Healy Kelsey M, Ritter Jacob, Barr Emily, Churchill Jessica L, Trasolini Nicholas A, Waterman Brian R, Reynolds Alan W
Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, USA.
Campbell University School of Osteopathic Medicine, Lillington, USA.
Curr Rev Musculoskelet Med. 2024 Dec;17(12):559-569. doi: 10.1007/s12178-024-09927-6. Epub 2024 Sep 14.
The aim of this review is to aggregate currently available literature as it pertains to treating surgical shoulder pathology in patients with osteoporosis.
Emerging data surrounding perioperative use of anti-osteoporosis medications for patients undergoing shoulder surgery have not shown definitively favorable or unfavorable outcomes. Similar evaluations in animal studies have shown promising results as a biologic augment to tendon and bone healing, especially with newer, anabolic agents. The mainstay of bone health management remains pre-operative evaluation, using opportunistic radiographic and CT based validated measurements, along with optimization of risk factors. Surgical techniques continue to incorporate implants that perform well in osteopenic bone. Promising pre-clinical studies have identified anabolic anti-osteoporosis medications as viable biologic augments to shoulder surgery, which has not been borne out in any clinical studies at this time.
本综述的目的是汇总目前与治疗骨质疏松症患者肩部手术病理相关的文献。
关于肩部手术患者围手术期使用抗骨质疏松药物的新数据尚未明确显示出有利或不利的结果。动物研究中的类似评估显示,作为肌腱和骨愈合的生物增强剂,尤其是使用新型合成代谢药物时,有令人鼓舞的结果。骨骼健康管理的主要支柱仍然是术前评估,采用基于机会性放射成像和CT的有效测量方法,以及优化风险因素。手术技术继续采用在骨质减少的骨骼中表现良好的植入物。有前景的临床前研究已确定合成代谢抗骨质疏松药物是肩部手术可行的生物增强剂,但目前尚未在任何临床研究中得到证实。