Evidence map›Paper›PMID 38587674›Full record

ReviewOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024

Impact of osteoporosis and osteoporosis medications on fracture healing: a narrative review.

M Chandran, K E Akesson, M K Javaid, N Harvey, R D Blank, M L Brandi, T Chevalley, P Cinelli, C Cooper, W Lems and 8 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Abaloparatide and pelvic fracture healing: a phase 2 randomized placebo-controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  4. [Anabolic treatment in geriatric patients with osteoporosis].Zeitschrift fur Gerontologie und Geriatrie · 2026
    Review
  5. Article
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  7. Review
  8. Article
  9. Review
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  11. Osteoporosis and osteoporosis therapies as determinants of implant fixation failure in arthroplasty and spinal fusion constructs: a position statement from the Fracture Working Group of the Council of Scientific Advisors of the International Osteoporosis Foundation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Review
  12. Article
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  17. Anabolics in Cancer Patients: To Use or Not to Use?Endocrinology and metabolism (Seoul, Korea) · 2026
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

M ChandranOsteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, DUKE NUS Medical School, Singapore, Singapore. mchandran7@gmail.com.ORCID http://orcid.org/0000-0001-9119-8443
K E AkessonClinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Department of Orthopedics, Skåne University Hospital, Malmö, Sweden.
M K JavaidNIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
N HarveyMRC Lifecourse Epidemiology Centre, University of Southampton, NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
R D BlankGarvan Institute of Medical Research, Medical College of Wisconsin, Darlinghurst, NSW, Australia.
M L BrandiDepartment of Biomedical, Experimental and Clinical Sciences, University of Florence, Largo Palagi 1, Florence, Italy.
T ChevalleyDivision of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
P CinelliDepartment of Trauma Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
C CooperMRC Lifecourse Epidemiology Centre, University of Southampton, NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.
W LemsDepartment of Rheumatology, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.
G P LyritisHellenic Osteoporosis Foundation, Athens, Greece.
P MakrasDepartment of Medical Research, 251 Hellenic Air Force & VA General Hospital, Athens, Greece.
J PaccouDepartment of Rheumatology, MABlab ULR 4490, CHU Lille, Univ. Lille, 59000, Lille, France.
D D PierrozInternational Osteoporosis Foundation, Nyon, Switzerland.
M SosaUniversity of Las Palmas de Gran Canaria, Investigation Group on Osteoporosis and Mineral Metabolism, Canary Islands, Spain.
T ThomasDepartment of Rheumatology, North Hospital, CHU Saint-Etienne and INSERM U1059, University of Lyon-University Jean Monnet, Saint‑Etienne, France.
S SilvermanCedars-Sinai Medical Center and Geffen School of Medicine UCLA, Los Angeles, CA, USA.
Fracture Working Group of the Committee of Scientific Advisors of the International Osteoporosis Foundation, on behalf of the International Osteoporosis Foundation, Société Internationale de Chirurgie Orthopédique et de Traumatologie

Funding

Medical Research Council MC_PC_21003Medical Research Council MC_UP_A620_1015Medical Research Council MC_UU_12011/2
6 · The paper itself

Abstract

Antiresorptive medications do not negatively affect fracture healing in humans. Teriparatide may decrease time to fracture healing. Romosozumab has not shown a beneficial effect on human fracture healing.

backgroundFracture healing is a complex process. Uncertainty exists over the influence of osteoporosis and the medications used to treat it on fracture healing.

methodsNarrative review authored by the members of the Fracture Working Group of the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF), on behalf of the IOF and the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT).

resultsFracture healing is a multistep process. Most fractures heal through a combination of intramembranous and endochondral ossification. Radiographic imaging is important for evaluating fracture healing and for detecting delayed or non-union. The presence of callus formation, bridging trabeculae, and a decrease in the size of the fracture line over time are indicative of healing. Imaging must be combined with clinical parameters and patient-reported outcomes. Animal data support a negative effect of osteoporosis on fracture healing; however, clinical data do not appear to corroborate with this. Evidence does not support a delay in the initiation of antiresorptive therapy following acute fragility fractures. There is no reason for suspension of osteoporosis medication at the time of fracture if the person is already on treatment. Teriparatide treatment may shorten fracture healing time at certain sites such as distal radius; however, it does not prevent non-union or influence union rate. The positive effect on fracture healing that romosozumab has demonstrated in animals has not been observed in humans.

conclusionOverall, there appears to be no deleterious effect of osteoporosis medications on fracture healing. The benefit of treating osteoporosis and the urgent necessity to mitigate imminent refracture risk after a fracture should be given prime consideration. It is imperative that new radiological and biological markers of fracture healing be identified. It is also important to synthesize clinical and basic science methodologies to assess fracture healing, so that a convergence of the two frameworks can be achieved.

Indexed as

Bone Density Conservation AgentsFracture HealingOsteoporosisOsteoporotic FracturesAnimalsAntibodies, MonoclonalHumansTeriparatideAntibodies, MonoclonalBone Density Conservation AgentsromosozumabTeriparatideFracture healingOsteoporosisOsteoporosis medicationUnion

Identifiers

PMID38587674
PMCPMC11282157

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.