Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Osteoporos Int. 2023 Oct;34(10):1657-1675. doi: 10.1007/s00198-023-06809-4. Epub 2023 Jun 8.
Recent studies have demonstrated the positive effects of parathyroid hormone (PTH) on bone healing, and findings support the use of PTH to accelerate bone healing following distraction osteogenesis. The goal of this review was to compile and discuss the mechanisms potentially underlying the effects of PTH on newly formed bone following a bone-lengthening procedure incorporating all relevant evidence in both animal and clinical studies.
This review summarized all evidence from in vivo to clinical studies regarding the effects of PTH administration on a bone-lengthening model. In addition, a comprehensive evaluation of what is currently known regarding the potential mechanisms underlying the potential benefits of PTH in bone lengthening was presented. Some controversial findings regarding the optimal dosage and timing of administration of PTH in this model were also discussed.
The findings demonstrated that the potential mechanisms associated with the action of PTH on the acceleration of bone regeneration after distraction osteogenesis are involvement in mesenchymal cell proliferation and differentiation, endochondral bone formation, membranous bone formation, and callus remodeling.
In the last 20 years, a number of animal and clinical studies have indicated that there is a prospective role for PTH treatment in human bone lengthening as an anabolic agent that accelerates the mineralization and strength of the regenerated bone. Therefore, PTH treatment can be viewed as a potential treatment to increase the amount of new calcified bone and the mechanical strength of the bone in order to shorten the consolidation stage after bone lengthening.
最近的研究表明甲状旁腺激素（PTH）对骨骼愈合有积极影响，并且有研究结果支持使用 PTH 来加速牵张成骨术后的骨骼愈合。本综述的目的是综合并讨论 PTH 在骨延长术后新形成骨中的潜在作用机制，汇集所有相关的动物和临床研究证据。
本综述总结了关于 PTH 给药对骨延长模型影响的所有体内至临床研究证据。此外，还全面评估了目前已知的 PTH 在骨延长中潜在益处的潜在机制。还讨论了关于该模型中 PTH 最佳剂量和给药时间的一些有争议的发现。
研究结果表明，PTH 对牵张成骨术后骨再生加速作用相关的潜在机制包括参与间充质细胞增殖和分化、软骨内骨形成、膜内骨形成和骨痂重塑。
在过去的 20 年中，许多动物和临床研究表明，PTH 治疗作为一种促进再生骨矿化和增强其强度的合成代谢剂，在人类骨延长中具有潜在作用。因此，PTH 治疗可被视为一种增加新钙化骨量和骨机械强度的潜在治疗方法，以缩短骨延长后的骨整合阶段。
