Fracture healing in the elderly patient.
Clinical experience gives rise to the impression that there are differences in fracture healing in different age groups. It is evident that fractures heal more efficiently in children than in adults. However, minimal objective knowledge exists to evaluate this assumption. Temporal, spatial, and cellular quantitative and qualitative interrelationships, as well as signaling molecules and extracellular matrix have not been comprehensively and adequately elucidated for fracture healing in the geriatric skeleton. The biological basis of fracture healing will provide a context for revealing the pathophysiology of delayed or even impaired bone regeneration in the elderly. We will summarize experimental studies on age-related changes at the cellular and molecular level that will add to the pathophysiological understanding of the compromised bone regeneration capacity believed to exist in the elderly patient. We will suggest why this understanding would be useful for therapeutics focused on bone regeneration, in particular fracture healing at an advanced age.
Gruber
Reinhard
R
Department of Oral Surgery, Medical University of Vienna, Austria.
Koch
Hannjörg
H
Doll
Bruce A
BA
Tegtmeier
Florian
F
Einhorn
Thomas A
TA
Hollinger
Jeffrey O
JO
D000368:Aged; D000375:Aging / Q000502:physiology*; D015415:Biomarkers / Q000032:analysis; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use; D001861:Bone Regeneration / Q000502:physiology; D001842:Bone and Bones / Q000503:physiopathology; D002452:Cell Count; D002455:Cell Division / Q000502:physiology; D017102:Fracture Healing / Q000502:physiology*; D050723:Fractures, Bone / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D015316:Genetic Therapy / Q000379:methods; D006801:Humans; D059630:Mesenchymal Stem Cells / Q000502:physiology; D018919:Neovascularization, Physiologic / Q000502:physiology; D010024:Osteoporosis / Q000503:physiopathology; D010641:Phenotype
D015415:Biomarkers; D019485:Bone Morphogenetic Proteins