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 year...
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 isola...
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 even ...
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
