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Proton Pump Inhibitors and Bone Health

What the Orthopaedic Surgeon Needs to Know

Wagner, Scott C., MD1

doi: 10.2106/JBJS.RVW.18.00029
Review Articles

  • * Proton pump inhibitors (PPIs) are widely prescribed medications that are utilized for the treatment of gastroesophageal reflux and similar gastrointestinal disorders in all patient populations.
  • * There is evidence that prolonged use of PPIs can lead to osteoporosis and altered bone metabolism and can even affect developing bone in pediatric patients.
  • * There is evidence that the use of these medications increases the risk of fractures in pediatric and adult patients, including fragility fractures of the hip and spine in elderly patients.
  • * There is preclinical evidence that the use of PPIs can affect bone-healing after fracture, delaying callus formation and altering the biomechanics of healing bone.
  • * Orthopaedic surgeons, primary-care managers, and gastroenterologists should consider these risks when their patients are receiving prolonged PPI therapy, and the risks and benefits of PPI use should be taken into account when tailoring PPI use to each individual patient.

1Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, Maryland

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Written work prepared by employees of the Federal Government as part of their official duties is, under the United States Copyright Act, a “work of the United States Government” for which copyright protection under that Act is not available. As such, copyright protection does not extend to the contributions of employees of the Federal Government prepared as part of their employment. The views expressed in this manuscript are those of the authors and do not reflect the official policy of the Department of Navy, Department of Defense, or U.S. Government.
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