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Can Intermittent Teriparatide Facilitate Supraphysiological-Rate Distraction Osteogenesis? A Feasibility Study in the

Siddhartha Sharma1, John Khing1, Navin Kumar2

  • 1Department of Orthopaedics, PGIMER, Chandigarh, India.

Indian Journal of Orthopaedics
|July 14, 2025
PubMed
Summary

Intermittent teriparatide administration can accelerate bone healing. This study shows it facilitates supraphysiological distraction osteogenesis in rabbits without compromising bone regenerate quality.

Keywords:
Animal modelDistraction osteogenesisLimb lengtheningPTHRabbitRecombinant human parathyroid hormoneTeriparatideTibial lengthening

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Area of Science:

  • Orthopedics
  • Regenerative Medicine
  • Bone Biology

Background:

  • Intermittent teriparatide administration is recognized for enhancing bone healing.
  • Distraction osteogenesis (DO) is a surgical technique used to lengthen bone.
  • Investigating accelerated DO rates is crucial for clinical applications.

Purpose of the Study:

  • To evaluate the efficacy of intermittent teriparatide in facilitating supraphysiological-rate distraction osteogenesis.
  • To assess if accelerated DO compromises the quality of the bone regenerate.
  • To establish a proof of concept for teriparatide-enhanced bone lengthening.

Main Methods:

  • Twenty-four rabbits underwent tibial lengthening via distraction osteogenesis (10 mm).
  • Groups were divided by DO rate (physiological: 0.75 mm/day vs. supraphysiological: 1.5 mm/day) and treatment (teriparatide vs. saline control).
  • Outcome measures included failure rates, regenerate volume, bone mineral density, and biomechanical properties (stiffness, load to failure).

Main Results:

  • Supraphysiological DO (1.5 mm/day) showed significantly higher failure rates compared to physiological DO (0.75 mm/day), particularly in the control group (Group B2).
  • Teriparatide administration did not significantly increase failure rates at either DO speed.
  • While regenerate stiffness showed significant differences among groups, overall volume, bone mineral density, and ultimate load to failure were comparable.

Conclusions:

  • Intermittent teriparatide administration is a feasible method to accelerate distraction osteogenesis to supraphysiological rates.
  • Accelerated distraction osteogenesis using teriparatide can be achieved without compromising the quality of the bone regenerate.
  • This study provides a foundation for further research into teriparatide's role in advanced bone regeneration techniques.