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Three years of alendronate treatment does not continue to decrease microstructural stresses and strains associated

J O Green¹, T Diab, M R Allen

¹Parker H. Petit Institute for Bioengineering and Bioscience and George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, 315 Ferst Drive, Atlanta, GA 30332-0405, USA.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA

|January 13, 2012

Summary

Prolonged alendronate treatment did not further decrease trabecular stresses linked to microdamage. Increased mineralization in damaged bone may explain why stresses did not continue to decline with longer alendronate use.

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Area of Science:

Biomedical Engineering
Orthopedics
Pharmacology

Background:

Alendronate is an anti-remodeling drug reducing osteoporotic fractures.
Studies show increased microdamage density with alendronate.
Previous research indicated decreased microstructural stresses after 1 year of alendronate.

Purpose of the Study:

To investigate the effects of 3-year alendronate treatment on trabecular stresses and strains.
To determine if stresses associated with microdamage continue to decrease with extended treatment duration.

Main Methods:

Image-based finite element modeling (FEM) was used to analyze stresses and strains in microdamaged trabeculae.
Trabeculae from groups treated with different alendronate doses or saline control were compared.
3D microcomputed tomography analyzed architectural characteristics and mineralization.

Main Results:

Severely damaged trabeculae in the low-dose alendronate group showed increased stress compared to the high-dose group (p=0.006) and approached significance versus controls (p=0.02).
Trabecular mineralization was significantly greater in severely damaged areas of the low-dose group compared to high-dose and control groups.
These findings suggest tissue-level changes, specifically mineralization, influence stress distribution.

Conclusions:

Trabecular stresses associated with microdamage do not decrease further with prolonged alendronate treatment.
Increased mineralization in bone tissue may be responsible for the observed stress patterns.
Findings highlight the complex interplay between drug treatment, bone structure, and microdamage accumulation.