Weiss Matthew B, Syed Shoaib A, Whiteson Harris Z, Hirani Rahim, Etienne Mill, Tiwari Raj K
School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Graduate School of Biomedical Sciences, New York Medical College, Valhalla, NY 10595, USA.
Life (Basel). 2024 Apr 26;14(5):561. doi: 10.3390/life14050561.
Post-traumatic osteoporosis (PTO) presents a significant challenge in clinical practice, characterized by demineralization and decreased skeletal integrity following severe traumatic injuries. This literature review manuscript addresses the knowledge gaps surrounding PTO, encompassing its epidemiology, pathophysiology, risk factors, diagnosis, treatment, prognosis, and future directions. This review emphasizes the complexity of the etiology of PTO, highlighting the dysregulation of biomineralization processes, inflammatory cytokine involvement, hormonal imbalances, glucocorticoid effects, vitamin D deficiency, and disuse osteoporosis. Moreover, it underscores the importance of multidisciplinary approaches for risk mitigation and advocates for improved diagnostic strategies to differentiate PTO from other musculoskeletal pathologies. This manuscript discusses various treatment modalities, including pharmacotherapy, dietary management, and physical rehabilitation, while also acknowledging the limited evidence on their long-term effectiveness and outcomes in PTO patients. Future directions in research are outlined, emphasizing the need for a deeper understanding of the molecular mechanisms underlying PTO and the evaluation of treatment strategies' efficacy. Overall, this review provides a comprehensive overview of PTO and highlights avenues for future investigation to enhance clinical management and patient outcomes.
创伤后骨质疏松症(PTO)在临床实践中是一项重大挑战,其特征是严重创伤后出现骨质脱矿和骨骼完整性下降。这篇文献综述手稿探讨了围绕PTO的知识空白,涵盖其流行病学、病理生理学、危险因素、诊断、治疗、预后及未来方向。本综述强调了PTO病因的复杂性,突出了生物矿化过程失调、炎症细胞因子参与、激素失衡、糖皮质激素作用、维生素D缺乏及废用性骨质疏松症。此外,它强调了多学科方法对降低风险的重要性,并主张改进诊断策略以区分PTO与其他肌肉骨骼疾病。本文讨论了各种治疗方式,包括药物治疗、饮食管理和物理康复,同时也承认关于这些治疗方式对PTO患者长期有效性和结果的证据有限。概述了未来的研究方向,强调需要更深入了解PTO潜在的分子机制并评估治疗策略的疗效。总体而言,本综述全面概述了PTO,并突出了未来研究方向,以加强临床管理和改善患者预后。