BoneKEy-Osteovision | Perspective

Bisphosphonate treatment and fracture repair

Michelle M McDonald
Aaron Schindeler
David G Little

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DOI:10.1138/20070271

Abstract

Bisphosphonates are widely used in patients who sustain fractures. Despite much research in the area, it is still unclear whether bisphosphonates in the current regimens used have a positive or negative effect on bone repair. Most evidence suggests that bisphosphonates have little effect on the progression of endochondral ossification. However, as suppressors of bone resorption, they clearly affect callus remodeling. Many studies have been performed utilizing continuous daily dosing of bisphosphonates. While it is not proven that dosing frequency is critical in clinical practice, the recently introduced intermittent dosing regimens may have less of an effect on callus remodeling. Lastly, protocols may be able to be modified to have a desirable impact on initial callus accumulation at the fracture site while still allowing remodeling to proceed.

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