Pharmacological agents and impairment of fracture healing: What is the evidence?
Abstract
Bone healing is an extremely complex process which depends on the coordinated action of several cell lineages on a cascade of biological events, and has always been a major medical concern. The use of several drugs such as corticosteroids, chemotherapeutic agents, non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, anticoagulants and drugs which reduce osteoclastic activity have been shown to affect bone healing. This review article presents our current understanding on this topic, focusing on data illustrating the effect of these drugs on fracture healing and bone regeneration.
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The inference that acute inflammation usually has positive effects is strongly supported by findings that inhibiting the inflammatory response by nonsteroidal anti-inflammatory drugs worsens wound and bone healing, increases the risk of anastomotic failure or sepsis after surgery, aggravates heart and renal failure, interferes with an adequate immune response to antigen presentation in the gut, or
“The inference that acute inflammation usually has positive effects is strongly supported by the finding that inhibiting the inflammatory response by nonsteroidal anti‐inflammatory drugs worsens wound and bone healing,47, 48, 49, 50 increases the risk of anastomotic failure or sepsis after surgery,51, 52 aggravates heart and renal failure,53, 54 interferes with an adequate immune response to”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [50]
Cites
Weinstein, R. S., Jilka, R. L., Parfitt, A. M., & Manolagas, S. C. (1998) · Journal of Clinical Investigation · doi:10.1172/jci2799 · Cited by 1,753 · see citing works
Effects of cyclooxygenase inhibition on bone, tendon, and ligament healing
Radi, Z. A., & Khan, N. K. (2005) · Inflammation Research · doi:10.1007/s00011-005-1367-4 · Cited by 113 · see citing works
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Hypoalbuminemia: Pathogenesis and Clinical Significance
Soeters, P. B., Wolfe, R. R., & Shenkin, A. (2019) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.1451 · Cited by 1,448 · see citing works
The conditional role of inflammation in pregnancy and cancer
Soeters, P. B., & Grimble, R. F. (2013) · Clinical Nutrition · doi:10.1016/j.clnu.2012.07.010 · Cited by 24 · see citing works
- Authors
- Pountos, I., Georgouli, T., Blokhuis, T. J., Pape, H. C., & Giannoudis, P. V.
- Affiliations
- University of Leeds (GB)
- Corresponding author
- Giannoudis, Peter V.
- Venue
- Injury
- Publisher
- Elsevier BV
- Published
- 2008-04
- Volume
- 39
- Issue
- 4
- Pages
- 384-394
- ISSN
- 0020-1383 (ISSN-L)
- OpenAlex
- W2155496315
- Cited by
- 168
- References
- 2
- Citations by year
- 2026: 9 · 2024: 1 · 2023: 10 · 2022: 7 · 2021: 11 · 2020: 14 · 2019: 10 · 2018: 16 · 2017: 11 · 2016: 10 · 2015: 12 · 2014: 11 · 2013: 12 · 2012: 9
- FWCI
- 0.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Injury (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- fracture healing, bone regeneration, pharmacological agents, corticosteroids, anticancer agents, nonsteroidal anti-inflammatory drugs, antibiotics, anticoagulants, osteoclast inhibitors, drug effects on bone
- MeSH terms
- Adrenal Cortex Hormones, Animals, Anti-Inflammatory Agents, Non-Steroidal, Anticoagulants, Bone Regeneration, Bony Callus, Diphosphonates, Disease Models, Animal, Humans, Osteogenesis, Fracture Healing, Evidence-Based Medicine
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