Is Parathyroid Hormone A Viable Solution For Nonunion? A Systematic Review And Pooled Analysis

Area of Science:

• Orthopedics
• Endocrinology
• Regenerative Medicine

Background:

• Bone nonunion and delayed union are significant clinical challenges, often requiring prolonged treatment and resulting in impaired function.
• Current treatment options for fracture healing complications have limitations, necessitating exploration of novel therapeutic agents.

Purpose of the Study:

• To systematically review and analyze published data on the clinical efficacy and safety of parathyroid hormone (PTH) in treating bone nonunion and delayed union.
• To assess the union rates, time to union, and adverse effects associated with PTH therapy for fracture healing.

Main Methods:

• A systematic review and pooled analysis of studies published between 1950 and 2016.
• Searches were conducted across four major electronic databases: PubMed, Web of Science, EMBASE, and the Cochrane Library.
• Data from 24 patients across 13 studies were included, focusing on fracture types, treatment duration, and outcomes.

Main Results:

• Parathyroid hormone (PTH) therapy demonstrated a high union rate of 96% in patients with nonunion and delayed union.
• The mean time to union after PTH treatment was 7.3 months.
• No adverse side effects were reported by any patients during the PTH treatment period.

Conclusions:

• Parathyroid hormone (PTH) is a safe and effective anabolic treatment for delayed union and nonunion.
• PTH therapy shows significant promise as a viable option for enhancing fracture healing and improving clinical outcomes.
• Further research can build upon these findings to optimize PTH protocols for various fracture types.