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Preventive anti-resorptive drug administration in disuse osteoporosis might preserve trabecular connectivity

European Society of Biomechanics
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  • Computer Science
  • Medicine


PREVENTIVE ANTI-RESORPTIVE DRUG ADMINISTRATION IN DISUSE OSTEOPOROSIS MIGHT PRESERVE TRABECULAR CONNECTIVITY Ronald Ruimerman (1), Esther Tanck (2), Bert van Rietbergen (1), Peter Hilbers (1), Rik Huiskes (1) 1. Dept. of Biomed. Eng., Eindhoven University of Technology, The Netherlands. 2. Orthop. Res. Lab., UMCN, University Nijmegen, The Netherlands INTRODUCTION Osteoporosis is caused by altered bone forming osteoblast and bone resorbing osteoclast activities, causing degenerated bone structure. In disuse osteoporosis reduced loads cause this condition. It is often treated with anti-resorptive drugs (ARD), which preserve bone mass and fracture resistance. We developed a theory for bone modeling and remodeling as governed by mechanical forces (Huiskes, 2000). In this work we investigated whether the theory can describe the known morphological effects of osteoporosis and anti-resorptive drug treatment on trabecular structure. We then asked the question whether preventive treatment could preserve bone mass and structure on the long term. METHODS We incorporated our theory in a computational model. Starting from a conceptual morphology, representing bone tissue at the post-mineralized fetal stage, the modeling simulation was continued to morphological homeostasis, representing mature bone where only remodeling still occurred (Ruimerman, 2003). After this stage disuse osteoporosis was invoked by reducing the mechanical loading magnitude by 50%. In the resulting osteoporotic structure the osteoclastic activation frequency was reduced by 70% in order to mimic the effects of – therapeutic or late - anti-resorptive drug administration (Steiniche, 1991). To study the effects of preventive treatment, we repeated the simulation of inducing disuse osteoporosis and reduced osteoclastic activation prematurely, i.e. at the moment of reducing the loading magnitude. RESULTS Starting from the post-mineralized fetal stage, the simulation produced

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