Biophysical stimuli as potentialtreatment for osteoporosis

Osteoporosis is a disease characterized by diminished bone mass and deterioration of the bone microarchitecture leading to a higher susceptibility for fractures. The best known ‘osteoporotic fractures’ are those of the hip and vertebrae because these fractures have the most detrimental effects. However, other fragility fractures of the distal radius, humerus, ankle, pelvis, clavicula, and ribs account for 67% of all osteoporotic fractures and also significantly affect a patient’s wellbeing and performance, although generally for a shorter period of time. The incidence of osteoporotic fractures in the Netherlands is comparable to that in other West-European countries, which is higher than that in the USA for other (yet undetermined) reasons, that are most likely attributed to lifestyle factors. The incidence varies widely between sexes, ages, races and the existence of other risk factors such as glucocorticoid use, low body mass index, smoking, rheumatoid arthritis and previous fractures. In the Netherlands, two-thirds of the patients aged 55 years and older with a hip fracture are women. The incidence of a hip fracture strongly depends on age. In women aged 65-69 years the incidence is 1.6 per 1000, whereas in women aged 75-79 years it is 7.1 per 100010. In contrast to hip fractures, the incidence of wrist fractures does not rise with age. The incidence of wrist fractures in women older than 55 years is 6 in 1000, leading to more than 12,000 wrist fractures in women in the Netherlands annually. For vertebral fractures it is much harder to present incidence data because many vertebral fractures occur without any trauma, and at the moment of the fracture many patients do not seek medical help.