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Anabolic therapy aids in osteoporotic femoral neck fracture treatment
The discovery, one physician said, could ‘open new therapeutic perspectives.’
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MADRID — The use of adjuvant anabolic therapy — in the form of teriparatide — in osteoporotic femoral neck fractures displays enhanced repair, stability of osteosynthesis, pain relief and the recovery of autonomy in walking, according to an orthopaedic investigator.
Costantino Corradini, MD, presented the results here, at the 2010 EFORT Congress.
“We planned this study to determine if an anabolic agent may enhance the repair of femoral neck fractures in osteoporotic elderly synthesized with internal fixation,” Corradini said.
Injections and repeated X-rays
Corradini’s team studied 31 compliant female patients between 57 and 95 years of age presenting with lateral femoral neck fractures. Upon admission into the orthopaedic unit, they underwent testing and were divided into two subgroups based on whether or not they were found to have concomitant vertebral compression fractures.
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Patients with a vertebral compression fracture were given 20 µg injections of teriparatide daily, as indicated by the Italian commission for drugs. Both groups received 1 g of calcium carbonate and 1200 IU of colecalciferol daily from the first postoperative week.
All patients underwent repeated X-rays of affected segments and bone turnover markers at 1, 3 and 6 months. Pain was detected through a self-reported Visual Analog Scale, and functional outcome was evaluated in terms of hospitalization and walking on crutches.
‘Significant increase’
According to Corradini, the teriparatide group experienced a “significant increase” in bone formation markers after 1 month. This increase peaked at 3 months without an increase in bone resorption markers. Callus formation in the teriparatide group was radiologically evident from the first month, followed by consolidation within the third month. The increase in bone mineral density for the teriparatide group was also described as significant at 6 months.
Corradini noted that the control group’s fracture repair was less detectable at the third month, with a “heterogeneous trend”: One needed a reoperation, four were afflicted by delayed union and one was afflicted by a vertebral compression fracture.
Furthermore, Corradini said, patients in the teriparatide group were walking and abandoning their crutches earlier — which the researchers correlated with a decrease in pain. Other studies are in progress to extend the population and the actual indications for teriparatide. – by Robert Press
Reference:
- Corradini C, Zanotta M, Malagoli E, et al. Enhanced repair with teriparatide of synthesized femoral neck fractures in osteoporotic elderly: new therapeutic perspectives. Paper F311. Presented at the 2010 EFORT Congress. June 2-5, 2010. Madrid, Spain.
- Costantino Corradini, MD, can be reached at costantino.corradini@unimi.it.
