In the oncology section of this issue of Orthopedic Clinics of North America , we examine bisphosphonates, among the most widely used medications in orthopedics, and common polyostotic skeletal conditions.
In “Use of Bisphosphonates in Orthopaedic Surgery: Pearls and Pitfalls,” Dr Santiago Lozano-Calderon and coauthors review the most common indications for these powerful anti-osteoclastic medications, including senile and glucocorticoid-mediated osteoporosis, metastatic carcinoma osteolysis in arthroplasty, and Paget disease. They also review the available evidence for bisphosphonate use in pediatric bone disorders.
Although increasing use has created more awareness of adverse effects, these drugs remain highly effective interventions and this review offers valuable insights for almost any orthopedic surgeon. Dr Lozano-Calderon recently completed fellowship in musculoskeletal oncology at Harvard University.
In “Five Polyostotic Conditions that General Orthopedic Surgeons Should Recognize (or Should Not Miss),” Dr Muthusamy and coauthors provide a well-organized description of multiple enchondromas and osteochondromas, polyostotic fibrous dysplasia, Paget disease, and skeletal metastases. While the radiographic diagnosis of bone tumors can sometimes be challenging for the nononcologic orthopedist, the presence of multiple lesions markedly narrows the number of potential diagnoses–and thus familiarity with the most common polyostotic conditions can be very useful for the non-oncologic orthopedic surgeon.