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Medicina
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Update on Osteoporosis
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Update on Osteoporosis

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 5031

Special Issue Editors

Dr. Tommaso Greco

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Guest Editor
Orthopedics & Traumatology Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Interests: trauma surgery; fracture; infection; arthroplasty; osteoporosis; knee surgery; hip; sports injuries; bone loss
Special Issues, Collections and Topics in MDPI journals
Dr. Carlo Perisano

E-Mail Website
Guest Editor
Orthopedics and Trauma Surgery Unit, Department of Aging, Orthopedic and Rheumatologic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Interests: trauma surgery; orthopedic; hip fracture; arthroplasty; osteoporosis; bone tumors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Osteoporosis is a disorder that affects the female sex most frequently, although it can impact the male sex with effects that are equally devastating. Globally, it is estimated that approximately 20% of men aged 50 or over will experience an osteoporotic fracture, with the disease commonly remaining undiagnosed and untreated despite the episode. The risk of fracture, which can be as high as 27% in those over 50, supersedes the risk of developing prostate cancer (11.3%), a fact that goes mostly unnoticed. The mortality rate following a femur fracture increases proportionately with age and peaks within the first 12 months following the trauma. However, within the first 6 months, the fatality rate in men doubles that of their female counterparts of the same age, and it is calculated that one third of men die within a year of experiencing a femur fracture. Great attention should be given to disease prevention, non-modifiable risk factors, and reductions in modifiable risk factors. In addition to risk factors that are common to both genders, primary or secondary hypogonadism, resulting in testosterone deficiency and treated with androgen deprivation therapy (for prostate cancer treatment), should also be considered.

We welcome colleagues who are involved in osteoporosis research on risk factors, prevention, and treatment in men to contribute original articles or reviews to this Special Issue.

Dr. Tommaso Greco
Dr. Carlo Perisano
Guest Editors

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Keywords

  • osteoporosis
  • hip fracture
  • fragility fracture
  • survival
  • elderly

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Published Papers (4 papers)

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Research

10 pages, 1222 KiB  
Article
Impact of Teriparatide and Denosumab on Clinical and Radiographic Outcomes in Osteoporotic Vertebral Compression Fractures
by Byung-Taek Kwon, Dae-Woong Ham, Sang-Min Park, Ho-Joong Kim and Jin S. Yeom
Medicina 2024, 60(8), 1314; https://doi.org/10.3390/medicina60081314 - 14 Aug 2024
Viewed by 1096
Abstract
Background and Objectives: Osteoporotic vertebral compression fractures (OVCFs) are prevalent among the elderly, often leading to significant pain, morbidity, and mortality. Effective management of underlying osteoporosis is essential to prevent subsequent fractures. This study aimed to compare the clinical and radiographic outcomes of [...] Read more.
Background and Objectives: Osteoporotic vertebral compression fractures (OVCFs) are prevalent among the elderly, often leading to significant pain, morbidity, and mortality. Effective management of underlying osteoporosis is essential to prevent subsequent fractures. This study aimed to compare the clinical and radiographic outcomes of teriparatide and denosumab treatments in patients with OVCFs to determine their relative effectiveness in improving patient outcomes. Materials and Methods: This retrospective study included 78 patients diagnosed with an acute thoracolumbar OVCF who received either teriparatide (35 patients) or denosumab (43 patients) within three months of a fracture. Clinical outcomes were assessed using the visual analog scale (VAS) for back pain, Oswestry disability index (ODI), and EQ-5D quality of life scores at baseline, 6 months, and 12 months. Bone mineral density (BMD) and radiographic outcomes were evaluated initially and at 12 months post-treatment. Results: Both treatment groups demonstrated significant improvements in VAS, ODI, and EQ-5D scores over 12 months. No significant differences were observed between the teriparatide and denosumab groups in terms of clinical outcomes or radiographic measurements at any time point. Fracture union and BMD improvements were similarly observed in both groups. The teriparatide group had a lower baseline BMD, but this did not affect the overall outcomes. Conclusions: Both teriparatide and denosumab are effective in improving clinical and radiographic outcomes in patients with OVCFs. Despite concerns about denosumab’s potential to hinder fracture healing, our study found no significant differences between the two treatments. These findings support the use of denosumab for early treatment of OVCFs to prevent subsequent fractures without compromising fracture healing. Further prospective studies are needed to confirm these results. Full article
(This article belongs to the Special Issue Update on Osteoporosis)
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12 pages, 1708 KiB  
Article
Availability of Observational Pain Assessment Tools in Hospitalized Patients with Osteoporotic Vertebral Fractures
by Youhei Yoshimi, Takanori Matsuura, Kazuaki Miyazato, Shiho Takahashi, Nami Tanaka, Hanae Morinaga, Asuka Hayata, Minami Onishi, Yousuke Nagano and Hideo Ohnishi
Medicina 2024, 60(8), 1217; https://doi.org/10.3390/medicina60081217 - 27 Jul 2024
Viewed by 685
Abstract
Background and Objectives: Osteoporotic vertebral fractures in older patients cause lower back pain and abnormal posture, resulting in impaired activities of daily living (ADLs). Assessing pain using self-reported assessment tools is difficult, especially in patients with moderate-to-severe cognitive impairment. Recently, observational assessment [...] Read more.
Background and Objectives: Osteoporotic vertebral fractures in older patients cause lower back pain and abnormal posture, resulting in impaired activities of daily living (ADLs). Assessing pain using self-reported assessment tools is difficult, especially in patients with moderate-to-severe cognitive impairment. Recently, observational assessment tools have been used when self-reported ones were difficult to administer. No studies have reported the usefulness of observational assessment tools in patients with acute-phase orthopedic disorders without complication. This study aimed to examine the availability of observational tools for pain assessment in patients with lumbar vertebral fractures. Materials and Methods: Patients admitted to our hospital with acute-phase vertebral fractures were enrolled in this prospective observational study. Pain was assessed using Japanese versions of the Abbey pain scale and Doloplus-2 observational assessment tools, and the Numerical Rating Scale, a self-reported assessment tool. To compare the pain assessment tool, we examined whether each tool correlated with ADLs and ambulatory status. ADLs were assessed using the Barthel Index. Ambulatory status was assessed using the Functional Ambulation Categories and the 10-m walking test. Results: Similar to the Numerical Rating Scale scores, assessments with the Abbey pain scale and Doloplus-2 showed significant decreases in scores over time. A significant positive correlation was observed between the self-reported and observational assessment tools. Each pain assessment tool was significantly negatively correlated with ADLs and ambulatory status. Conclusions: When self-reported assessment with the Numerical Rating Scale is difficult for patients with cognitive impairment, pain can be estimated using the Abbey pain scale and Doloplus-2 observational assessment tools. Full article
(This article belongs to the Special Issue Update on Osteoporosis)
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7 pages, 468 KiB  
Article
Hip Fractures in Elderly Individuals Did Not Decrease during the Coronavirus Disease 2019 Pandemic: Insights from the 2015 and 2020 Niigata Prefecture Fragility Hip Fracture Surveys
by Asami Nozaki, Norio Imai, Yugo Shobugawa, Yoji Horigome, Hayato Suzuki and Hiroyuki Kawashima
Medicina 2024, 60(4), 573; https://doi.org/10.3390/medicina60040573 - 30 Mar 2024
Viewed by 1120
Abstract
Background and Objectives: The incidence of osteoporotic hip fractures in Niigata Prefecture, Japan, has been studied approximately every 5 years since 1985. In 2020, as in previous surveys, a prefecture-wide survey was initiated as planned; however, the global outbreak of the coronavirus [...] Read more.
Background and Objectives: The incidence of osteoporotic hip fractures in Niigata Prefecture, Japan, has been studied approximately every 5 years since 1985. In 2020, as in previous surveys, a prefecture-wide survey was initiated as planned; however, the global outbreak of the coronavirus disease 2019 (COVID-19) began simultaneously. This study aimed to compare the results of the 2015 and 2020 Niigata Prefecture Fragility Hip Fracture Surveys to determine whether the COVID-19 pandemic affected the occurrence and treatment of proximal femoral fractures throughout Niigata Prefecture. Materials and Methods: In this study, data from the 2015 and 2020 Niigata Prefecture Fragility Hip Fracture Surveys were used. Data were obtained from registration forms returned by hospitals and clinics in Niigata Prefecture for patients living therein who were diagnosed with osteoporotic hip fractures over a 1-year period in 2015 and 2020. Results: In Niigata Prefecture, the total annual number of fractures increased from 3181 in 2015 to 3369 in 2020, whereas the age-adjusted fracture rate decreased. Regarding the location of the fractures, the proportion of outdoor fractures was lower than that of indoor fractures. The proportion of outdoor fractures decreased over the year as a whole, but in particular, the proportion of outdoor fractures decreased significantly under the issued emergency declarations. The most common reasons for delayed surgery related to COVID-19 were “waiting for PCR results” and “quarantine for fever,” accounting for approximately 1.9% of all causes. Conclusions: In Niigata Prefecture, Japan, the effect of the COVID-19 pandemic on the number and rate of fractures was minuscule. The proportion of indoor fractures to outdoor fractures increased during the emergency declaration period. Considering that the number of fragility fractures remains the same during an infectious disease pandemic such as COVID-19, it is necessary to ensure that healthcare resources are available to deal with them. Full article
(This article belongs to the Special Issue Update on Osteoporosis)
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11 pages, 1091 KiB  
Article
Treatment of Osteoporosis in Men on Androgen Deprivation Therapy in Japan
by Hanako Nishimoto, Atsuyuki Inui, Yutaka Mifune, Kohei Yamaura, Yukari Bando, Yasuyoshi Okamura, Takuto Hara, Tomoaki Terakawa and Ryosuke Kuroda
Medicina 2024, 60(4), 551; https://doi.org/10.3390/medicina60040551 - 28 Mar 2024
Cited by 1 | Viewed by 1646
Abstract
Background and Objectives: Androgen deprivation therapy (ADT) for prostate cancer has greatly improved treatment outcomes. As patient survival rates have increased, reports of decreased bone density and increased bone fractures as side effects of ADT have emerged. The prevalence of osteoporosis in [...] Read more.
Background and Objectives: Androgen deprivation therapy (ADT) for prostate cancer has greatly improved treatment outcomes. As patient survival rates have increased, reports of decreased bone density and increased bone fractures as side effects of ADT have emerged. The prevalence of osteoporosis in Japanese men was 4.6%. The purpose of this study was to evaluate the effect of osteoporosis treatment in prostate cancer patients who underwent ADT in Japan. Materials and Methods: The subjects were 33 male patients who had undergone ADT for prostate cancer, who were noted to have decreased bone density. Mean age was 76.2 ± 7.7 years (64–87). Medications included vitamin D in one case, bisphosphonates (BP) in 27 cases, and denosumab in five cases. The evaluation method examined the rate of change in bone mineral density (BMD) before osteoporosis treatment and 1 year after. For comparison, a group without osteoporosis treatment intervention (n = 33) was selected, and matched for prostate cancer treatment and age. The rate of change in trabecular bone score (TBS) was also calculated. Results: The percentage changes in BMD before and 1 year after treatment were as follows: lumbar spine, 7.1 ± 5.8% in the treatment group versus −3.9 ± 4.1% in the no treatment group; femoral neck, 5.5 ± 6.2% in the treatment group versus −0.9 ± 3.9% in the no treatment group; total femur, 6.6 ± 6.4% in the treatment group versus the no treatment group which was −1.7 ± 3.2%. In all cases, there was a clear significant difference (p < 0.01). The percent change in TBS was further calculated in the same manner. There was no significant difference between the two groups: +1.7 ± 3.8% in the treated group versus +0.3 ± 4.1% in the untreated group. Conclusions: Osteoporosis treatment in Japanese patients with prostate cancer on ADT therapy was found to significantly increase BMD compared to the untreated group. BP and denosumab were found to be very effective in increasing BMD. Full article
(This article belongs to the Special Issue Update on Osteoporosis)
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