Osteoporosis International最新文献

{"title":"Intellectual disabilities and risk of fractures: A population-based cohort study.","authors":"Yoo Jin Um, In Young Cho, Hye Yeon Koo, Yong-Moon Mark Park, Kyung Mee Kim, Chung Eun Lee, Kyungdo Han","doi":"10.1007/s00198-025-07519-9","DOIUrl":"10.1007/s00198-025-07519-9","url":null,"abstract":"<p><p>In this retrospective cohort study, people with intellectual disabilities (ID) had higher risks of fractures, including any fractures, vertebral fractures, and hip fractures, compared to those without ID. The risk was especially pronounced in younger adults (20-39 years), emphasizing the importance of targeted healthcare interventions in individuals with ID.</p><p><strong>Background: </strong>Life expectancies of individuals with ID have increased over the past few decades. We aimed to evaluate the risk of any fractures, vertebral fractures, and hip fractures in people with ID compared to those without ID.</p><p><strong>Methods: </strong>This retrospective cohort study analysed Korean National Disability Registry data with the Korean National Health Insurance Service database. A total of 3,815,545 individuals who underwent national health examinations in 2009 were followed until 2020. Cox-proportional hazard analyses were performed to estimate the hazard ratios (HRs) of any fractures, vertebral fractures, and hip fractures in individuals with compared to those without ID with adjustment for covariates.</p><p><strong>Results: </strong>During a mean follow-up period of 10.0 years, among 3582 individuals with ID, there were 207 cases of any fractures, 47 cases of vertebral fractures, and 27 cases of hip fractures. The multivariable-adjusted hazard ratios for risk of any fractures, vertebral fractures, and hip fractures in the ID group compared to those without ID were 1.69 (95% CI 1.47-1.94), 2.07 (95% CI 1.55-2.75), and 3.01 (95% CI 2.07-4.39), respectively. In subgroup analysis, individuals with ID aged 20-39 years had higher risk of fractures compared to those in older age groups.</p><p><strong>Conclusion: </strong>Individuals with ID are at an increased risk of any fractures, vertebral fractures, and hip fractures compared to those without ID. Healthcare professionals should be aware of the elevated risk of fractures in this population.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1185-1192"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video-estimated peak jump power using deep learning is associated with sarcopenia and low physical performance in adults.","authors":"Sang Wouk Cho, Sung Joon Cho, Eun-Young Park, Na-Rae Park, Sookyeong Han, Yumie Rhee, Namki Hong","doi":"10.1007/s00198-025-07515-z","DOIUrl":"10.1007/s00198-025-07515-z","url":null,"abstract":"<p><p>Video-estimated peak jump power (vJP) using deep learning showed strong agreement with ground truth jump power (gJP). vJP was associated with sarcopenia, age, and muscle parameters in adults, with providing a proof-of-concept that markerless monitoring of peak jump power could be feasible in daily life space.</p><p><strong>Objectives: </strong>Low peak countermovement jump power measured by ground force plate (GFP) is associated with sarcopenia, impaired physical function, and elevated risk of fracture in older adults. GFP is available at research setting yet, limiting its clinical applicability. Video-based estimation of peak jump power could enhance clinical applicability of jump power measurement over research setting.</p><p><strong>Methods: </strong>Data were collected prospectively in osteoporosis clinic of Severance Hospital, Korea, between March and August 2022. Individuals performed three jump attempts on GFP (ground truth, gJP) under video recording, along with measurement of handgrip strength (HGS), 5-time chair rise (CRT) test, and appendicular lean mass (ALM). Open source deep learning pose estimation and machine learning algorithms were used to estimate video-estimated peak jump power (vJP) in 80% train set. Sarcopenia was defined by Korean Working Group for Sarcopenia 2023 definition.</p><p><strong>Results: </strong>A total of 658 jump motion data from 220 patients (mean age 62 years; 77% women; sarcopenia 19%) were analyzed. In test set (20% hold-out set), average difference between predicted and actual jump power was 0.27 W/kg (95% limit of agreement - 5.01 to + 5.54 W/kg; correlation coefficient 0.93). vJP detected gJP-defined low jump power with 81.8% sensitivity and 91.3% specificity. vJP showed a steep decline across age like gJP, with modest to strong correlation with HGS and CRT. Eight landmarks (both shoulders, hip, knee joints, and ears) were the most contributing features to vJP estimation. vJP was associated with the presence of sarcopenia (unadjusted and adjusted, - 3.95 and - 2.30 W/kg), HGS (- 3.69 and - 1.96 W/kg per 1 SD decrement), and CRT performance (- 2.79 and - 1.87 W/kg per 1 SD decrement in log-CRT) similar to that of gJP.</p><p><strong>Conclusion: </strong>vJP was associated with sarcopenia, age, and muscle parameters in adults, with good agreement with ground truth jump power.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1193-1201"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Nonoperative versus operative management of frail institutionalized older patients with a proximal femoral fracture: a cost-utility analysis alongside a multicenter prospective cohort study.","authors":"S A I Loggers, A J L M Geraerds, P Joosse, H C Willems, T Gosens, R Van Balen, C L P Van de Ree, K J Ponsen, J Steens, R G Zuurmond, M H J Verhofstad, S Polinder, Esther M M Van Lieshout","doi":"10.1007/s00198-025-07490-5","DOIUrl":"10.1007/s00198-025-07490-5","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1295"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between walking and hip fracture in women aged 65 and older: 20-year follow-up from the study of osteoporotic fractures.","authors":"Enwu Liu, Ryan Yan Liu, John Moraros, Eugene V McCloskey, Nicholas C Harvey, Mattias Lorentzon, Helena Johansson, John A Kanis","doi":"10.1007/s00198-025-07508-y","DOIUrl":"10.1007/s00198-025-07508-y","url":null,"abstract":"<p><p>Hip fractures in elderly women pose significant healthcare challenges. Promoting walking for exercise as a cost-effective intervention may help reduce the risk of fractures in this population.</p><p><strong>Purpose: </strong>This study aimed to examine the relationship between walking and hip fracture risk among women aged 65 years and older.</p><p><strong>Methods: </strong>A 20-year prospective study (1986-2006) included 9704 women from the Study of Osteoporotic Fractures (SOF) in the USA. Participants were followed biennially, and walking exposure was assessed by the number of city blocks walked for exercise, routine activity, and total blocks walked daily. Cox regression models with time-varying covariates assessed associations, with competing risks addressed using Fine and Gray models. Penalized splines were used to explore dose-response relationships.</p><p><strong>Results: </strong>In total, 1419 hip fractures were identified through the study period. The mean and median follow-up times for hip fractures or censoring were 15.0 and 15.8 years in the walking for exercise group, vs. 13.2 and 13.7 years in the not walking for exercise group. The hip fracture incidence rate was 10.0 cases per 1000 person-years (py) in the walking for exercise group compared to 10.9 per 1000 py in the not walking for exercise group. All-cause mortality was 37.1 per 1000 py in the walking for exercise group compared to 46.4 per 1000 py in the not walking for exercise group. Adjusted models showed that walking for exercise significantly reduced hip fracture risk (HR, 0.864; 95% CI, 0.762-0.980; P = 0.0230), with each additional block walked for exercise reducing risk (HR per block, 0.986; 95% CI, 0.978-0.995; P = 0.0022). Walking for routine activities showed no significant association. Spline analysis indicated walking 16 blocks (≈3200 steps) daily significantly lowered hip fracture risk.</p><p><strong>Conclusion: </strong>Walking for exercise is linked to a reduced risk of hip fractures in elderly women. Walking the equivalent of 16 blocks or more (> 3200 steps) per day might be an effective way to reduce the risk of hip fractures in this vulnerable population.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1155-1164"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Optimum dose of vitamin D for disease prevention in older people: BEST-D trial of vitamin D in primary care.","authors":"H Hin, J Tomson, C Newman, R Kurien, M Lay, J Cox, J Sayer, M Hill, J Emberson, J Armitage, R Clarke","doi":"10.1007/s00198-025-07522-0","DOIUrl":"10.1007/s00198-025-07522-0","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1293"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis screening in the mammography setting via digital wrist tomosynthesis.","authors":"Daniel Oravec, Ram N Yadav, Terra Cushman, Michael J Flynn, George W Divine, Sudhaker D Rao, Yener N Yeni","doi":"10.1007/s00198-025-07516-y","DOIUrl":"10.1007/s00198-025-07516-y","url":null,"abstract":"<p><p>Adherence to osteoporosis screening guidelines could be considerably higher if offered at the time of routine mammography using the same imaging modality. We found that forearm density measurements using a breast imaging system provides density information with excellent diagnostic capability for osteoporosis and osteopenia status determined by hip and spine DXA.</p><p><strong>Purpose: </strong>Adherence to osteoporosis screening guidelines via bone mineral density (BMD) measurements with dual-energy x-ray absorptiometry (DXA) is low. Since adherence to breast cancer screening is quite high, it was suggested that the rate of osteoporosis screening can be improved if wrist imaging were performed at the time of breast screening using the very same equipment.</p><p><strong>Methods: </strong>Digital wrist tomosynthesis (DWT) imaging was performed in 150 women using a 3D mammography system and BMD was measured from both 3D tomosynthesis and synthesized 2D images. In addition, standard DXA based BMD measurements were performed at the hip, spine, and forearm sites. We examined the extent to which DWT-derived ultradistal radius BMD correlates with DXA based BMD measurements, evaluated DWT measurement precision errors, and determined the accuracy of DWT in diagnosing low bone mass and osteoporosis in vivo.</p><p><strong>Results: </strong>DWT BMD strongly correlated with DXA-derived ultradistal radius BMD (R2 up to 0.814) and discriminated osteoporosis (AUC up to 0.978) and osteopenia (AUC up to 0.938) by ultradistal T-score with low in vivo precision errors (0.91-2.3%). BMD derived from 3D DWT BMD performed comparably to forearm DXA BMD in the diagnosis of osteopenia (AUC up to 0.916) and osteoporosis (AUC up to 0.946) determined by hip and spine DXA.</p><p><strong>Conclusions: </strong>DWT can be readily implemented in mammography settings with similar diagnostic accuracy to DXA, has the potential to increase adherence to osteoporosis screening recommendations, and offers a convenient means to measure bone density within the highly accessible breast screening environment.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1165-1173"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the time-dependent discriminatory accuracy of femoral strength and bone mineral density for predicting future hip and major osteoporotic fractures: a 16-year follow-up of the AGES-Reykjavik cohort.","authors":"Anitha D Praveen, Dheeraj Jha, Alexander Baker, Ingmar Fleps, Páll Björnsson, Lotta María Ellingsen, Thor Aspelund, Sigurdur Sigurdsson, Vilmundur Gudnason, Halldór Pálsson, David Matchar, Fjola Johannesdottir, Stephen J Ferguson, Benedikt Helgason","doi":"10.1007/s00198-025-07503-3","DOIUrl":"10.1007/s00198-025-07503-3","url":null,"abstract":"<p><p>The discriminative accuracy of femoral strength was significantly higher than that of aBMD over 16 years of follow-up for classifying hip fractures and major osteoporotic fractures. The use of accurate thresholds, whether for aBMD or other imaging-based biomarkers, is crucial to improve sensitivity and identify high-risk older adults.</p><p><strong>Background: </strong>Areal bone mineral density (aBMD) is a surrogate for bone strength but has limited prognostic value. Finite element (FE)-derived femoral strength offers a biomechanical alternative to aBMD for fracture risk assessment, but its long-term predictive value remains unclear. This study compared the discriminatory accuracy of aBMD and femoral strength for hip (HFs) and major osteoporotic fractures (MOFs) over 16 years, accounting for mortality risk.</p><p><strong>Methods: </strong>In the prospective Age Gene/Environment Susceptibility-Reykjavik (AGES-Reykjavik) Study, elderly participants underwent CT scans at entry and automated algorithms were used to compute aBMD and femoral strength. Time-dependent area under the receiver operating characteristic curves (AUC) was used to compare the predictive abilities of aBMD and femoral strength. Optimal cutoffs at the Youden's index were compared with the World Health Organization (WHO)-defined aBMD cutoffs at various time points.</p><p><strong>Results: </strong>The cohort comprised 4621 older adults (mean age 76 ± 5 years). Femoral strength had a significantly higher AUC than aBMD in identifying HFs (p < 0.05) from the 6th year in males and females, while their AUCs in predicting MOFs were similar. WHO-defined aBMD showed low sensitivity (17-52%) but high specificity (78-94%) for both HFs and MOFs. The sensitivity of optimal femoral strength was significantly higher than that of aBMD at comparable specificity by 5-19% for HFs and 2-10% for MOFs (p < 0.05).</p><p><strong>Conclusions: </strong>Both image-based markers predict long-term fracture risk and enable opportunistic screening with existing CT scans. However, femoral strength demonstrates better discriminatory accuracy than aBMD. The low sensitivity of the WHO-defined aBMD demonstrates the necessity to revise current risk assessment criteria.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1175-1184"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone microstructure and TBS in diabetes: what have we learned? A narrative review.","authors":"S Ferrari, K E Akesson, N Al-Daghri, E Biver, M Chandran, T Chevalley, R G Josse, D L Kendler, N E Lane, P Makras, C Meier, Ambrish Mithal, A Suzuki, S Vasikaran, D D Pierroz, W D Leslie","doi":"10.1007/s00198-025-07495-0","DOIUrl":"10.1007/s00198-025-07495-0","url":null,"abstract":"<p><p>Diabetes is associated with an increased risk of fracture. Areal bone mineral density (aBMD), the most reliable indicator of fracture risk in healthy adults, is low in patients with type 1 diabetes mellitus but normal or high in patients with type 2 diabetes mellitus. Most trabecular and cortical parameters measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) are lower in type 1 diabetes and higher in type 2 diabetes, in parallel with aBMD. In contrast, lumbar spine trabecular bone score (TBS) has been reported to be lower in women with both type 1 and type 2 diabetes. The discordance between improved bone microstructure and degraded TBS reflects the effect of central obesity (currently the subject of a revision to the TBS algorithm). Meanwhile, evidence supports use of TBS in conjunction with aBMD and/or FRAX for improved fracture prediction in patients with type T2D. This position paper, on behalf of the Bone and Diabetes Working Group of the International Osteoporosis Foundation, summarizes alterations in bone microarchitecture measured by HR-pQCT in diabetes. It also addresses the technical and clinical considerations of the trabecular bone score, particularly discussing the significance of this measurement in individuals with diabetes and the influence of abdominal fat.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1115-1128"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess subsequent fracture and mortality risk after ankle fractures: a relative survival analysis of the 45 and Up Study.","authors":"Weiwen Chen, Lyn M March, Fiona M Blyth, Dunia Alarkawi, Robert D Blank, Dana Bliuc, Thach Tran, Jacqueline R Center","doi":"10.1007/s00198-025-07400-9","DOIUrl":"10.1007/s00198-025-07400-9","url":null,"abstract":"<p><p>Ankle fractures are one of the common fractures that account for hospitalization. Ankle fractures were often thought of inconsequential as limited data on their long-term consequences. After accounting for age, sex, and time, ankle fractures were associated with increased risk of subsequent fracture and mortality.</p><p><strong>Background: </strong>Ankle fractures are common but it is uncertain whether they are indicative of poor bone health. There are limited data about subsequent fracture and mortality risk following ankle fractures.</p><p><strong>Objective: </strong>To determine if there is increased subsequent fracture and mortality risk after ankle fractures.</p><p><strong>Methods: </strong>A prospective population-based cohort of 143,070 women and 123,818 men in the 45 and Up Study (NSW, Australia) had baseline questionnaire responses that were linked to Emergency Department Data Collection (EDDC), the Admitted Patient Data Collection (APDC), and the NSW Registry of Births Deaths & Marriages death registrations from 2006 to 2017. Secure data access was provided through the Sax Institute's Secure Unified Research Environment (SURE). Sex-specific excess risks of subsequent fracture and mortality following ankle fractures were quantified using relative survival analysis.</p><p><strong>Results: </strong>During 1,490,651 person-years, women and men experienced 1379 and 579 ankle fractures and 78 deaths and 76 deaths, respectively. Ankle fractures were associated with a 5-year 5% (95% CI 3-8%) excess risk of subsequent fracture in both women and men, compared to subjects' risk of an incident fracture in the study. There was a 5-year cumulative excess mortality of 10% (95% CI 6-13%) following ankle fractures in men but no excess mortality in women compared to the overall cohort. Participants with ankle fractures who died were older (P < 0.001), more likely to have had a second fracture (P < 0.001), have had a prior fracture (P < 0.001), and have more comorbidities (P < 0.001).</p><p><strong>Conclusion: </strong>In the 45 and Up cohort, there was a modest but significant increased risk of fracture following ankle fracture seen in both women and men. In men, but not women, ankle fractures were associated with 10% excess mortality. Ankle fractures should be considered for secondary fracture prevention in those who are older and have more comorbidities.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1031-1038"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic indicators in medication-related osteonecrosis of the jaw: A systematic review and meta-analysis.","authors":"Ling-Ying Wei, Ching-Ming Chiu, Sang-Heng Kok, Hung-Ying Lin, Wei-Yih Chiu, Chih-Wei Yang, Jang-Jaer Lee","doi":"10.1007/s00198-025-07464-7","DOIUrl":"10.1007/s00198-025-07464-7","url":null,"abstract":"<p><p>Modulation of bone turnover by antiresorptive agents impairs wound healing of jaw bones, and can result in an adverse event termed medication-related osteonecrosis of the jaw (MRONJ). In recent years, the prevalence, risk factors, and prevention strategies for MRONJ have been extensively investigated, but only few studies have focused on its treatment outcome, and the proposed prognostic factors have varied greatly. We systematically reviewed the prognostic factors in patients undergoing treatment for MRONJ. In total, 33 studies met the inclusion criteria out of 1,388 screened citations. For analysis, we grouped the prognostic factors into five categories as follows: medication-related, underlying conditions, lesion-related, serum markers, and treatment modalities. Discontinuation of antiresorptive therapy was a medication-related factor significantly associated with better treatment outcomes. Regarding underlying conditions, malignancy, especially multiple myeloma, was associated with worse treatment outcomes. Among lesion-related factors, better treatment outcome was noted for maxillary lesions and lesions with sequestrum formation. By contrast, lesions of advanced stages and those with periosteal reaction had poor treatment outcomes. Regarding treatment modality, surgical therapy was associated with a better chance of healing. Results of our meta-analysis helped identify prognostic indicators of MRONJ and will assist in decision-making in the clinical setting. Based on our results, surgeons may have a better cognitive context to discuss treatment options with patients. Additionally, our findings provide convincing evidence for physicians to consider postponing antiresorptive therapy in patients with MRONJ lesions.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"969-979"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}