He and his colleagues are always looking for new information on bone fractures in older patients. One area of research from the study he thinks reasonable to pursue is to potentially target cells involved in bone repair and quality. “It may be important to look at different cells to target therapeutically,” he says. “Current medications primarily look at minimizing the rate of turnover of cells as opposed to looking at the cells that actually do the repair.”
Look to the Future
Emphasizing the prospective nature of the study, Dr. Acevedo says more research is needed to better understand the role of osteocytes to repair damaged bone. Also needed are better ways to identify which patients may be at fracture risk because of microcracks. Although imaging is useful, she says it is not sufficient to detect very small cracks. The only common symptom currently indicative of a patient with microcracks is pain.
She says pain in an elderly patient may be a sign of someone at risk of fracture. “This study tries to make clinicians aware that stress fracture can occur in the elderly under daily activities,” she says.
For Dr. Vail the research points to new avenues for prevention and treatment of skeletal pathologies that lead to fracture. Citing the great advances that have revolutionized the treatment of inflammatory arthritis with the use of tumor necrosis factor (TNF) inhibitors, he says he is “hopeful that these processes of identifying and understanding microtrauma of aging would provide avenues for similar breakthroughs of medical treatment of skeletal pathologies.”
Mary Beth Nierengarten is a freelance medical journalist based in Minneapolis.
Reference
- Acevedo C, Stadelmann VA, Pioletti DP, et al. Fatigue as the missing link between bone fragility and fracture. Nat Biomed Eng. 2018;2(2):62–71.
