title: Orthobiologics in the augmentation of osteoporotic fractures.
abstract: Many orthobiologic adjuvants are available and widely utilized for general skeletal restoration. Their use for the specific task of osteoporotic fracture augmentation is less well recognized. Common conductive materials are reviewed for their value in this patient population including the large group of allograft adjuvants categorically known as the demineralized bone matrices (DBMs). Another large group of alloplastic materials is also examined-the calcium phosphate and sulfate ceramics. Both of these materials, when used for the proper indications, demonstrate efficacy for these patients. The inductive properties of bone morphogenic proteins (BMPs) and platelet concentrates show no clear advantages for this group of patients. Systemic agents including bisphosphonates, receptor activator of nuclear factor κβ ligand (RANKL) inhibitors, and parathyroid hormone augmentation all demonstrate positive effects with this fracture cohort. Newer modalities, such as trace ion bioceramic augmentation, are also reviewed for their positive effects on osteoporotic fracture healing.
authors.affiliation: Orthopaedic Trauma Service, Department of Orthopaedic Surgery, Saint Louis University School of Medicine, 3635 Vista Ave., 7th Floor Desloge Towers, St. Louis, MO, 63110, USA, watsonjt@slu.edu.
authors.forename: J Tracy
authors.initials: JT
authors.lastname: Watson
authors.forename: Daemeon A
authors.initials: DA
authors.lastname: Nicolaou
mesh_terms: D001688:Biological Products / Q000627:therapeutic use*; D006801:Humans; D010024:Osteoporosis / Q000150:complications; D058866:Osteoporotic Fractures / Q000628:therapy*
chemical_list: D001688:Biological Products