Parathyroid hormone--a drug for orthopedic surgery?
Whereas continuous exposure to PTH results in bone resorption, administration at intermittent doses results in bone formation by increasing osteoblast number and activity. The anabolic action of PTH has also been demonstrated in clinical trials, in which PTH increased the bone mass and reduced fracture rate in patients with osteoporosis. In animal models of fracture healing and fixation of orthopedic implants, PTH increases the bone density in a dose-dependent manner, leading to faster repair and better fixation. The effect appears to be stronger on the new forming bone than on pre-existing bone. Based on these preclinical studies, we suggest that intermittent PTH treatment may also benefit fracture healing and implant fixation in patients.
Skripitz
Ralf
R
Department of Orthopedics, University Hospital Eppendorf, Hamburg, Germany. skripitz@uke.uni-hamburg.de
Aspenberg
Per
P
D000818:Animals; D001696:Biomechanical Phenomena; D015519:Bone Density / Q000187:drug effects; D001862:Bone Resorption / Q000188:drug therapy; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D017102:Fracture Healing / Q000187:drug effects; D006801:Humans; D019637:Orthopedic Procedures; D010012:Osteogenesis / Q000187:drug effects*; D010024:Osteoporosis / Q000188:drug therapy / Q000378:metabolism; D010281:Parathyroid Hormone / Q000008:administration & dosage*; D011475:Prosthesis Failure
D010281:Parathyroid Hormone