To enhance osteoporotic fracture healing, novel intervention therapies including microRNA, 7 small interfering RNA (siRNA), 8 or various kinds of biomaterials have been identified to rescue bone loss and promote bone healing in preclinical studies. 3- 5 Therefore, it is now recommended that scientific studies should concentrate in these regions, which focus on trabecular bone formation. 2, 3 It is well known that most osteoporotic fractures occur at the metaphyseal regions of long bones, including the distal radius, proximal humerus, or proximal femur. 1 In fact, the disease has become a worldwide threat, with the lifetime fracture risk of osteoporotic patients reaching as high as 40%. Osteoporosis predisposes patients to increased risk of fragility fractures and approximately 2.5 million osteoporotic fractures occur each year in the USA, with costs projecting to $25 billion USD by 2025. The findings of this animal study may need to be verified in human studies. The improved mechanical properties, acceleration of fracture healing, and safety justify its role into translation to future clinical studies.Ĭite this article: Bone Joint Res 2021 10(1):41–50. LMHFV is a promising intervention for osteoporotic metaphyseal fracture healing. Metaphyseal fracture healing is enhanced by LMHFV, and one of the important molecular pathways it acts on is fibrinolysis. Mechanical testing revealed the mean energy to failure was significantly higher for OVX-VT at 37.6 N mm (SD 8.4) and 71.9 N mm (SD 30.7) compared with OVX at 5.76 N mm (SD 7.1) (p = 0.010) and 17.7 N mm (SD 11.5) (p = 0.030) at week 2 and week 6, respectively. Mean tPA from muscle was significantly higher for OVX-VT compared to OVX (p = 0.020) on day 3. Martius Scarlet Blue (MSB) staining revealed a significant decrease of fibrin content in the callus in OVX-VT compared with OVX on day 3 (p = 0.020). ResultsĪll rats achieved healing, and x-ray relative radiopacity for OVX-VT was significantly higher compared to OVX at week 2. Fibrinolytic potential was evaluated by quantifying fibrin, tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1) along with healing outcomes at three days, one week, two weeks, and six weeks post-fracture. MethodsĪ total of 144 rats were randomized to four groups: sham control sham and LMHFV ovariectomized (OVX) and ovariectomized and LMHFV (OVX-VT). This study investigates the effect of LMHFV on fibrinolysis in a clinically relevant animal model to accelerate osteoporotic fracture healing. Low-magnitude high-frequency vibration (LMHFV) is a non-invasive biophysical modality proven to enhance fibrinolytic factors. Fibrinolysis plays a key transition step from haematoma formation to angiogenesis and fracture healing.
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