title: Use of bisphosphonates in orthopedic surgery: pearls and pitfalls.
abstract: Bisphosphonates are medications known to decrease bone resorption by inhibiting osteoclastic activity. They are the first-line therapy for the treatment of osteoporosis because a significant body of literature has proved their efficacy in reducing the risk of fracture in the hip, spine and other nonvertebral osseous sites. In addition, the use of bisphosphonates has significantly decreased morbidity and increased survival, and they have also proved to be cost-effective. Unexpected adverse effects have been reported recently, but the benefit of bisphosphonates use outweighs the risks. This article reviews the current use of bisphosphonates in orthopedic surgery.
authors: Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA; Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, USA. Electronic address: slozanocalderon@mgh.harvard.edu.
authors: Santiago A
authors: SA
authors: Lozano-Calderon
authors: Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA; Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, USA.
authors: Matthew W
authors: MW
authors: Colman
authors: Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors: Kevin A
authors: KA
authors: Raskin
authors: Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors: Francis J
authors: FJ
authors: Hornicek
authors: Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, USA.
authors: Mark
authors: M
authors: Gebhardt
mesh_terms: D001178:Arthroplasty; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000453:epidemiology; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D003131:Combined Modality Therapy; D004164:Diphosphonates / Q000494:pharmacology / Q000627:therapeutic use*; D005598:Fractures, Spontaneous / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D007873:Legg-Calve-Perthes Disease / Q000188:drug therapy / Q000601:surgery; D009101:Multiple Myeloma / Q000188:drug therapy; D009369:Neoplasms / Q000150:complications; D019637:Orthopedic Procedures; D010001:Osteitis Deformans / Q000188:drug therapy; D010014:Osteolysis; D058866:Osteoporotic Fractures / Q000188:drug therapy* / Q000601:surgery
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: Bisphosphonates; Bone turnover; Jaw osteonecrosis; Osseous metastasis; Osteoclast; Osteoporosis; Paget disease; Pathologic fractures