Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, National and Kapodistrian University of Athens, KAT General Hospital of Athens, Greece.
1st Department of Orthopaedics, General Children's Hospital "Aghia Sofia", Athens, Greece.
J Musculoskelet Neuronal Interact. 2022 Dec 1;22(4):587-595.
Bisphosphonates represent an established treatment against bone resorption and osseous loss. Local application could help increase bone mineral density while minimizing their systemic use side-effects. Bone cement, used on a large scale in orthopedic surgery and a historically successful drug carrier, could represent an effective scaffold. The aim of this review was to investigate the alterations produced on the cement's structure and properties by this mixture, as well as its antiosteoporotic and antitumor effect. After a thorough research of articles, title screening and duplicate removal we retained 51 papers. Two independent authors performed abstract and full-text reading, finally leaving 35 articles included in this review. In the current literature, acrylic and calcium phosphate bone cement have been used as carriers. A combination with nitrogen-containing bisphosphonates, e.g., zoledronic acid, provokes modifications in terms of setting time prolongation and mechanical strength decline within acceptable levels, on the condition that the drug's quantity stays beneath a certain plateau. Bisphosphonates in bone cement seem to have a powerful anti-osteoclastic and osteogenic local impact as well as a direct cytotoxic effect against several neoplastic lesions. Further investigation on the subject is required, with specifically designed studies focusing on this method's advantages and potential clinical applications.
双膦酸盐是一种成熟的抗骨质吸收和骨质流失的治疗方法。局部应用有助于增加骨密度，同时将其全身使用的副作用降至最低。骨水泥在矫形外科手术中大规模使用，是一种历史上成功的药物载体，可作为有效的支架。本综述的目的是研究这种混合物对水泥结构和性能的改变，以及其抗骨质疏松和抗肿瘤作用。在对文章进行彻底研究、标题筛选和重复去除后，我们保留了 51 篇论文。两位独立的作者进行了摘要和全文阅读，最终纳入了 35 篇文章进行综述。在当前的文献中，已将丙烯酸和磷酸钙骨水泥用作载体。与含氮双膦酸盐（如唑来膦酸）联合使用，在药物数量保持在一定水平以下的情况下，会导致凝固时间延长和机械强度下降，但在可接受的范围内。骨水泥中的双膦酸盐似乎具有强大的抗破骨细胞和成骨局部作用，以及对几种肿瘤病变的直接细胞毒性作用。需要进一步研究该主题，设计专门的研究来关注该方法的优势和潜在的临床应用。
