Journal of Bone and Mineral Research

Schnitzler, Christine M.; Mesquita, Julia M.; Gear, Ann K.; Robson, Heather J.; Wing, Jeffrey; Smyth, Amelia E.

doi:10.1002/jbmr.5650051330

Cited by 14 publications

References 18 publications

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Iliac bone biopsies at the time of periarticular stress fractures during fluoride therapy: Comparison with pretreatment biopsies

Schnitzler

Mesquita

Gear

et al. 1990

Journal of Bone and Mineral Research

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We attempted to establish whether systemic changes in trabecular bone explain the development of stress fractures in the lower limbs during fluoride therapy for osteoporosis. To this end we compared transiliac bone biopsies obtained before treatment with those taken around the time of stress fractures after 14.3 +/- 10.9 (SD) months of therapy in six patients (group A). Biopsies from a comparable group of six patients without stress fractures at the time of the second biopsy (after 11.9 +/- 2.7 months of treatment) served for comparison (group B). The biopsies were processed undecalcified and examined by routine histomorphometry. The second biopsies did not show any significant improvement in mean bone volume or trabecular architecture. Although the second biopsies in group A had increased erosion surfaces (p less than 0.05) and greater osteoid volume (p less than 0.05), group B biopsies showed no difference in erosion surfaces but an increase in all osteoid parameters: osteoid volume (p less than 0.05), osteoid surface (p less than 0.05), and osteoid seam thickness (p less than 0.01). We reached the following conclusions: (1) the combination of increased erosion and replacement of removed bone by as yet unmineralized osteoid in the stress fracture group must have weakened bone and allowed the development of stress fractures. (2) Stress fracture patients may have mounted a less vigorous osteoblast response to fluoride than non-stress fracture patients. Under these conditions microfractures are likely to heal poorly and propagate to develop into full stress fractures. (3) Renal failure is a contraindication to fluoride therapy.

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Iliac bone biopsies at the time of periarticular stress fractures during fluoride therapy: Comparison with pretreatment biopsies

Schnitzler

Mesquita

Gear

et al. 1990

Journal of Bone and Mineral Research

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Response of cortical bone to local controlled release of sodium fluoride: The effect of implant insertion site

Anderson

Copenhaver

Tencer

et al. 1991

Journal Orthopaedic Research

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In a previous experiment, sodium fluoride in a biodegradable polymer matrix was introduced into the femoral canal of the rabbit and bone formation was compared with contralateral controls. We noted significant bone formation, but only in the distal third of the periosteal surface of the femur. This experiment was performed to distinguish fluoride-induced periosteal bone formation from that due to the reactive osteogenic changes associated with local injury caused by the process of implantation. A proximal approach on the right leg and a distal approach on the left were used for the insertion of the implants in rabbits. Femurs were removed after 30 days and tested for stiffness and load to failure. The cross-sectional area of mineralized bone was determined at proximal, midshaft, and distal locations. Fluorescent bone tissue growth labels were injected at weekly intervals to measure the rate of new periosteal bone formation. The results were compared with a control group that received sham implants. Results showed no difference between measured properties in right and left femurs in the control group or in those exposed to fluoride. A significant increase was found in the fluoride group in load to failure, along with cross-sectional area of mineralized bone, and periosteal growth rates compared with the control group, but no difference was seen in stiffness. No difference was detected between the response proximally and distally in the fluoride group regardless of the location of insertion. There were no detectable changes in serum fluoride level after implantation of the poly L-lactic acid/sodium fluoride matrix. These results show that fluoride exerts its osteogenic effects equally at proximal, midshaft, and distal regions of diaphyseal bone and is uninfluenced by the site of local injury due to insertion of the implant.

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Effect of controlled local release of sodium fluoride on bone formation: Filling a defect in the proximal femoral cortex

McCormack

Anderson

Tencer

1993

Journal Orthopaedic Research

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To assess the effect of sodium fluoride (NaF) in the healing of a defect in cortical bone, an experimental model was created by the drilling of 5.0 mm holes in the proximal ends of both femora of 12 adult male New Zealand White rabbits. An interlocking intramedullary implant constructed of poly(d,l-lactic acid) containing NaF was placed in the right femur and an identical implant without NaF (sham), in the left. The implant in the right femur was designed to release NaF in a controlled manner over the duration of the experiment. Ten weeks after implantation, the specimens were removed and were tested in torsion. The mechanical properties were not significantly different between the groups. The femora exposed to NaF had an 18.6% increase in intact cortex near the defect (p = 0.023), however, the deposition of mineralized bone within the defect was not significantly greater. In fact, healing appeared to be impaired by the presence of NaF. There was complete closure of the defect in all but one of the femora with a sham implant, but the tissue had not yet calcified. In contrast, only one femoral defect exposed to NaF had closed. Examination of the material filling the defects of the femora exposed to NaF showed that it was predominantly uncalcified osteogenic mesenchymal tissue.

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Journal of Bone and Mineral Research

Cited by 14 publications

References 18 publications

Iliac bone biopsies at the time of periarticular stress fractures during fluoride therapy: Comparison with pretreatment biopsies

Iliac bone biopsies at the time of periarticular stress fractures during fluoride therapy: Comparison with pretreatment biopsies

Response of cortical bone to local controlled release of sodium fluoride: The effect of implant insertion site

Effect of controlled local release of sodium fluoride on bone formation: Filling a defect in the proximal femoral cortex

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