Use of bisphosphonates in orthopedic surgery

Abstract

Over the past three decades, the members of the substance group called bisphosphonates (BP) have been employed with growing success to manage osteopathies caused by increased osteoclastic activity. The following developments in BP are responsible: Modern BP are now already 20,000 times more potent than the first preparation approved for use. Their biochemical and cellular mechanisms of action have meanwhile been elucidated. They have no effect on hormones so that they are open for all patients. They are well tolerated and can be administered orally or intravenously. They have admirably been thoroughly studied in multinational trials. They are the "gold standard" in the treatment of osteoporosis, a widespread disease. Rare but serious side effects such as osteonecrosis of the jaw or acute renal insufficiency can be avoided to a large extent. BP also have tumoricidal properties and are used to suppress tumor growth in bones. Their anti-inflammatory activity is also successfully used in the treatment of bone marrow edema and bone pain.