasts, chondrocytes, marrow adipocytes, and stromal cells. We review the evidence for existence and functionality of different skeletal stem cell pools, and the tools available for identifying or targeting these populations in mouse and human tissues.Recent FindingsLineage tracing and single cell-based techniques in mouse models indicate that multiple pools of stem cells exist in postnatal bone. These include growth plate stem cells, ste...
Source: Current Osteoporosis Reports - October 9, 2020 Category: Orthopaedics Source Type: research

The Effects of Calcitonin Gene-Related Peptide on Bone Homeostasis and Regeneration
AbstractPurpose of ReviewThe goals of this review are two folds: (1) to describe the recent understandings on the roles of calcitonin gene-related peptide- α (CGRP) in bone homeostasis and the underlying mechanisms of related neuronal regulation and (2) to propose innovative CGRP-modulated approaches for enhancing bone regeneration in challenging bone disorders.Recent FindingsCGRP is predominantly produced by the densely distributed sensory neuronal fibers in bone, declining with age. Under mechanical and biochemical stimulations, CGRP releases and exerts either physiological or pathophysiological roles. CGRP at phys...
Source: Current Osteoporosis Reports - October 8, 2020 Category: Orthopaedics Source Type: research

Impact of Bone Fracture on Muscle Strength and Physical Performance —Narrative Review
AbstractPurpose of ReviewLow muscle strength and poor physical performance are associated with high risk of fracture. Many studies assessed clinical and functional outcomes of fractures. Fewer studies analyzed the impact of fractures on muscle strength and physical performance.Recent FindingsVertebral fractures (especially multiple and severe ones) are associated with back pain, back-related disability, lower grip strength, lower strength of lower limbs, lower gait speed, and poor balance. Patients with hip fracture have slower gait and lower quadriceps strength. Non-vertebral fractures were associated with lower strength ...
Source: Current Osteoporosis Reports - October 8, 2020 Category: Orthopaedics Source Type: research

The Gut Microbiome and Bone Strength
AbstractPurpose of ReviewOsteoporosis is commonly diagnosed through the clinical assessment of bone quantity using bone mineral density; however, the primary clinical concern is bone fragility. Bone fragility is determined by both bone quantity and bone quality. Over the past decade, the gut microbiome has emerged as a factor that can regulate diseases throughout the body. This review discusses how microbial organisms and their genetic products that inhabit the gastrointestinal tract influence bone quantity, bone quality, and bone strength.Recent FindingsRecent studies have shown that the gut microbiome regulates bone loss...
Source: Current Osteoporosis Reports - October 8, 2020 Category: Orthopaedics Source Type: research

Do Bisphosphonates Alleviate Pain in Children? A Systematic Review
AbstractPurpose of ReviewThe goal of this systematic review is to analyze the effectiveness of bisphosphonates (BPs) to treat bone pain in children and adolescents who have diseases with skeletal involvement.Recent FindingsWe included 24 studies (2 randomized controlled trials, 3 non-randomized controlled trials, 10 non-randomized open-label uncontrolled studies, 8 retrospective studies, and 1 study with design not specified). The majority of included studies assessed pain from a unidimensional approach, with pain intensity the most frequently evaluated dimension. Only 38% of studies used validated tools; visual analogue s...
Source: Current Osteoporosis Reports - September 21, 2020 Category: Orthopaedics Source Type: research

Genetic Pleiotropy of Bone-Related Phenotypes: Insights from Osteoporosis
AbstractPurpose of ReviewWe summarize recent evidence on the shared genetics within and outside the musculoskeletal system (mostly related to bone density and osteoporosis).Recent FindingsOsteoporosis is determined by an interplay between multiple genetic and environmental factors. Significant progress has been made regarding its genetic background revealing a number of robustly validated loci and respective pathways. However, pleiotropic factors affecting bone and other tissues are not well understood.SummaryThe analytical methods proposed to test for potential associations between genetic variants and multiple phenotypes...
Source: Current Osteoporosis Reports - September 7, 2020 Category: Orthopaedics Source Type: research

Bone-Targeting Systems to Systemically Deliver Therapeutics to Bone Fractures for Accelerated Healing
AbstractPurpose of ReviewCompared with the current standard of implanting bone anabolics for fracture repair, bone fracture-targeted anabolics would be more effective, less invasive, and less toxic and would allow for control over what phase of fracture healing is being affected. We therefore sought to identify the optimal bone-targeting molecule to allow for systemic administration of therapeutics to bone fractures.Recent FindingsWe found that many bone-targeting molecules exist, but most have been developed for the treatment of bone cancers, osteomyelitis, or osteoporosis. There are a few examples of bone-targeting ligan...
Source: Current Osteoporosis Reports - August 28, 2020 Category: Orthopaedics Source Type: research

Bone-Specific Drug Delivery for Osteoporosis and Rare Skeletal Disorders
AbstractPurpose of ReviewThe skeletal system provides an important role to support body structure and protect organs. The complexity of its architecture and components makes it challenging to deliver the right amount of the drug into bone regions, particularly avascular cartilage lesions. In this review, we describe the recent advance of bone-targeting methods using bisphosphonates, polymeric oligopeptides, and nanoparticles on osteoporosis and rare skeletal diseases.Recent FindingsHydroxyapatite (HA), a calcium phosphate with the formula Ca10(PO4)6(OH)2, is a primary matrix of bone mineral that includes a high concentrati...
Source: Current Osteoporosis Reports - August 25, 2020 Category: Orthopaedics Source Type: research

Assessment, Quantification, and Management of Fracture Pain: from Animals to the Clinic
AbstractPurpose of ReviewFractures are painful and disabling injuries that can occur due to trauma, especially when compounded with pathologic conditions, such as osteoporosis in older adults. It is well documented that acute pain management plays an integral role in the treatment of orthopedic patients. There is no current therapy available to completely control post-fracture pain that does not interfere with bone healing or have major adverse effects. In this review, we focus on recent advances in the understanding of pain behaviors post-fracture.Recent FindingsWe review animal models of bone fracture and the assays that...
Source: Current Osteoporosis Reports - August 21, 2020 Category: Orthopaedics Source Type: research