Osteoporosis: Advances in Diagnosis, Risk Assessment, Surgical Treatment, and Regenerative Therapies

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 30 June 2026 | Viewed by 789

Special Issue Editors


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Guest Editor
1. Department of Orthopaedic Surgery, Showa Medical University Northern Yokohama Hospital, Yokohama, Japan
2. Nonprofit Organization, Kanagawa Spine Research Society, Isehara, Kanagawa, Japan
Interests: orthopaedic surgery; spine surgery; bone tumor; osteoporosis

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Guest Editor
1. Department of Orthopaedic Surgery, Kitasato University School of Medicine, Kanagawa, Japan
2. Nonprofit Organization, Kanagawa Spine Research Society, Isehara, Kanagawa, Japan
Interests: orthopaedic surgery; spine surgery; osteoporosis

Special Issue Information

Dear Colleagues,

Osteoporosis is a leading cause of fragility fractures and consequent disability worldwide, yet it remains underdiagnosed and undertreated. Recent advances have expanded our understanding beyond bone mineral density. Novel diagnostic tools such as trabecular bone scores, vertebral bone quality assessment, high-resolution imaging, and circulating biomarkers, together with AI-driven risk prediction models, are improving our ability to detect disease and stratify fracture risk.

On the therapeutic side, new options are rapidly emerging. Beyond conventional antiresorptive and anabolic agents, monoclonal antibodies and dual-acting drugs such as romosozumab have transformed care, while regenerative strategies, including stem cell therapy, biomaterials, and tissue engineering, offer hope to patients.

Furthermore, surgical treatments for osteoporotic fractures—including those of the spine, proximal femur, distal radius, and proximal humerus—have evolved toward minimally invasive and biologically friendly approaches, such as percutaneous vertebral augmentation, minimally invasive fixation techniques, and expandable implants. These advances help reduce perioperative complications and facilitate early mobilisation, especially in elderly and frail patients.

Guidelines now emphasise personalised, evidence-based management, and real-world data are increasingly essential in evaluating effectiveness, safety, and adherence in a wide range of populations. Importantly, osteoporosis often coexists with frailty and sarcopenia, requiring an integrated, interdisciplinary approach in order to improve outcomes in ageing patients.

For this Special Issue, “Osteoporosis: Advances in Diagnosis, Risk Assessment, Surgical Treatment, and Regenerative Therapies”, we welcome contributions from around the world, including both original research articles and reviews, that can help advance precision medicine and long-term management for individuals at risk of osteoporotic fractures.

Dr. Yusuke Oshita
Dr. Takayuki Imura
Guest Editors

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Keywords

  • osteoporosis
  • fragility fracture
  • bone mineral density (BMD)

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Published Papers (1 paper)

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Research

11 pages, 728 KB  
Article
Association of Standing Sacral–Abdominal Wall Distance and Android/Gynoid Fat Distribution with Locomotive Syndrome in Older Women
by Takashi Nagai, Takako Tachikawa, Eriko Hoshi, Yu Nishida, Hanae Nomura, Mizuki Sugiyama, Fumihito Kasai, Yoshifumi Kudo and Nobuyuki Kawate
Medicina 2026, 62(4), 674; https://doi.org/10.3390/medicina62040674 - 1 Apr 2026
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Abstract
Background: Locomotive syndrome (LS) is a major cause of mobility impairment and loss of independence in older adults. Abdominal morphology and patterns of body fat distribution are thought to affect physical function; however, their relationships with the severity of LS in women with [...] Read more.
Background: Locomotive syndrome (LS) is a major cause of mobility impairment and loss of independence in older adults. Abdominal morphology and patterns of body fat distribution are thought to affect physical function; however, their relationships with the severity of LS in women with osteoporosis remain insufficiently characterized. Standing sacral–abdominal wall distance (SAD) is considered an indicator of compromised trunk support mechanisms, whereas the android/gynoid fat ratio (A/G ratio) primarily reflects body fat distribution patterns. Methods: This retrospective cross-sectional study included 221 women aged 65 years or older attending an osteoporosis outpatient clinic. LS was assessed using the stand-up test, the two-step test, and the Locomo 25 questionnaire according to official criteria. The most severe stage among the three tests was defined as the overall LS stage, and participants were classified into LS stage 0–1 and LS stage ≥ 2 groups. Associations of SAD and the A/G ratio with LS were examined using multivariable logistic regression analysis adjusted for age, skeletal muscle mass index (SMI), femoral neck T-score, and the Controlling Nutritional Status (CONUT) score. Results: Among the participants, 93 (42.1%) were classified as having LS stage ≥ 2. The LS stage ≥ 2 group had a significantly greater SAD than the LS stage 0–1 group (median, 167.3 mm vs. 154.6 mm; p < 0.001), whereas no significant difference was observed in the A/G ratio (p = 0.054). In multivariable analyses (n = 208), SAD was independently associated with LS stage ≥ 2 (odds ratio per 1 mm increase, 1.035; 95% confidence interval, 1.016–1.054; p < 0.001), corresponding to an odds ratio of 1.41 per 10 mm increase. The A/G ratio also showed an independent association, while no significant interaction between SAD and the A/G ratio was observed. Conclusions: In women with osteoporosis, SAD was independently associated with LS severity, reflecting mobility impairment from a perspective distinct from body fat distribution. SAD may serve as a simple and clinically useful indicator for assessing the risk of severe LS. Full article
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