Correction to: New Developments in Fracture Risk Assessment
The article, “New Developments in Fracture Risk Assessment for Current Osteoporosis Reports. (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - May 21, 2020 Category: Orthopaedics Source Type: research

The Actions of IGF-1 in the Growth Plate and Its Role in Postnatal Bone Elongation
AbstractPurpose of ReviewBone elongation is a complex process driven by multiple intrinsic (hormones, growth factors) and extrinsic (nutrition, environment) variables. Bones grow in length by endochondral ossification in cartilaginous growth plates at ends of developing long bones. This review provides an updated overview of the important factors that influence this process.Recent FindingsInsulin-like growth factor-1 (IGF-1) is the major hormone required for growth and a drug for treating pediatric skeletal disorders. Temperature is an underrecognized environmental variable that also impacts linear growth. This paper revie...
Source: Current Osteoporosis Reports - May 15, 2020 Category: Orthopaedics Source Type: research

Delivery of RNAi-Based Therapeutics for Bone Regeneration
AbstractPurpose of ReviewThe clinical significance, target pathways, recent successes, and challenges that preclude translation of RNAi bone regenerative approaches are overviewed.Recent FindingsRNA interference (RNAi) is a promising new therapeutic approach for bone regeneration by stimulating or inhibiting critical signaling pathways. However, RNAi suffers from significant delivery challenges. These challenges include avoiding nuclease degradation, achieving bone tissue targeting, and reaching the cytoplasm for mRNA inhibition. Many drug delivery systems have overcome stability and intracellular localization challenges b...
Source: Current Osteoporosis Reports - May 11, 2020 Category: Orthopaedics Source Type: research

Modelling Human Locomotion to Inform Exercise Prescription for Osteoporosis
AbstractPurpose of ReviewWe review the literature on hip fracture mechanics and models of hip strain during exercise to postulate the exercise regimen for best promoting hip strength.Recent FindingsThe superior neck is a common location for hip fracture and a relevant exercise target for osteoporosis. Current modelling studies showed that fast walking and stair ambulation, but not necessarily running, optimally load the femoral neck and therefore theoretically would mitigate the natural age-related bone decline, being easily integrated into routine daily activity. High intensity jumps and hopping have been shown to promote...
Source: Current Osteoporosis Reports - April 25, 2020 Category: Orthopaedics Source Type: research

Epidemiology, Clinical Assessments, and Current Treatments of Nonunions
AbstractPurpose of ReviewThe failure of bony union following a fracture, termed a fracture nonunion, has severe patient morbidity and economic consequences. This review describes current consensuses and future directions of investigation for determining why, detecting when, and effective treatment if this complication occurs.Recent FindingsCurrent nonunion investigation is emphasizing an expanded understanding of the biology of healing. This has led to assessments of the immune environment, multiple cytokines and morphogenetic factors, and the role of skeletogenic stem cells in the development of nonunion. Detecting biolog...
Source: Current Osteoporosis Reports - April 21, 2020 Category: Orthopaedics Source Type: research

New Developments in Fracture Risk Assessment for Current Osteoporosis Reports
AbstractPurpose of ReviewIdentifying individuals at high fracture risk can be used to target those likely to derive the greatest benefit from treatment. This narrative review examines recent developments in using specific risk factors used to assess fracture risk, with a focus on publications in the last 3  years.Recent FindingsThere is expanding evidence for the recognition of individual clinical risk factors and clinical use of composite scores in the general population. Unfortunately, enthusiasm is dampened by three pragmatic randomized trials that raise questions about the effectiveness of widespread population sc...
Source: Current Osteoporosis Reports - April 13, 2020 Category: Orthopaedics Source Type: research

Are Probiotics the New Calcium and Vitamin D for Bone Health?
AbstractPurpose of ReviewCalcium and vitamin D supplementation is recommended for patients at high risk of fracture and/or for those receiving pharmacological osteoporosis treatments. Probiotics are micro-organisms conferring a health benefit on the host when administered in adequate amounts, likely by influencing gut microbiota (GM) composition and/or function. GM has been shown to influence various determinants of bone health.Recent FindingsIn animal models, probiotics prevent bone loss associated with estrogen deficiency, diabetes, or glucocorticoid treatments, by modulating both bone resorption by osteoclasts and bone ...
Source: Current Osteoporosis Reports - April 13, 2020 Category: Orthopaedics Source Type: research

Exercise and Nutritional Approaches to Combat Cancer-Related Bone and Muscle Loss
AbstractPurpose of ReviewThe aim of this narrative review is to summarise recent literature on the effects of exercise and nutrition interventions alone or in combination on muscle and bone loss in people with cancer.Recent FindingsThere is emerging evidence to support the inclusion of targeted exercise and nutrition strategies to counter loss of muscle and bone associated with cancer treatments. Although research in this field is advancing, the optimal exercise and nutrition prescription to combat cancer-related bone and muscle loss remain unknown.SummaryThis review identifies specific components of nutrition and exercise...
Source: Current Osteoporosis Reports - April 8, 2020 Category: Orthopaedics Source Type: research

The Skeletal Consequences of Bariatric Surgery
AbstractPurpose of ReviewThis review outlines the recent findings regarding the impact of bariatric surgery on bone. It explores potential mechanisms for skeletal changes following bariatric surgery and strategies for management.Recent FindingsBone loss following bariatric surgery is multifactorial. Probable mechanisms include skeletal unloading, abnormalities in calciotropic hormones, and changes in gut hormones. Skeletal changes that occur after bariatric surgery are specific to procedure type and persist for several years post-operatively. Studies suggest that while bone loss begins early, fracture risk may be increased...
Source: Current Osteoporosis Reports - April 6, 2020 Category: Orthopaedics Source Type: research

Exercise and Peak Bone Mass
AbstractPurpose of reviewThe main goal of this narrative review is to assess whether physical activity (PA) influences peak bone mass and fracture risk.Recent findingsSeveral randomized controlled trials (RCT) show that short-term PA intervention programs in childhood improve the accrual of bone mineral. There are now also long-term controlled PA intervention studies demonstrating that both boys and girls with daily school PA through puberty gain higher bone mineral content (BMC) and bone mineral density (BMD) and greater bone size than boys and girls with school PA 1 –2 times/week. These benefits seem to be followed...
Source: Current Osteoporosis Reports - April 6, 2020 Category: Orthopaedics Source Type: research

The Effect of Opiates on Bone Formation and Bone Healing
AbstractPurpose of ReviewOpioids have been shown to be associated with an increased risk of fracture. The purpose of this paper is to review recent research into the effects of opioids on bone formation and bone healing in animal models and in human studies.Recent FindingsMost opioids, such as morphine and fentanyl, negatively affected bone remodeling and bone healing in animal models. Conversely, remifentanil has been recently shown to promote in vitro osteoblast differentiation and to inhibit differentiation and maturation of osteoclasts, therefore reducing bone resorption. According to the possible negative role of opio...
Source: Current Osteoporosis Reports - April 6, 2020 Category: Orthopaedics Source Type: research

Dietary Protein Intake and Bone Across Stages of Chronic Kidney Disease
AbstractPurpose of ReviewThis review aims to summarize the current evidence on the effect of very-low-, low-, and high-protein diets on outcomes related to chronic kidney disease-mineral and bone disorder (CKD-MBD) and bone health in patients with CKD.Recent FindingsDietary protein restriction in the form of low- and very-low-protein diets have been used to slow down the progression of CKD. These diets can be supplemented with alpha-keto acid (KA) analogues of amino acids. Observational and randomized controlled trials have shown improvements in biochemical markers of CKD-MBD, including reductions in phosphorus, parathyroi...
Source: Current Osteoporosis Reports - April 2, 2020 Category: Orthopaedics Source Type: research

Developing Registries and Effective Care Models for the Management of Hip Fractures: Aligning Political, Organizational Drivers with Clinical Outcomes
AbstractPurpose of ReviewThe aim of the review is to conduct a literature search on cost-effectiveness or cost savings of osteoporosis fracture liaison services.Recent FindingsWe identified four types of FLS. A total of 11 cost-effectiveness studies examining 15 models of secondary fracture prevention models were identified. Nine models were found to be cost-saving, and five were found to be cost-effective.SummaryIt is possible to adopt a cost-effective model for fracture liaison services and expand across geographical regions. Adopting registries can have the added benefit of monitoring quality improvement practices and t...
Source: Current Osteoporosis Reports - April 2, 2020 Category: Orthopaedics Source Type: research

Management of Pain Associated with Fractures
AbstractPurpose of ReviewThe purpose is to review current literature on pain management strategies from initial presentation to postoperative care on common fracture types.Recent Findings- Hip fractures benefit from use of multimodal pain control for early mobility and decreased narcotic requirement.- Distal radius fracture pain during reduction can be managed with hematoma block. Postoperatively, a soft dressing is adequate, and use of a compression glove may improve pain control and edema.- Ankle fractures can be reduced with hematoma block, though use of procedural sedation may reduce reduction attempts for fracture dis...
Source: Current Osteoporosis Reports - March 31, 2020 Category: Orthopaedics Source Type: research

Effects of PTH and PTH Hypersecretion on Bone: a Clinical Perspective
AbstractPurpose of ReviewHyperparathyroidism may be due to an autonomous hypersecretion of parathyroid hormone (PTH) or occurs in response to a number of physiological stimuli. A number of recent findings have provided new insights into the importance of the calcium-parathyroid-vitamin D axis to bone in normal physiology and pathological conditions.Recent FindingsPTH is known to affect bone microarchitecture with different effects on cortical and trabecular bone compartments. In trabecular bone, PTH may exert anabolic effects, whereas PTH promotes bone resorption in cortical bone. Vertebral fractures are prevalent in prima...
Source: Current Osteoporosis Reports - March 28, 2020 Category: Orthopaedics Source Type: research

Transcriptomics: a Solution for Renal Osteodystrophy?
AbstractPurpose of ReviewThe molecular mechanisms of the bone disease associated with chronic kidney disease (CKD), called renal osteodystrophy (ROD), are poorly understood. New transcriptomics technologies may provide clinically relevant insights into the pathogenesis of ROD. This review summarizes current progress and limitations in the study and treatment of ROD, and in transcriptomics analyses of skeletal tissues.Recent FindingsROD is characterized by poor bone quality and strength leading to increased risk of fracture. Recent studies indicate permanent alterations in bone cell populations during ROD. Single-cell trans...
Source: Current Osteoporosis Reports - March 28, 2020 Category: Orthopaedics Source Type: research

Chondrogenesis Defines Future Skeletal Patterns Via Cell Transdifferentiation from Chondrocytes to Bone Cells
AbstractPurpose of ReviewThe goal of this review is to obtain a better understanding of how chondrogenesis defines skeletal development via cell transdifferentiation from chondrocytes to bone cells.Recent FindingsA breakthrough in cell lineage tracing allows bone biologists to trace the cell fate and demonstrate that hypertrophic chondrocytes can directly transdifferentiate into bone cells during endochondral bone formation. However, there is a knowledge gap for the biological significance of this lineage extension and the mechanisms controlling this process.SummaryThis review first introduces the history of the debate on ...
Source: Current Osteoporosis Reports - March 26, 2020 Category: Orthopaedics Source Type: research

Imaging Modalities to Assess Fracture Healing
AbstractPurpose of ReviewThis review discusses imaging modalities for fracture repair assessment, with an emphasis on pragmatic clinical and translational use, best practices for implementation, and challenges and opportunities for continuing research.Recent FindingsSemiquantitative radiographic union scoring remains the clinical gold standard, but has questionable reliability as a surrogate indicator of structural bone healing, particularly in early-stage, complex, or compromised healing scenarios. Alternatively, computed tomography (CT) scanning enables quantitative assessment of callus morphometry and mechanics through ...
Source: Current Osteoporosis Reports - March 25, 2020 Category: Orthopaedics Source Type: research

Kidney Disease and Bone: Changing the Way We Look at Skeletal Health
AbstractPurpose of ReviewKidney disease imparts profound skeletal changes, and unlike many other skeletal diseases, cortical bone is predominantly impacted. Significant advances in medical imaging have led to our ability to now obtain high-resolution three-dimensional views of cortical bone. This paper overviews recent work focused on cortical bone imaging, specifically cortical porosity, in kidney disease.Recent FindingsAlthough a number of clinical papers have used high-resolution imaging to assess cortical bone porosity, the most impactful work involves longitudinal study designs that have assessed cortical porosity cha...
Source: Current Osteoporosis Reports - March 19, 2020 Category: Orthopaedics Source Type: research

Pharmacologic Treatments to Preserve Bone and Muscle Mass in Osteosarcopenia
AbstractPurpose of ReviewWe aim to recast the diagnosis of osteosarcopenia in light of its pathophysiology rather than of the age at which it is diagnosed. We will consider why we think the diagnosis of osteosarcopenia is missed in those who are not elderly and why pharmacologic treatment based on pathophysiology rather than age may provide a more comprehensive treatment for patients with the condition.Recent FindingsWe will present recent findings on the pathogenesis of osteosarcopenia from two distinct groups of patients which will highlight why pathophysiology is of paramount importance in designing treatment.SummaryWe ...
Source: Current Osteoporosis Reports - March 14, 2020 Category: Orthopaedics Source Type: research

The Role of Diet in Osteoporotic Fracture Healing: a Systematic Review
AbstractPurpose of ReviewSummarize the in vivo evidences on the association between nutrition and osteoporosis fracture healing.Recent FindingsOsteoporotic fractures constitute a considerable public health burden. The healing capacity of fractures is influenced by local factors related to the fracture and by general factors (e.g., age, sex, osteoporosis, muscular mass, smoking, alcohol, drugs, and diet).SummaryThe systematic review was conducted according to PRISMA statement. From the literature search on PubMed and Web of Science, from January 2016 to October 2019, twelve studies were selected and resulted highly variable...
Source: Current Osteoporosis Reports - March 14, 2020 Category: Orthopaedics Source Type: research

Skeletal Stem Cells for Bone Development and Repair: Diversity Matters
AbstractPurpose of ReviewSkeletal stem cells (SSCs) are considered to play important roles in bone development and repair. These cells have been historically defined by their in vitro potential for self-renewal and differentiation into “trilineage” cells; however, little is known about their in vivo identity. Here, we discuss recent progress on SSCs and how they potentially contribute to bone development and repair.Recent FindingsBone is composed of diverse tissues, which include cartilage and its perichondrium, cortical bone and its periosteum, and bone marrow and its trabecular bone and stromal compartment. W...
Source: Current Osteoporosis Reports - March 14, 2020 Category: Orthopaedics Source Type: research

Generalized Arterial Calcification of Infancy: New Insights, Controversies, and Approach to Management
AbstractPurpose of ReviewThis review summarizes current understanding of generalized arterial calcification of infancy (GACI), emphasizing pathophysiology, clinical presentation, and approaches and controversies in management.Recent FindingsIdentification of causativeENPP1 mutations revealed that GACI arises from deficiencies in inorganic pyrophosphate (leading to calcifications) and adenosine monophosphate (leading to intimal proliferation). Identification of genotypic and phenotypic overlap with pseudoxanthoma elasticum and autosomal recessive hypophosphatemic rickets further advanced understanding of GACI as a complex, ...
Source: Current Osteoporosis Reports - March 14, 2020 Category: Orthopaedics Source Type: research

Bone Disease in Patients with Ehlers –Danlos Syndromes
AbstractPurpose of ReviewTo summarize the bone findings, mainly bone mass and fracture risk, in Ehlers –Danlos syndromes (EDS).Recent FindingsLow bone mineral density and fractures seem to be frequent in some of the rare EDS types (kyphoscoliotic, arthrochalasia, spondylodysplastic, and classic-like EDS). For the more prevalent hypermobile and classic EDS types, some case –control studies found mildly decreased bone mineral density, but it was not clear that fracture rates were increased. Nevertheless, abnormalities in vertebral shape seem to be common in classical and hypermobile EDS types. In a cohort of indi...
Source: Current Osteoporosis Reports - March 12, 2020 Category: Orthopaedics Source Type: research

Review of Secondary Causes of Osteoporotic Fractures Due to Diabetes and Spinal Cord Injury
AbstractPurpose of ReviewThe aim of this review is to gain a better understanding of osteoporotic fractures and the different mechanisms that are driven in the scenarios of bone disuse due to spinal cord injury and osteometabolic disorders due to diabetes.Recent FindingsDespite major advances in understanding the pathogenesis, prevention, and treatment of osteoporosis, the high incidence of impaired fracture healing remains an important complication of bone loss, leading to marked impairment of the health of an individual and economic burden to the medical system.SummaryThis review underlines several pathways leading to bo...
Source: Current Osteoporosis Reports - March 9, 2020 Category: Orthopaedics Source Type: research

Osteosarcopenia: the Path Beyond Controversy
We present a case for the path forward by reflecting on our recent history. (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - March 4, 2020 Category: Orthopaedics Source Type: research

Critical Assessment of In Vitro and In Vivo Models to Study Marrow Adipose Tissue
AbstractPurpose of the ReviewThe purpose of this review is to describe thein vitro andin vivo methods that researchers use to model and investigate bone marrow adipocytes (BMAds).Recent FindingsThe bone marrow (BM) niche is one of the most interesting and dynamic tissues of the human body. Relatively little is understood about BMAds, perhaps in part because these cells do not easily survive flow cytometry and histology processing and hence have been overlooked. Recently, researchers have developedin vitro andin vivo models to study normal function and dysfunction in the BM niche. Using these models, scientists and clinicia...
Source: Current Osteoporosis Reports - March 3, 2020 Category: Orthopaedics Source Type: research

General and Specific Considerations as to why Osteoporosis-Related Care Is Often Suboptimal
AbstractPurpose of ReviewThe assessment of fracture risk and use of antiosteoporosis medications have increased greatly over the last 20 –30 years. However, despite this, osteoporosis care remains suboptimal worldwide. Even in patients who have sustained a fragility fracture, fewer than 20% actually receive appropriate antiosteoporosis therapy in the year following the fracture. There is also evidence that treatment rates have dec lined substantially in the last 5–10 years, in many countries. The goal of this article is to consider the causes for this decline and consider how this situation could be r...
Source: Current Osteoporosis Reports - February 26, 2020 Category: Orthopaedics Source Type: research

In Vivo Assessment of Cortical Bone Fragility
AbstractPurpose of ReviewThis review updates readers on recent developments in the assessment of cortical bone fragility in vivo. The review explains the clinical need that motivated the development of Cortical Bone Mechanics Technology ™ (CBMT) as a scientific instrument, its unique capabilities, and its necessary further development as a medical device.Recent FindingsClinical experience with dual-energy X-ray absorptiometry has led to calls for new clinical methods for assessing bone health. CBMT is a noninvasive, dynamic 3-point bending test that makes direct, functional measurements of the mechanical properties o...
Source: Current Osteoporosis Reports - February 22, 2020 Category: Orthopaedics Source Type: research

Complicated Muscle-Bone Interactions in Children with Cerebral Palsy
AbstractPurpose of ReviewThe goal of this review is to highlight the deficits in muscle and bone in children with cerebral palsy (CP), discuss the muscle-bone relationship in the CP population, and identify muscle-based intervention strategies that may stimulate an improvement in their bone development.Recent FindingsThe latest research suggests that muscle and bone are both severely underdeveloped and weak in children with CP, even in ambulatory children with mild forms of the disorder. The small and low-performing muscles and limited participation in physical activity are likely the major contributors to the poor bone de...
Source: Current Osteoporosis Reports - February 14, 2020 Category: Orthopaedics Source Type: research

Correction to: Stopping Denosumab
The author Elena Gonzalez Rodriguez is not properly referenced in PubMed. The reference shows as “Rodriguez E.G.”, but should be “Gonzalez Rodriguez E.”. (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - January 31, 2020 Category: Orthopaedics Source Type: research

The Interrelationship Between Diabetes, IL-17 and Bone Loss
AbstractPurpose of ReviewDiabetes has a detrimental effect on bone, increasing the risk of fracture and formation of osteolytic lesions such as those seen in periodontitis. Several diabetic complications are caused by diabetes-enhanced inflammation. This review examines mechanisms by which IL-17 contributes to diabetes-enhanced periodontitis and other effects of IL-17 on bone.Recent FindingsIL-17 upregulates anti-bacterial defenses, yet its expression is also linked to a destructive host response in the periodontium. Periodontal disease is caused by bacteria that stimulate an inflammatory response. Diabetes-enhanced IL-17 ...
Source: Current Osteoporosis Reports - January 31, 2020 Category: Orthopaedics Source Type: research

The Effects of Sclerostin on the Immune System
AbstractPurpose of ReviewWe reviewed recent progress on the role of sclerostin (SOST) and its effects on the immune system in order to summarize the current state of knowledge in osteoimmunology, in regard to hematopoiesis, lymphopoiesis, and inflammation.Recent FindingsChanges in sclerostin levels affect distinct niches within the bone marrow that support hematopoietic stem cells and B cell development. Sclerostin ’s regulation of adipogenesis could also be important for immune cell maintenance with age. Surprisingly, B cell development in the bone marrow is influenced bySost produced by mesenchymal stem cells and o...
Source: Current Osteoporosis Reports - January 22, 2020 Category: Orthopaedics Source Type: research

MRI Assessment of Bone Marrow Composition in Osteoporosis
AbstractPurpose of ReviewTo provide an overview on recent technical development for quantifying marrow composition using magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques, as well as a summary on recent findings of interrelationship between marrow adipose tissue (MAT) and skeletal health in the context of osteoporosis.Recent FindingsThere have been significant technical advances in reliable quantification of marrow composition using MR techniques. Cross-sectional studies have demonstrated a negative correlation between MAT and bone, with trabecular bone associating more strongly with MAT than cortical bone...
Source: Current Osteoporosis Reports - January 18, 2020 Category: Orthopaedics Source Type: research

Osteocyte-Mediated Translation of Mechanical Stimuli to Cellular Signaling and Its Role in Bone and Non-bone-Related Clinical Complications
AbstractPurpose of ReviewOsteocytes comprise>  95% of the cellular component in bone tissue and produce a wide range of cytokines and cellular signaling molecules in response to mechanical stimuli. In this review, we aimed to summarize the molecular mechanisms involved in the osteocyte-mediated translation of mechanical stimuli to cellular si gnaling, and discuss their role in skeletal (bone) diseases and extra-skeletal (non-bone) clinical complications.Recent FindingsTwo decades before, osteocytes were assumed as a dormant cells buried in bone matrix. In recent years, emerging evidences have shown that osteocyte...
Source: Current Osteoporosis Reports - January 17, 2020 Category: Orthopaedics Source Type: research

Correction to: Aging and Mechanoadaptive Responsiveness of Bone
The author missed to include the below statement in the Acknowledgement of the original article. (Source: Current Osteoporosis Reports)
Source: Current Osteoporosis Reports - January 6, 2020 Category: Orthopaedics Source Type: research

Spaceflight-Induced Bone Tissue Changes that Affect Bone Quality and Increase Fracture Risk
AbstractPurpose of ReviewBone mineral density and systemic factors are used to assess skeletal health in astronauts. Yet, even in a general population, these measures fail to accurately predict when any individual will fracture. This review considers how long-duration human spaceflight requires evaluation of additional bone structural and material quality measures that contribute to microgravity-induced skeletal fragility.Recent FindingsIn both humans and small animal models following spaceflight, bone mass is compromised via reduced bone formation and elevated resorption levels. Concurrently,bone structural quality (e.g.,...
Source: Current Osteoporosis Reports - January 2, 2020 Category: Orthopaedics Source Type: research

Quality Measures and Quality Improvement Initiatives in Osteoporosis —an Update
AbstractPurpose of ReviewThe aims of this review are to summarize current performance for osteoporosis quality measures used by Centers for Medicare and Medicaid (CMS) for pay-for-performance programs and to describe recent quality improvement strategies around these measures.Recent FindingsHealthcare Effectiveness Data and Information (HEDIS) quality measures for the managed care population indicate gradual improvement in osteoporosis screening, osteoporosis identification and treatment following fragility fracture, and documentation of fall risk assessment and plan of care between 2006 and 2016. However, population-based...
Source: Current Osteoporosis Reports - November 28, 2019 Category: Orthopaedics Source Type: research

Pragmatic Clinical Trials in Osteoporosis
AbstractPurpose of ReviewIn this review, we present the application of pragmatic clinical trials for evaluating interventions in osteoporosis, and we discuss methodological considerations for designing and conducting a pragmatic clinical trial compared with a classical randomized clinical trial.Recent FindingsPragmatic clinical trials are a popular study design testing effectiveness of health interventions and are intended to address the limitations associated with traditional explanatory randomized clinical trials testing efficacy of interventions. To date, only few pragmatic clinical trials have been conducted in osteopo...
Source: Current Osteoporosis Reports - November 26, 2019 Category: Orthopaedics Source Type: research

Bone Health in Men with Prostate Cancer: Review Article
AbstractPurpose of ReviewThe improvement in prostate cancer survival over time, even in those with advanced disease, has led to an increasing recognition of the impact of prostate cancer and its treatment on bone health. Cancer treatment –induced bone loss (CTIBL) is a well-recognized entity but greater awareness of the risks associated with CTIBL and its treatment is required.Recent FindingsThe principal culprit in causing CTIBL is hormonal ablation induced by prostate cancer treatment, including several new agents which have been developed in recent years which significantly improve survival, but may cause CTIBL. T...
Source: Current Osteoporosis Reports - November 23, 2019 Category: Orthopaedics Source Type: research

Aging and Mechanoadaptive Responsiveness of Bone
AbstractPurpose of ReviewOsteoporosis is an age-related disorder characterized by bone loss and increased fracture susceptibility. Whether this is due to reduced loading in less active elderly individuals or inherent modifications in bone cells is uncertain. We suppose that osteoporosis is nonetheless prima facie evidence for impaired mechanoadaptation; either capacity to accrue new bone declines, or the stimulus for such accrual is absent/can no longer be triggered in the aged. Herein, we provide only sufficient background to enable a focus on recent advances which seek to address such dilemmas.Recent FindingsRecent advan...
Source: Current Osteoporosis Reports - November 23, 2019 Category: Orthopaedics Source Type: research

Mechanical Regulation of the Maternal Skeleton during Reproduction and Lactation
AbstractPurpose of reviewThis review summarizes recently published data on the effects of pregnancy and lactation on bone structure, mechanical properties, and mechano-responsiveness in an effort to elucidate how the balance between the structural and metabolic functions of the skeleton is achieved during these physiological processes.Recent findingsWhile pregnancy and lactation induce significant changes in bone density and structure to provide calcium for fetal/infant growth, the maternal physiology also comprises several innate compensatory mechanisms that allow for the maintenance of skeletal mechanical integrity. Both...
Source: Current Osteoporosis Reports - November 21, 2019 Category: Orthopaedics Source Type: research

Biomechanics of Osteoporotic Fracture Fixation
AbstractPurpose of ReviewFractures of osteoporotic bone in elderly individuals need special attention. This manuscript reviews the current strategies to provide sufficient fracture fixation stability with a particular focus on fractures that frequently occur in elderly individuals with osteoporosis and require full load-bearing capacity, i.e., pelvis, hip, ankle, and peri-implant fractures.Recent FindingsElderly individuals benefit immensely from immediate mobilization after fracture and thus require stable fracture fixation that allows immediate post-operative weight-bearing. However, osteoporotic bone has decreased holdi...
Source: Current Osteoporosis Reports - November 21, 2019 Category: Orthopaedics Source Type: research

Insulin Signaling in Bone Marrow Adipocytes
AbstractPurpose of ReviewThe goal of this review is to discuss the role of insulin signaling in bone marrow adipocyte formation, metabolic function, and its contribution to cellular senescence in relation to metabolic bone diseases.Recent FindingsInsulin signaling is an evolutionally conserved signaling pathway that plays a critical role in the regulation of metabolism and longevity. Bone is an insulin-responsive organ that plays a role in whole body energy metabolism. Metabolic disturbances associated with obesity and type 2 diabetes increase a risk of fragility fractures along with increased bone marrow adiposity. In obe...
Source: Current Osteoporosis Reports - November 20, 2019 Category: Orthopaedics Source Type: research

Endogenous Glucocorticoid Signaling in the Regulation of Bone and Marrow Adiposity: Lessons from Metabolism and Cross Talk in Other Tissues
AbstractPurpose of ReviewThe development of adiposity in the bone marrow, known as marrow adipose tissue (MAT), is often associated with musculoskeletal frailty. Glucocorticoids, which are a key component of the biological response to stress, affect both bone and MAT. These molecules signal through receptors such as the glucocorticoid receptor (GR), but the role of the GR in regulation of MAT is not yet clear from previous studies. The purpose of this review is to establish and determine the role of GR-mediated signaling in marrow adiposity by comparing and contrasting what is known against other energy-storing tissues lik...
Source: Current Osteoporosis Reports - November 20, 2019 Category: Orthopaedics Source Type: research

The Regulation of Marrow Fat by Vitamin D: Molecular Mechanisms and Clinical Implications
AbstractPurpose of ReviewTo review the available literature regarding a possible relationship between vitamin D and bone marrow adipose tissue (BMAT), and to identify future avenues of research that warrant attention.Recent FindingsResults from in vivo animal and human studies all support the hypothesis that vitamin D can suppress BMAT expansion. This is achieved by antagonizing adipogenesis in bone marrow stromal cells, through inhibition of PPAR γ2 activity and stimulation of pro-osteogenic Wnt signalling. However, our understanding of the functions of BMAT is still evolving, and studies on the role of vitamin D in...
Source: Current Osteoporosis Reports - November 20, 2019 Category: Orthopaedics Source Type: research

Exosomes and Extracellular RNA in Muscle and Bone Aging and Crosstalk
AbstractPurpose of ReviewExtracellular vesicles (EV), which include exosomes and microvesicles, are membrane-bound particles shed by most cell types and are important mediators of cell-cell communication by delivering their cargo of proteins, miRNA, and mRNA to target cells and altering their function. Here, we provide an overview of what is currently known about EV composition and function in bone and muscle cells and discuss their role in mediating crosstalk between these two tissues as well as their role in musculoskeletal aging.Recent FindingsRecent studies have shown that muscle and bone cells produce EV, whose protei...
Source: Current Osteoporosis Reports - November 18, 2019 Category: Orthopaedics Source Type: research

Update on Menopausal Hormone Therapy for Fracture Prevention
AbstractPurpose of ReviewThe goal of the review is to assess the appropriateness of menopausal hormone therapy (MHT) for the primary prevention of bone loss in women at elevated risk in the early years after menopause.Recent FindingsEstrogen alone or combined with progestin to protect the uterus from cancer significantly reduces the risk of osteoporosis-related fractures. MHT increases type 1 collagen production and osteoblast survival and maintains the equilibrium between bone resorption and bone formation by modulating osteoblast/osteocyte and T cell regulation of osteoclasts. Estrogens have positive effects on muscle an...
Source: Current Osteoporosis Reports - November 18, 2019 Category: Orthopaedics Source Type: research

Marrow Fat-Secreted Factors as Biomarkers for Osteoporosis
AbstractPurpose of ReviewThe age-related accumulation of bone marrow adipose tissue (BMAT) negatively impacts bone metabolism and hematopoiesis. This review provides an overview about BMAT-secreted factors as biomarkers for BMAT accumulation and osteoporosis risk.Recent FindingsThe adipokines leptin and adiponectin are regulators of BMAT. It remains to be clarified if locally produced adipokines substantially contribute to their peripheral serum levels and if they influence bone metabolism beyond that of extraosseous adipokine production. Existing data also suggests that BMAT disturbs bone metabolism primarily through palm...
Source: Current Osteoporosis Reports - November 16, 2019 Category: Orthopaedics Source Type: research

Bone Health in Glomerular Kidney Disease
AbstractPurpose of ReviewTo summarize the literature regarding alterations in bone health in patients with glomerular kidney disease and highlight areas in need of additional investigation.Recent FindingsThere is mounting evidence that children and adults with glomerular conditions, with or without compromised kidney function, comprise a distinct subgroup of patients with unique risk factors for altered bone health.SummaryPatients with glomerular kidney disease are exposed to both disease-related and treatment-related factors that affect bone structure and function. In addition to chronic kidney disease –related risk...
Source: Current Osteoporosis Reports - November 16, 2019 Category: Orthopaedics Source Type: research