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Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation

Osteoporosis is characterized by a decrease in bone mass and strength, rendering people prone to osteoporotic fractures caused by low-energy forces. The primary treatment strategy for osteoporotic fractures is surgery; however, the compromised and comminuted bones in osteoporotic fracture sites are...

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Autores principales: Xie, Yong, Zhang, Licheng, Xiong, Qi, Gao, Yanpan, Ge, Wei, Tang, Peifu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6804735/
https://www.ncbi.nlm.nih.gov/pubmed/31646015
http://dx.doi.org/10.1038/s41413-019-0066-7
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author Xie, Yong
Zhang, Licheng
Xiong, Qi
Gao, Yanpan
Ge, Wei
Tang, Peifu
author_facet Xie, Yong
Zhang, Licheng
Xiong, Qi
Gao, Yanpan
Ge, Wei
Tang, Peifu
author_sort Xie, Yong
collection PubMed
description Osteoporosis is characterized by a decrease in bone mass and strength, rendering people prone to osteoporotic fractures caused by low-energy forces. The primary treatment strategy for osteoporotic fractures is surgery; however, the compromised and comminuted bones in osteoporotic fracture sites are not conducive to optimum reduction and rigid fixation. In addition, these patients always exhibit accompanying aging-related disorders, including high inflammatory status, decreased mechanical loading and abnormal skeletal metabolism, which are disadvantages for fracture healing around sites that have undergone orthopedic procedures. Since the incidence of osteoporosis is expected to increase worldwide, orthopedic surgeons should pay more attention to comprehensive strategies for improving the poor prognosis of osteoporotic fractures. Herein, we highlight the molecular basis of osteoimmunology and bone mechanosensation in different healing phases of elderly osteoporotic fractures, guiding perioperative management to alleviate the unfavorable effects of insufficient mechanical loading, high inflammatory levels and pathogen infection. The well-informed pharmacologic and surgical intervention, including treatment with anti-inflammatory drugs and sufficient application of antibiotics, as well as bench-to-bedside strategies for bone augmentation and hardware selection, should be made according to a comprehensive understanding of bone biomechanical properties in addition to the remodeling status of osteoporotic bones, which is necessary for creating proper biological and mechanical environments for bone union and remodeling. Multidisciplinary collaboration will facilitate the improvement of overall osteoporotic care and reduction of secondary fracture incidence.
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spelling pubmed-68047352019-10-23 Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation Xie, Yong Zhang, Licheng Xiong, Qi Gao, Yanpan Ge, Wei Tang, Peifu Bone Res Review Article Osteoporosis is characterized by a decrease in bone mass and strength, rendering people prone to osteoporotic fractures caused by low-energy forces. The primary treatment strategy for osteoporotic fractures is surgery; however, the compromised and comminuted bones in osteoporotic fracture sites are not conducive to optimum reduction and rigid fixation. In addition, these patients always exhibit accompanying aging-related disorders, including high inflammatory status, decreased mechanical loading and abnormal skeletal metabolism, which are disadvantages for fracture healing around sites that have undergone orthopedic procedures. Since the incidence of osteoporosis is expected to increase worldwide, orthopedic surgeons should pay more attention to comprehensive strategies for improving the poor prognosis of osteoporotic fractures. Herein, we highlight the molecular basis of osteoimmunology and bone mechanosensation in different healing phases of elderly osteoporotic fractures, guiding perioperative management to alleviate the unfavorable effects of insufficient mechanical loading, high inflammatory levels and pathogen infection. The well-informed pharmacologic and surgical intervention, including treatment with anti-inflammatory drugs and sufficient application of antibiotics, as well as bench-to-bedside strategies for bone augmentation and hardware selection, should be made according to a comprehensive understanding of bone biomechanical properties in addition to the remodeling status of osteoporotic bones, which is necessary for creating proper biological and mechanical environments for bone union and remodeling. Multidisciplinary collaboration will facilitate the improvement of overall osteoporotic care and reduction of secondary fracture incidence. Nature Publishing Group UK 2019-08-15 /pmc/articles/PMC6804735/ /pubmed/31646015 http://dx.doi.org/10.1038/s41413-019-0066-7 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Review Article
Xie, Yong
Zhang, Licheng
Xiong, Qi
Gao, Yanpan
Ge, Wei
Tang, Peifu
Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation
title Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation
title_full Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation
title_fullStr Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation
title_full_unstemmed Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation
title_short Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation
title_sort bench-to-bedside strategies for osteoporotic fracture: from osteoimmunology to mechanosensation
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6804735/
https://www.ncbi.nlm.nih.gov/pubmed/31646015
http://dx.doi.org/10.1038/s41413-019-0066-7
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