title: The Second Most Common Bone Disease: A Review on Paget's Disease of Bone.
abstract: Paget disease of bone (PDB) is the second most common metabolic bone disease. It is a chronic disease with a mono- or polyostotic appearance that is characterized by an increased bone turnover. The orthopedic surgeon is often confronted with such symptoms and complications as bone pain, skeletal deformities, and pathologic fractures caused by the "out-of-balance bone remodeling process". Careful evaluation of the clinical and radiographic findings is necessary to determine whether treatment of PDB is indicated. The mode of action of effective pharmacological treatments consists of reducing the increase in osteoclast-mediated bone resorption that characterizes the disease. Bisphosphonates are the compounds of choice for PDB therapy; these are readily available and have received approval. Patients with PDB are at increased risk for surgical complications, such as blood loss and heterotopic bone formation, if operative treatment is necessary. However, advances in surgical techniques and accompanying medical treatment could potentially improve the overall outcome of these patients. To achieve that goal, careful perioperative interdisciplinary management and monitoring are essential.
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. sseitz@uke.uni-hamburg.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Seitz
authors.forename: Matthias
authors.initials: M
authors.lastname: Priemel
authors.forename: Christoph
authors.initials: C
authors.lastname: von Domarus
authors.forename: F Timo
authors.initials: FT
authors.lastname: Beil
authors.forename: Florian
authors.initials: F
authors.lastname: Barvencik
authors.forename: Michael
authors.initials: M
authors.lastname: Amling
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Center for Biomechanics and Skeletal Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Rueger
keywords: Epidemiology; Paget disease of bone; Treatment
references.citation: Spine (Phila Pa 1976). 2006 May 20;31(12 ):1344-50
references.pmid: 16721297
references.citation: Bone. 2004 Jun;34(6):1078-83
references.pmid: 15260016
references.citation: J Bone Miner Res. 2002 Mar;17(3):465-71
references.pmid: 11878305
references.citation: Dtsch Med Wochenschr. 1979 Dec 28;104(52):1837-42
references.pmid: 520181
references.citation: Joint Bone Spine. 2007 Jan;74(1):90-5
references.pmid: 17254823
references.citation: Clin Orthop Relat Res. 1987 Apr;(217):99-125
references.pmid: 2951050
references.citation: Med Chir Trans. 1877;60:37-64.9
references.pmid: 20896492
references.citation: Am J Med. 1996 Oct;101(4):339-40
references.pmid: 8873502
references.citation: Arthritis Rheum. 2003 Aug;48(8):2321-3
references.pmid: 12905487
references.citation: J Bone Miner Res. 2006 Dec;21 Suppl 2:P75-82
references.pmid: 17229013
references.citation: J Bone Miner Res. 2006 Dec;21 Suppl 2:P3-8
references.pmid: 17229005
references.citation: J Bone Miner Res. 2006 Dec;21 Suppl 2:P92-3
references.pmid: 17229017
references.citation: Nat Genet. 2004 Apr;36(4):377-81
references.pmid: 15034582
references.citation: J Bone Miner Res. 2009 Jan;24(1):62-9
references.pmid: 18767930
references.citation: J Arthroplasty. 2007 Aug;22(5):692-6
references.pmid: 17689777
references.citation: Arch Pathol Lab Med. 2007 Jun;131(6):942-6
references.pmid: 17550323
references.citation: J Orthop Trauma. 1989;3(4):317-22
references.pmid: 2600700
references.citation: Unfallchirurgie. 1997 Feb;23(1):18-22
references.pmid: 9173645
references.citation: Bone. 1987;8(4):211-7
references.pmid: 3446257
references.citation: J Arthroplasty. 2005 Sep;20(6):689-93
references.pmid: 16139702
references.citation: J Bone Miner Res. 2006 Dec;21 Suppl 2:P14-21
references.pmid: 17229002
references.citation: J Bone Miner Res. 1988 Feb;3(1):101-6
references.pmid: 3213601
references.citation: Clin Orthop Relat Res. 2005 Sep;438:97-102
references.pmid: 16131876
references.citation: J Bone Miner Res. 1999 Feb;14 (2):192-7
references.pmid: 9933472
references.citation: J Bone Miner Res. 2004 Apr;19(4):566-70
references.pmid: 15005843
references.citation: Clin Orthop Relat Res. 2002 Oct;(403):127-34
references.pmid: 12360018
references.citation: Science. 1976 Oct 8;194(4261):201-2
references.pmid: 959849
references.citation: J Bone Miner Res. 2006 Dec;21 Suppl 2:P38-44
references.pmid: 17229007
references.citation: Int J Epidemiol. 1978 Jun;7(2):121-30
references.pmid: 681058
references.citation: N Engl J Med. 2005 Sep 1;353(9):898-908
references.pmid: 16135834
references.citation: Radiology. 1984 Sep;152(3):583-90
references.pmid: 6235535
references.citation: Bone. 1999 May;24(5 Suppl):43S-46S
references.pmid: 10321926