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Abstract
BackgroundBisphosphonates are a main component in the therapy of osteoporosis and other bone resorptive diseases. Previous studies have shown a positive effect of systemically applied bisphosphonates on fracture healing. Nevertheless high doses are related to side effects like osteonecrosis of the jaw, nephrotoxis and gastrointestinal symptoms. In this study we investigated the effect of locally applied pamidronate on fracture healing.MethodsIn a rodent model a simple femur fracture was set in female Wistar rats. We performed intramedullary fixation of the fracture and placed a collagen matrix around the fracture area. One group was treated with pamidronate, the other group with placebo via the matrix.To investigate the volume and quality of the callus we used micro-CT (μCT) and histology after 14 and 28 days.ResultsOur results show a positive influence of local applied pamidronate on callus volume. After 14 days an insignificant increase of callus volume in the treated animals was seen. 28 days after trauma the increase of callus volume in the treatment group was significantly higher in comparison to the control group. Osteonecrosis was not seen.ConclusionsLocally applied bisphosphonates increase the callus volume in fracture healing.
Highlights
Bisphosphonates are a main component in the therapy of osteoporosis and other bone resorptive diseases
Histology Callus formation and fracture healing were investigated by standard calcified bone histology
In this study we have investigated the effect of local application of bisphosphonate via a bisphosphonate loaded collagen matrix in a well established fracture model
Summary
Bisphosphonates are a main component in the therapy of osteoporosis and other bone resorptive diseases. Previous studies have shown a positive effect of systemically applied bisphosphonates on fracture healing. High doses are related to side effects like osteonecrosis of the jaw, nephrotoxis and gastrointestinal symptoms. In this study we investigated the effect of locally applied pamidronate on fracture healing. Osteoporosis is a major health problem of the elderly western society and gains economical importance [1, 2] besides its obvious impact on clinical practice. The risk of fractures is directly related to bone density [3]. Fracture fixation in osteopenic bone has become a major task in modern orthopaedic surgery. In the elderly a rapid mobilisation after surgery is necessary to reduce the incidence of complications like pneumonia and venous thromboembolism as well as mental confusion
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