A new systematic review and meta-analysis led by Andrew Duckworth, Professor of Trauma and Orthopaedics at the Usher Institute, has found that commonly used osteoporosis medications do not delay fracture healing following acute fractures in adults. Osteoporosis increases the risk of fragility fractures following low-energy trauma. Common injuries include hip fractures, distal radius fractures and proximal humerus fractures, which are associated with morbidity and an increased risk of mortality. The risk of sustaining a second fragility fracture within one year of an initial fracture is reported to be over 4%, with a further increased risk of mortality associated with this. Bisphosphonates and teriparatide are used in the management of osteoporosis and to reduce fracture risk. However, there have been ongoing concerns that their effects on bone remodelling could impair fracture healing and delay fracture union. The study, a systematic review and meta-analysis of 28 randomised trials involving 5,085 patients, assessed the effects of anti-osteoporotic medications on fracture union and clinical outcomes in adults with acute fractures. The researchers found that bisphosphonates do not appear to affect the time to or rate of fracture healing. The findings suggest that bisphosphonates can be commenced or continued without concern that they will cause delayed or non-union of fractures in adult patients. The review also found that teriparatide does not appear to delay fracture healing and may even reduce the time to union for osteoporotic fractures, although further prospective evidence is required. The research also highlighted the variation in reporting across existing studies, including differences in drug agents, doses and outcomes assessed. The authors suggest that future research in this area should aim to standardise reporting to improve the quality and comparability of evidence. Our study provides reassuring evidence that commonly used osteoporosis medications, particularly bisphosphonates, do not delay fracture healing or increase the risk of non-union, addressing a longstanding among clinicians and patients. These findings support the early continuation or initiati concern on of osteoporosis treatment after a fragility fracture, while also suggesting that teriparatide may have the potential to accelerate healing, although further high-quality research is needed. Professor Andrew Duckworth Professor of Trauma and Orthopaedics, Usher Institute Cite as N Agarwal, K R Bell, L E Ross, N D Clement, S H Ralston, A D Duckworth, ‘The effects of anti-osteoporotic medication on fracture healing and outcomes: a systematic review and meta-analysis’, The Lancet Healthy Longevity, Volume 7, Issue 5, 2026, 100827, ISSN 2666-7568, https://doi.org/10.1016/j.lanhl.2026.100827 Further information Read the full paper at The effects of anti-osteoporotic medication on fracture healing and outcomes: a systematic review and meta-analysis |ScienceDirect This article was published on Thursday 18 June 2026
