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 administrati...
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 and bone cells. This...
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 to multi...
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 interse...
Source: Current Osteoporosis Reports - April 14, 2021 Category: Orthopaedics Source Type: research
