Overview of Skeletal Repair (Fracture Healing and Its Assessment)

Methods in molecular biology (Clifton, N.J.) (Impact Factor: 1.29). 01/2014; 1130:13-31. DOI: 10.1007/978-1-62703-989-5_2
Source: PubMed


The study of postnatal skeletal repair is of immense clinical interest. Optimal repair of skeletal tissue is necessary in all varieties of elective and reparative orthopedic surgical treatments. However, the repair of fractures is unique in this context in that fractures are one of the most common traumas that humans experience and are the end-point manifestation of osteoporosis, the most common chronic disease of aging. In the first part of this introduction the basic biology of fracture healing is presented. The second part discusses the primary methodological approaches that are used to examine repair of skeletal hard tissue and specific considerations for choosing among and implementing these approaches.

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Available from: Louis C Gerstenfeld, Apr 04, 2014
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    • "Once the continuity of the bone and its mechanical properties are restored, the bone structure recovers its pre-injury state. Fracture healing is a complex process involving biological factors and mechanical principles[4]. The stability of the fracture, depending of the K E Y W O R D S fracture healing osteoporosis diamond concept bisphosphonates parathyroid hormone (PTH) Wnt sclerostin Dikkopf-1 A B S T R A C T Bone differs from other tissues in its capacity to self-repair after a fracture. "
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    ABSTRACT: Bone differs from other tissues in its capacity to self-repair after a fracture. The low bone mass and structural deterioration of bone associated with osteoporosis increases the risk of fragility fracture compared with healthy individuals. The intention of this article is to review the complex process of fracture repair and essential requirements for a successful fracture healing response summarized as the “diamond concept” in terms of aging and osteoporosis. The current preclinical and clinical evidence for a beneficial or harmful influence of anti-osteoporosis medications such as bisphosphonates, parathyroid hormone (PTH), strontium ranelate and antibodies of Wnt-inhibiting signaling proteins on bone healing is presented and discussed. Literature suggests that there are no detrimental consequences of such therapeutics on fracture repair processes. Following a fragility fracture, it seems that early start of preventive anti-osteoporotic treatment right after surgery does not delay the union of the fracture, except perhaps in the case of very rigidly fixed fracture requiring direct bone healing. There is some promising experimental and clinical evidence for possible enhancement of the bone repair process via administration of systemic agents. Further well designed studies in humans are necessary to accumulate more evidence on the positive effects and to translate this knowledge into valid therapeutic applications.
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    ABSTRACT: Mechanoresponses in mesenchymal stem cells (MSCs) guide both differentiation and function. In this review, we focus on advances in our understanding of how the cytoplasmic cytoskeleton, nuclear envelope, and nucleoskeleton, which are connected via linker of nucleoskeleton and cytoskeleton (LINC) complexes, are emerging as an integrated dynamic signaling platform to regulate MSC mechanobiology. This dynamic interconnectivity affects mechanical signaling and transfer of signals into the nucleus. In this way, nuclear and LINC-mediated cytoskeletal connectivity plays a critical role in maintaining mechanical signaling that affects MSC fate by serving as both mechanosensory and mechanoresponsive structures. We review disease- and age-related compromises of LINC complexes and nucleoskeleton that contribute to the etiology of musculoskeletal diseases. Finally, we invite the idea that acquired dysfunctions of LINC might be a contributing factor to conditions such as aging, microgravity, and osteoporosis and discuss potential mechanical strategies to modulate LINC connectivity to combat these conditions.
    Full-text · Article · Feb 2016