Intravenous bisphosphonates and vitamin D in the treatment of bone marrow oedema in professional athletes

TY - JOUR

T1 - Intravenous bisphosphonates and vitamin D in the treatment of bone marrow oedema in professional athletes

AU - Simon, Maciej J K

AU - Barvencik, Florian

AU - Luttke, Moritz

AU - Amling, Michael

AU - Mueller-Wohlfahrt, Hans-Wilhelm

AU - Ueblacker, Peter

N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.

PY - 2014/6/1

Y1 - 2014/6/1

N2 - INTRODUCTION: The goal of this retrospective study was to evaluate the safety and efficacy of ibandronate for bone marrow oedema (BMO) syndrome and stress fracture cases, and to demonstrate an additional field of therapeutic importance-the high-performance athlete.PATIENTS AND METHODS: This retrospective study included twenty-five high-performance athletes. Sixty per cent of the athletes were European soccer players and 40.0% other high-class international athletes (3 women and 22 men with an average age of 25.0±4.2), with BMO of the lower trunk or extremity diagnosed by magnetic resonance imaging (MRI). The treatment regimen consisted of high-dose vitamin D supplementation and intravenous ibandronate therapy.RESULTS: The time between the onset of pain and proper diagnosis of BMO was 106.3±104.1 days. Excellent pain reduction (pain at rest and under strain) and improved mobility was reported within the first two weeks after the first ibandronate administration by sixteen patients (64%). The time from first treatment until return to competition (RTC) was on average 102.6±65.2 days in total. If the time from onset of pain until diagnosis was within 40 days, the RTC was significantly reduced (p≤0.05) to almost 50% (63.8±48.1 days) when compared to the athletes with later diagnosis (124.4±63.2 days).CONCLUSIONS: The here-applied therapy regimen of intravenous BPs application and vitamin D supplementation in BMO syndrome has a beneficial effect for high-performance athletes. An early diagnosis and rapid treatment start can reduce the RTC significantly. An optimal bone metabolism with sufficient daily calcium and vitamin D intake is crucial and should not only be strived for the professional but also for the recreational athlete.

AB - INTRODUCTION: The goal of this retrospective study was to evaluate the safety and efficacy of ibandronate for bone marrow oedema (BMO) syndrome and stress fracture cases, and to demonstrate an additional field of therapeutic importance-the high-performance athlete.PATIENTS AND METHODS: This retrospective study included twenty-five high-performance athletes. Sixty per cent of the athletes were European soccer players and 40.0% other high-class international athletes (3 women and 22 men with an average age of 25.0±4.2), with BMO of the lower trunk or extremity diagnosed by magnetic resonance imaging (MRI). The treatment regimen consisted of high-dose vitamin D supplementation and intravenous ibandronate therapy.RESULTS: The time between the onset of pain and proper diagnosis of BMO was 106.3±104.1 days. Excellent pain reduction (pain at rest and under strain) and improved mobility was reported within the first two weeks after the first ibandronate administration by sixteen patients (64%). The time from first treatment until return to competition (RTC) was on average 102.6±65.2 days in total. If the time from onset of pain until diagnosis was within 40 days, the RTC was significantly reduced (p≤0.05) to almost 50% (63.8±48.1 days) when compared to the athletes with later diagnosis (124.4±63.2 days).CONCLUSIONS: The here-applied therapy regimen of intravenous BPs application and vitamin D supplementation in BMO syndrome has a beneficial effect for high-performance athletes. An early diagnosis and rapid treatment start can reduce the RTC significantly. An optimal bone metabolism with sufficient daily calcium and vitamin D intake is crucial and should not only be strived for the professional but also for the recreational athlete.

KW - Adult

KW - Athletes

KW - Bone Density

KW - Bone Density Conservation Agents

KW - Bone Marrow Diseases

KW - Diphosphonates

KW - Edema

KW - Female

KW - Fractures, Stress

KW - Humans

KW - Injections, Intravenous

KW - Magnetic Resonance Imaging

KW - Male

KW - Syndrome

KW - Treatment Outcome

KW - Vitamin D

U2 - 10.1016/j.injury.2014.01.023

DO - 10.1016/j.injury.2014.01.023

M3 - SCORING: Journal article

C2 - 24552768

VL - 45

SP - 981

EP - 987

JO - INJURY

JF - INJURY

SN - 0020-1383

IS - 6

ER -