Comparison of vitamin K, teriparatide, zoledronic acid and combination therapies for femoral fracture healing in osteoporosis rats

Objective: Osteoporosis is a disease characterized by decrease bone mineral density and micro-architectural deterioration of bone structure, which is characterized by decreased bone quality and increased fractures. It became an important public healt problem with the increase of the eldery population all over the world. In this study, we aimed to compare the results of Teriparatid, Zoledronic acid and vitamin K on osteoporotic rats. Materials and Methods: In this study we devided 50 female Sprague Dawley rats in 5 groups. After ovariectomy operation and administering subcutaneous Heparin 2 IU/kg dose for 4 weeks, osteoporosis ensued. Osteoporosis was proven by measuring bone mineral density. Bilateral femur shafts drilled to make a hole and nondeplaced fracture model rats. Group A was control group, group B and D Teriparatide were group, group C and E were Zoledronic acid group. Group A,B and C were fed with standart feed, group D and E were fed with vitamin K rich feed. After 4 weeks treatment, sacrification was performed. Right femur were seperated for histopathological evaluation and left femurs were seperated for biomechanic evaluation. For histopathologic evaluation, femurs were decalcified and the sections stained Hematoxlin-eosin ink and were evaluated under light microscope. Fracture healing was evaluated using the classification system described by Allen et al. For biomechanical evaluation, 3 point stress test and torsion stress test were applied to 10 femurs from each groups. Results: Teriparatide and Zoledronic acid groups found superior to the control group. The groups in which Vitamin K added to Teriparatid and Zoledronic acid treatment (D and E groups) were found superior to groups fed with standart feed (B and C groups) but it was not statistically significant. Conclusion: In our study, Teriparatid and Zoledronic acid found histopathological and biomechanical superior to control groups in fracture healing of osteporotic rats. But they have no significant statistically superiority to each other. Although, adding vitamin K to the treatment was histopathologically and biomechanically superior to fed with standart feed, there was no significant statistically differance.