Use of Systemic Pharmaceutical Adjuncts to Enhance Bone Healing After Surgery

Abstract

Anabolic agents such as parathyroid hormone and anti-catabolic agents such as diphosphonates were originally approved to treat bone disorders, including osteoporosis, Paget disease, and osteogenesis imperfecta. Today, these agents are increasingly being used to enhance bone healing after surgery. Yet despite the reported benefits of these medications in the postoperative period, most orthopaedic surgeons in the United States remain reluctant to use them after total joint arthroplasty, trauma surgery, or spine surgery. This article reviews the most commonly prescribed systemic pharmacologic agents for enhancing bone healing after surgery, with a particular focus on the mechanisms by which these medications work and their potential therapeutic applications, the complications and risks attending their prescription, and contraindications to their use. Prospects and trends in the use of both established and new therapeutic agents for enhancing bone healing are also presented.

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