Current Role and Application of Teriparatide in Fracture Healing of Osteoporotic Patients: A Systematic Review.
BACKGROUND
The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients.


METHODS
We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including "Fracture" [tiab] AND "Teriparatide [tiab] OR "PTH" [tiab].


RESULTS
This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis. Fracture location was 2 in pelvis, 3 in proximal femur, 1 in distal femur, 1 in shoulder, 2 in wrist and 2 in spine. The use of teriparatide yielded positive effects on radiographic bone healing in 6 studies, but was not associated with better radiographic outcome in 3. In terms of functional recovery, teriparatide injection was related with decrease in pain or shorter time to mobilization in 6 studies, but not related with pain numerical scale and mobility in 3.


CONCLUSIONS
Our findings suggest that teriparatide provide selective advantages to fracture healing or functional recovery in the management of osteoporotic fractures. A better understanding of the role of teriparatide on osteoporotic fractures requires greater evidences from large volume prospective trials.
Department of Orthopaedic Surgery, Seoul Medical Center, Seoul, Korea.
Sang-Min
SM
Kim
Department of Orthopaedic Surgery, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea.
Kyung-Chung
KC
Kang
Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Ji Wan
JW
Kim
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Seung-Jae
SJ
Lim
Department of Orthopaedics, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Cheonan, Korea.
Myung Hoon
MH
Hahn
Osteoporosis; Parathyroid hormone; Teriparatide