Effects of Bisphosphonates on Osteotomy Healing in Osteogenesis Imperfecta: A Case Series

Introduction: Bisphosphonates have become the standard drugs for the medical management of patients with moderate-to-severe forms of osteogenesis imperfecta (OI). This study was undertaken to study the effect of parenteral pamidronate or oral alendronate therapy, on bone healing after osteotomies in patients with moderately severe forms (Sillence type 4) of OI.

Materials and methodology: We retrospectively evaluated the effects of bisphosphonate therapy on the healing of seven osteotomies in five patients of OI (Sillence type 4) who underwent Sofield Millar procedure for deformity correction and non-union of long bone fractures.

Results: The patients were evaluated clinically and radiologically for the time taken for osteotomy healing and the radiological pattern of osteotomy healing. The minimum clinico-radiological follow-up period was 2 years and the mean follow-up period was 3.9 years (range 2-7 years). The mean time taken for the osteotomy to heal in the patients receiving bisphosphonates was 10.4 months (range 8-12 months) and the union was achieved without the typical exuberant callus formation. Periosteal new bone formation was uniquely absent.

Conclusion: We infer from our findings that bisphosphonate therapy in OI patients is associated with a different pattern of osteotomy healing and delay in healing of osteotomy.