Fracture healing in the elderly patient

被引:219
作者
Gruber, Reinhard
Koch, Hannjoerg
Doll, Bruce A.
Tegtmeier, Florian
Einhorn, Thomas A.
Hollinger, Jeffrey O. [1 ]
机构
[1] Carnegie Mellon Univ, Bone Tissue Engn Ctr, Pittsburgh, PA 15213 USA
[2] Med Univ Vienna, Dept Oral Surg, Vienna, Austria
[3] Univ Pittsburgh, Sch Dent Med, Pittsburgh, PA 15260 USA
[4] Ernst Moritz Arndt Univ Greifswald, Dept Orthoped Surg, D-17487 Greifswald, Germany
[5] Boston Univ, Med Ctr, Dept Orthopaed Surg, Boston, MA 02215 USA
[6] Univ Pittsburgh, Med Ctr, Dept Orthopaed Surg, Pittsburgh, PA 15260 USA
关键词
aging; bone regeneration; fracture; osteoporosis; gerontology; tissue engineering; growth factors;
D O I
10.1016/j.exger.2006.09.008
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Clinical experience gives rise to the impression that there are differences in fracture healing in different age groups. It is evident that fractures heal more efficiently in children than in adults. However, minimal objective knowledge exists to evaluate this assumption. Temporal, spatial, and cellular quantitative and qualitative interrelationships, as well as signaling molecules and extracellular matrix have not been comprehensively and adequately elucidated for fracture healing in the geriatric skeleton. The biological basis of fracture healing will provide a context for revealing the pathophysiology of delayed or even impaired bone regeneration in the elderly. We will summarize experimental studies on age-related changes at the cellular and molecular level that will add to the pathophysiological understanding of the compromised bone regeneration capacity believed to exist in the elderly patient. We will suggest why this understanding would be useful for therapeutics focused on bone regeneration, in particular fracture healing at an advanced age. (c) 2006 Elsevier Inc. All rights reserved.
引用
收藏
页码:1080 / 1093
页数:14
相关论文
共 173 条
[1]   Treatment of nonunions with electric and electromagnetic fields [J].
Aaron, RK ;
Ciombor, DM ;
Simon, BJ .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2004, (419) :21-29
[2]   PPARγ insufficiency enhances osteogenesis through osteoblast formation from bone marrow progenitors [J].
Akune, T ;
Ohba, S ;
Kamekura, S ;
Yamaguchi, M ;
Chung, UI ;
Kubota, N ;
Terauchi, Y ;
Harada, Y ;
Azuma, Y ;
Nakamura, K ;
Kadowaki, T ;
Kawaguchi, H .
JOURNAL OF CLINICAL INVESTIGATION, 2004, 113 (06) :846-855
[3]   Enhancement of experimental fracture-healing by systemic administration of recombinant human parathyroid hormone (PTH 1-34) [J].
Alkhiary, YM ;
Gerstenfeld, LC ;
Krall, E ;
Westmore, M ;
Sato, M ;
Mitlak, BH ;
Einhorn, TA .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2005, 87A (04) :731-741
[4]  
ANDREW JG, 1995, BONE, V16, P455
[5]  
[Anonymous], 2005, CELL, V120, P435
[6]   The Nicolas Andry Award - Modulation of distraction osteogenesis in the aged rat by fibroblast growth factor [J].
Aronson, J .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2004, (425) :264-283
[7]  
Avenell A, 2005, COCHRANE DB SYST REV, V18
[8]   THE EFFECT OF GROWTH-HORMONE ON FRACTURE-HEALING IN OLD RATS [J].
BAK, B ;
ANDREASSEN, TT .
BONE, 1991, 12 (03) :151-154
[9]   Deletion of iNOS gene impairs mouse fracture healing [J].
Baldik, Y ;
Diwan, AD ;
Appleyard, RC ;
Fang, ZM ;
Wang, Y ;
Murrell, GAC .
BONE, 2005, 37 (01) :32-36
[10]   Growth factor regulation of fracture repair [J].
Barnes, GL ;
Kostenuik, PJ ;
Gerstenfeld, LC ;
Einhorn, TA .
JOURNAL OF BONE AND MINERAL RESEARCH, 1999, 14 (11) :1805-1815