ArticleBone & joint research2017
The effect of long-term bisphosphonate therapy on trabecular bone strength and microcrack density.
Article in Bone & joint research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 35 citations in OpenAlex.
- Mechanism-Oriented Biomaterial Strategies for Bone Regeneration in BRONJ: From Pathological Barriers to Evidence-Matched Repair.Biomolecules · 2026Review
- Risk factors for atypical femur fractures with and without bisphosphonate treatment: a national nested case-control study.JBMR plus · 2026Article
- Review
- Microdamage in biological hard tissues and its repair mechanisms.Biomedical engineering online · 2025Review
- Runaway resorption of microcracks contributes to age-related hip-fracture patients.Scientific reports · 2025Article
- Long-term bisphosphonate use and femoral morphological changes in osteoporosis patients: a retrospective cohort study.European journal of medical research · 2025Article
- A Cross-Sectional Study of Bone Nanomechanics in Hip Fracture and Aging.Life (Basel, Switzerland) · 2023Article
- Dynamic Effects of the Third Generation Bisphosphonate of Risedronate on Rat Osteoporotic Fractures for Clinical Usage Guidance.Orthopaedic surgery · 2021Article
- Combined Effects of Exercise and Denosumab Treatment on Local Failure in Post-menopausal Osteoporosis-Insights from Bone Remodelling Simulations Accounting for Mineralisation and Damage.Frontiers in bioengineering and biotechnology · 2021Article
- Biomechanical Properties of Metastatically Involved Osteolytic Bone.Current osteoporosis reports · 2020Review
- Long-term bisphosphonate treatment coupled with ovariectomy in mice provokes deleterious effects on femoral neck fracture pattern and modifies tibial shape.Bone & joint open · 2020Article
- Nanoscale mechanisms in age-related hip-fractures.Scientific reports · 2020Article
- CaMKK2 Signaling in Metabolism and Skeletal Disease: a New Axis with Therapeutic Potential.Current osteoporosis reports · 2019Review
- Serum homocysteine levels are affected by renal function during a 3-year period of minodronate therapy in female osteoporotic patients.Journal of bone and mineral metabolism · 2019Article
- Skeletal Site-Specific Response of Jawbones and Long Bones to Surgical Interventions in Rats Treated with Zoledronic Acid.BioMed research international · 2019Article
- Recent Advances in Understanding Bisphosphonate Effects on Bone Mechanical Properties.Current osteoporosis reports · 2018Review
- Outcomes for Elderly Patients With Atypical Femoral Fractures Compared to Typical Femoral Fractures for Length of Stay, Discharge Destination, and 30-Day Mortality Rate.Geriatric orthopaedic surgery & rehabilitation · 2018Article
- Minodronate for the treatment of osteoporosis.Therapeutics and clinical risk management · 2018Review
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesBisphosphonates (BP) are the first-line treatment for preventing fragility fractures. However, concern regarding their efficacy is growing because bisphosphonate is associated with over-suppression of remodelling and accumulation of microcracks. While dual-energy X-ray absorptiometry (DXA) scanning may show a gain in bone density, the impact of this class of drug on mechanical properties remains unclear. We therefore sought to quantify the mechanical strength of bone treated with BP (oral alendronate), and correlate data with the microarchitecture and density of microcracks in comparison with untreated controls.
methodsTrabecular bone from hip fracture patients treated with BP (n = 10) was compared with naïve fractured (n = 14) and non-fractured controls (n = 6). Trabecular cores were synchrotron scanned and micro-CT scanned for microstructural analysis, including quantification of bone volume fraction, microarchitecture and microcracks. The specimens were then mechanically tested in compression.
resultsBP bone was 28% lower in strength than untreated hip fracture bone, and 48% lower in strength than non-fractured control bone (4.6 MPa
conclusionBP therapy had no detectable mechanical benefit in the specimens examined. Instead, its use was associated with substantially reduced bone strength. This low strength may be due to the greater accumulation of microcracks and a lack of any discernible improvement in bone volume or microarchitecture. This preliminary study suggests that the clinical impact of BP-induced microcrack accumulation may be significant.
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