title: Do bisphosphonates affect bone healing? A meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Whether bisphosphonates affect indirect bone healing is still unclear.
  
  
  METHODS
  We carried out a comprehensive search strategy. Only randomized controlled trials were included. Two reviewers independently assessed methodological qualities and extracted outcome data. Analysis was performed with RevMan 5.2.
  
  
  RESULTS
  Eight eligible randomized controlled trials with 2,508 patients were included. Meta-analysis results showed that no statistically significant differences were founded in indirect bone healing in short time (within 3 months) (relative risk (RR) 1.40, relative the control group; 95% CI 0.36 to 5.49) and in long-term (more than 12 months) postoperation (RR 1.0; 95% CI 0.98 to 1.02) between bisphosphonates infusion groups and control groups. There were no statistically significant differences of indirect bone healing between early and delay bisphosphonates administration groups. Bisphosphonates infusion after lumbar infusion surgery could promote bone healing and shorten fusion time in 6 months postoperation (RR 1.35; 95% CI 1.11 to 1.66).
  
  
  CONCLUSIONS
  There was no clinically detectable delay to fracture healing via external callus formation following bisphosphonates treatment. Considering the benefit aspects of bisphosphonates for osteoporosis treatment, we recommend bisphosphonates infusion after fracture fixation surgery and lumbar fusion surgery.
authors.forename: Deting
authors.initials: D
authors.lastname: Xue
authors.forename: Fangcai
authors.initials: F
authors.lastname: Li
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Shigui
authors.initials: S
authors.lastname: Yan
authors.affiliation: Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, Hangzhou 310009, China. zepzj@163.com.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Pan
mesh_terms: D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D004164:Diphosphonates / Q000008:administration & dosage*; D050723:Fractures, Bone / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates