title: Local strategies to prevent and treat osteoporosis.
abstract: Despite advances in systemic osteoporosis therapeutic outcomes, management of fragility fractures and implant fixation in osteoporotic bone remain difficult clinical challenges. Low initial bone density and a prolonged healing response can lead to fracture nonunion and aseptic implant loosening. Local treatment strategies could be used to prevent fracture, accelerate healing, and increase implant fixation by locally stimulating anabolic pathways or inhibiting catabolic pathways. Local strategies under investigation include direct drug release from injectable materials or implant surface coatings. Common locally delivered drugs include bisphosphonates, parathyroid hormone, and bone morphogenetic proteins, yet additional compounds targeting novel pathways in bone biology are also being actively explored. Mechanical stimulation via low intensity pulsed ultrasound, alone or in combination with drug therapy, may also prove effective to promote local bone healing and implant fixation within osteoporotic bone.
authors: The George W. Woodruff School of Mechanical Engineering, Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, 315 Ferst Dr. NW, Atlanta, GA, 30332-0363, USA.
authors: F Brennan
authors: FB
authors: Torstrick
authors: Robert E
authors: RE
authors: Guldberg
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D010024:Osteoporosis / Q000517:prevention & control* / Q000628:therapy; D058866:Osteoporotic Fractures / Q000517:prevention & control* / Q000628:therapy; D010281:Parathyroid Hormone / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D019485:Bone Morphogenetic Proteins; D004164:Diphosphonates; D010281:Parathyroid Hormone