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Introduction: Transient osteoporosis of the hip (TOH) is a rare, self-limiting disorder characterized by acute hip pain and reversible osteopenia. The aim of this study was to evaluate clinical outcomes following treatment with Neridronate, Clodronic Acid, Cholecalciferol, and pulsed electromagnetic field therapy (PEMF). Materials and Methods: A total of 45 patients presenting with non-traumatic hip pain were screened using a standardized diagnostic protocol. Magnetic resonance imaging (MRI) identified 8 patients (17.8%) with transient osteoporosis of the hip (TOH), who were subsequently enrolled in this analysis. Pain was evaluated using the Visual Analog Scale (VAS). Patients received a three-phase therapeutic protocol, including pharmacological therapy and PEMF. Clinical evaluations using the Harris Hip Score (HHS) were performed monthly, and follow-up MRI was conducted at the end of treatment. Results: We identified 8 cases of TOH (17.8%); the mean baseline HHS for these patients was 68.5 (range 51–83, SD 10.36). Pain reduction became evident within the first month of treatment. At the end of treatment, clinical improvement was observed in 7 patients, with mean HHS increasing to 88.0 (range 67–95, SD 8.84). Post-treatment MRI demonstrated complete resolution of bone marrow edema in all patients. One patient developed avascular necrosis despite therapy and required surgical intervention. Conclusions: TOH remains a controversial condition in terms of diagnosis and treatment. Early diagnosis and timely intervention are essential to progression to osteonecrosis. A combined therapeutic approach using bisphosphonates, vitamin D, and PEMF appears effective in reducing symptoms, promoting bone healing, and ensuring good patient compliance. Full article

Carbon nanotubes (CNTs) are applied in a drug delivery system, which can be reacted with different structures such biomolecules. Bones have vital functions and are the locations of biochemical reactions in cells that might be exposed various diseases. As different metal ions are integral components of bone tissue with different functions in the physiological cellular medium as well as in bone treatment, they can be used differently as a basis or as a supplement for various materials in the field of bone repair. Therefore, this research aims to represent the recent progress in conjugated bisphosphonate (BP)-divalent transition metal ions of Mn²⁺, Fe²⁺, and Co²⁺ with an emphasis on the properties of interaction with a (6, 6) armchair carbon nanotube as a nanocarrier to exhibit the potential biomedical application of drug delivery. In this article, “CNT” linked to “BP“ of alendronic acid, ibandronic acid, neridronic acid, and pamidronic acid, which are chelated to transition metal cations of Mn²⁺, Fe²⁺, and Co²⁺, was investigated based on DFT insights for obtaining the electron charge density. Transition metals chelating with phosphonate groups, which are large with six O atoms with negative charges, are active in generating chelated complexes with the bisphosphonates [BPs- Mn²⁺/Fe²⁺/Co²⁺] through the status of drug design. In this work, B3LYP/6-311+G(d,p)/lanl2dz we have estimated the susceptibility of CNT for conjugating alendronic acid, ibandronic acid, neridronic acid, and pamidronic acid, which are chelated to transition metal cations of Mn²⁺, Fe²⁺, and Co²⁺ through NMR, NQR, IR, UV-VIS spectroscopy, and HOMO-LUMO analysis. Finally, the obtained results have confirmed that the possibility of applying CNT and BPs of alendronic acid, ibandronic acid, neridronic acid, and pamidronic acid becomes suitable in transition metal chelating for delivery application. The calculated HOMO–LUMO energy gaps for BPs of alendronic acid, ibandronic acid, neridronic acid, and pamidronic acid at the B3LYP/6-311+G (d,p) level have revealed that the energy gap reflects the chemical activity of the molecule. Full article

Neridronate or ((6-amino-1-hydroxy-1-phosphonohexyl) phosphonic acid) is an amino-bisphosphonate (BP) synthetized in Italy in 1986. Bisphosphonates are molecules with a P-C-P bond in their structure that allows strong and selectively binding to hydroxyapatite (HAP) as well as osteoclasts inhibition through different mechanisms of action. Neridronate was initially used to treat Paget disease of the bone, demonstrating effectiveness in reducing bone turnover markers as well as pain. The interesting molecular properties of neridronate foster its wide use in several other conditions, such as osteogenesis imperfecta, and osteoporosis. Thanks to the unique safety and efficacy profile, neridronate has been used in secondary osteoporosis due to genetic, rheumatic, and oncological diseases, including in pediatric patients. In the last decade, this drug has also been studied in chronic musculoskeletal pain conditions, such as algodystrophy, demonstrating effectiveness in improving extraskeletal outcomes. This review highlights historical and clinical insights about the use of neridronate for metabolic bone disorders and musculoskeletal pain conditions. Full article