Enhancement of fracture healing with parathyroid hormone: preclinical studies and potential clinical applications

Abstract

Parathyroid hormone (PTH) has become the most widely studied hormone with regard to its administration to various species and their respective skeletal responses. Beyond its affirmative effect in osteoporosis treatment, systemic PTH administration seems to stimulate bone formation in the fracture healing process. According to preclinical experimental studies, once-daily administration of PTH enhances the morphometric and mechanical properties of fracture calluses and accelerates the normal fracture healing. Its anabolic effect is obvious even in low doses, as well as in cases of implant fixation and distraction osteogenesis. There is little evidence of toxic effects and there are only a few reports of adverse events related to its use. The incidence of bone neoplasms in animal studies depends on the dose and duration of treatment. However, it is not prognostic of an equivalent risk potential of carcinogenesis in humans. In summary, the clinical promise of parathyroid hormone is very high and a positive effect in fracture healing should be anticipated.

Keywords::

• fracture callus
• IGF-I
• mesenchymal cells
• osteoblast
• osteosarcoma
• teriparatide

Disclosure

This work is attributed to the Academic Unit, Trauma and Orthopaedic Surgery, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK.