American Society of Biomechanics Journal of Biomechanics Award 2013: Cortical bone tissue mechanical quality and biological mechanisms possibly underlying atypical fractures

被引:19
作者
Geissler, Joseph R. [1 ,2 ,3 ]
Bajaj, Devendra [1 ]
Fritton, J. Christopher [1 ,2 ,3 ]
机构
[1] Rutgers State Univ, Dept Orthopaed, New Jersey Med Sch, Newark, NJ 07103 USA
[2] Rutgers Biomed & Hlth Sci, Joint Program Biomed Engn, Newark, NJ USA
[3] New Jersey Inst Technol, Newark, NJ 07102 USA
基金
美国国家卫生研究院; 美国国家科学基金会;
关键词
Bone remodeling; Osteocytes; Osteoblasts; Osteoclasts; Antiresorptives; Osteoporosis; AGE-RELATED-CHANGES; FEMORAL-SHAFT FRACTURES; MICRODAMAGE ACCUMULATION; COMPACT-BONE; OSTEOCYTE APOPTOSIS; STRESS-FRACTURES; TRABECULAR BONE; NONENZYMATIC GLYCATION; POSTMENOPAUSAL WOMEN; CEMENT LINE;
D O I
10.1016/j.jbiomech.2015.01.032
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
The biomechanics literature contains many well-understood mechanisms behind typical fracture types that have important roles in treatment planning. The recent association of "atypical" fractures with longterm use of drugs designed to prevent osteoporosis has renewed interest in the effects of agents on bone tissue-level quality. While this class of fracture was recognized prior to the introduction of the antiresorptive bisphosphonate drugs and recently likened to stress fractures, the mechanism(s) that lead to atypical fractures have not been definitively identified. Thus, a causal relationship between these drugs and atypical fracture has not been established. Physicians, bioengineers and others interested in the biomechanics of bone are working to improve fracture-prevention diagnostics, and the design of treatments to avoid this serious side-effect in the future. This review examines the mechanisms behind the bone tissue damage that may produce the atypical fracture pattern observed increasingly with longterm bisphosphonate use. Our recent findings and those of others reviewed support that the mechanisms behind normal, healthy excavation and tunnel filling by bone remodeling units within cortical tissue strengthen mechanical integrity. The ability of cortical bone to resist the damage induced during cyclic loading may be altered by the reduced remodeling and increased tissue age resulting from long-term bisphosphonate treatment. Development of assessments for such potential fractures would restore confidence in pharmaceutical treatments that have the potential to spare millions in our aging population from the morbidity and death that often follow bone fracture. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:883 / 894
页数:12
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