[Bone and joint decade: osteoporotic fractures].
The Bone And Joint Decade was officially launched on January 13, 2000 at the WHO in Geneva, two years after the 1998 Consensus Conference in Lund. Its main objectives were to improve prevention and treatment strategies, to stimulate basic and translation research and to raise public and institutional awareness of the growing burden of musculoskeletal diseases. Amongst them, osteoporosis and its related fractures are an especially difficult challenge now and for the years to come for the health systems and societies of the "First World". The capacity for fracture healing in osteoporosis is limited and the success rates of implant fixation are lower than those of normal bone (60% vs 90%). This is due to mechanical and biological factors. Mass reduction and microstructural changes reduce the efficacy of conventional internal fixation systems and new designs specifically adapted to this type of bone have been introduced. New techniques with different types of biomaterials such as bioactive ceramics help to enhance the structural strength of porotic bone. The reduced osteogenic healing capacity of this tissue has been proven in clinical observations, "in vivo" animal models and "in vitro" experiments. Recent reports have shown a reduction in the number of mesenchymal stem cells and a limited capacity for proliferation and response to molecular and physical signals in this elderly population. Research in the use of growth factors and even gene therapy show promising results for the future to enhance reparative capacity in this group of patients.
Munuera Martínez
Luis
L
D050723:Fractures, Bone / Q000209:etiology*; D006293:Health Promotion; D006801:Humans; D010024:Osteoporosis / Q000150:complications*