Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
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Department of Trauma and Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
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, 15 , 16 , 17 ). On top of that, there is growing interest in the peri- and post- operative use of anti-resorptive therapies, such as bisphosphonates (BPs), to mitigate the risk of THA AL. BPs are the most widely used drugs to treat osteoporosis
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Introduction The introduction of bisphosphonates into osteoporosis therapy was a great breakthrough, leading to a remarkable reduction of fracture incidence and improvement of prognosis. 1 Since the effect is caused by a reduction of bone
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Mode of action Group Agent Vertebral fracture Nonvertebral fracture Hip fracture Antiresorptive Bisphosphonate Alendronate ↓; strong evidence ↓; strong evidence ↓; strong evidence Risedronate ↓; strong evidence
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Bone metastases are difficult to treat surgically, necessitating a multidisciplinary approach that must be applied to each patient depending on the specifics of their case.
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The main indications for surgical treatment are a lack of response to chemotherapy, radiation therapy, hormone therapy, immunotherapy, and bisphosphonates which is defined by persistent pain or tumor progression; the risk of imminent pathological bone fracture; and surgical treatment for single bone metastases.
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An important aspect of choosing the right treatment for these patients is accurately estimating life expectancy. Improved chemotherapy, postoperative radiation therapy, and sustainable reconstructive modalities will increase the patient’s life expectancy.
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The surgeon should select the best surgical strategy based on the primary tumor and its characteristics, the presence of single or multiple metastases, age, anatomical location, and the functional resources of the patient.
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Preventive osteosynthesis, osteosynthesis to stabilize a fracture, resections, and reconstructions are the main surgical options for bone metastases.
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Resection and reconstruction with a modular prosthesis remain the generally approved surgical option to restore functionality, increase the quality of life, and increase life expectancy.
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Preoperative embolization is necessary, especially in the case of metastases of renal or thyroid origin. This procedure is extremely important to avoid complications, with a major impact on survival rates.
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surgery (due to the surgical trauma or to the heat from curing cement). Interestingly, the resorption of necrotic bone can be pharmacologically inhibited with a bisphosphonate during the healing period, which reduces the early migration 25 and
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place for HBO therapy in the management of ONFH but further RCTs are required. 39 Bisphosphonates belong to a class of drug that has an effect on bone resorption by preventing the formation of woven bone as they reduce bone turnover and remodelling
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factors include patients undergoing treatment of osteoporosis with bisphosphonates, low total bone mineral density, and chronic diseases such as diabetes mellitus. 4 Anatomy To properly diagnose and treat ST fractures, orthopaedic surgeons must
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. Some of them have been used since the first case and are still used nowadays like bisphosphonates, vitamin D, calcium, corticosteroids and interferon α-2b. Other drugs such as octreotide, bevacizumab, propranolol, cyclophosphamide, vincristine
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
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Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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, Greece, and Japan, and 2 multicenter studies. Comparison with previous studies Our study provides important insights into the treatment of postmenopausal osteoporosis. Our findings suggest that teriparatide is more effective than bisphosphonates in
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extensive soft tissue involvement and fungation) Yu et al 20 Curettage plus PMMA plus internal fixation and oral bisphosphonates 0.0% 0% ∅ Saibaba et al 28 Curettage plus phenol plus subchondral bone graft plus gel foam layer
