This study quantified the length, number, and density of microcracks in bone from patients treated with bisphosphonates as a function of duration. Anterior iliac crest bone samples from 51 osteoporotic Caucasian females continuously treated with oral bisphosphonates for 1–16 years were obtained by bone biopsy. Samples were histologically processed and analyzed for bone area, microcrack number, and microcrack length. The analyses used statistical modeling and considered patient age, bone mineral density, bone volume/total volume, trabecular thickness, and bone turnover as potential covariates. Microcrack density (number of microcracks/total examined bone area) was linearly related (p = 0.018) to bisphosphonate treatment duration. None of the analyzed covariates contributed significantly to the observed relationship between microcrack density and bisphosphonate treatment duration. Observed increases in microcrack density with increasing bisphosphonate treatment duration is important because increasing levels of microcracks may not only affect bone remodeling but also reduce elastic modulus and are suspected to adversely affect other mechanical properties that may influence fracture risk. The present findings add to our prior results showing changes in bone material properties and modulus with bisphosphonate treatment duration and thereby provide a more comprehensive assessment of the relationship between bisphosphonate treatment duration and bone quality. Statement of Clinical Significance: The present findings provide information guiding clinical use of oral bisphosphonates for post-menopausal osteoporosis therapy.

中文翻译：

---

使用双膦酸盐治疗长达 16 年的患者骨小梁微裂纹累积


这项研究量化了接受双磷酸盐治疗的患者骨中微裂纹的长度、数量和密度，作为持续时间的函数。通过骨活检获得了 51 名骨质疏松的白人女性的前髂嵴骨样本，这些女性连续接受口服双磷酸盐治疗 1-16 年。对样品进行组织学处理并分析骨面积、微裂纹数量和微裂纹长度。该分析使用统计模型，并将患者年龄、骨矿物质密度、骨体积/总体积、小梁厚度和骨转换视为潜在的协变量。微裂纹密度（微裂纹数量/总检查骨面积）与双膦酸盐治疗持续时间呈线性相关（ p = 0.018）。所分析的协变量均未对观察到的微裂纹密度与双膦酸盐治疗持续时间之间的关系产生显着影响。观察到的微裂纹密度随着双膦酸盐治疗时间的增加而增加非常重要，因为微裂纹水平的增加不仅可能影响骨重塑，而且还会降低弹性模量，并且可能会对可能影响骨折风险的其他机械性能产生不利影响。本研究结果补充了我们之前的结果，显示骨材料特性和模量随双膦酸盐治疗持续时间的变化，从而对双膦酸盐治疗持续时间和骨质量之间的关系提供了更全面的评估。临床意义声明：本研究结果为临床使用口服双膦酸盐治疗绝经后骨质疏松症提供了指导信息。