minocycline and Bone-Diseases

Minocycline black bone disease is a rare finding that can cause concern when unexpectedly encountered during routine arthroplasty. Prolonged minocycline use can cause selective staining of subchondral bone, whilst peri-articular soft tissue and cartilage appear uninvolved.. A systematic review according to PRISMA guidelines was performed to identify all reported cases in the literature.. Including the patient we present, eleven cases of minocycline black bone disease encountered during arthroplasty have been reported in the literature. All cases have had an excellent outcome, with no complications reported to date.. Minocycline black bone disease can be a concerning intra-operative finding when unexpectedly encountered during routine arthroplasty, but should not affect the operative plan. Surgeons should exclude alternative causes of bone discolouration when the history is unclear.

Topics: Anti-Bacterial Agents; Arthroplasty; Bone and Bones; Bone Diseases; Humans; Minocycline

Tetracyclines (TCs) are a class of broad-spectrum antibiotics with diverse pharmacotherapeutic properties due to their various functional groups being attached to a common core structure. Beyond their antibacterial activity, TCs trigger pleiotropic effects on eukaryotic cells, including anti-inflammatory and potentially osteogenic capabilities. Consequently, TCs hold promise for repurposing in various clinical applications, including bone-related conditions. This study presents the first comprehensive comparison of the in vitro osteogenic potential of four TCs-tetracycline, doxycycline, minocycline, and sarecycline, within human mesenchymal stem cells. Cultures were characterized for metabolic activity, cell morphology and cytoskeleton organization, osteogenic gene expression, alkaline phosphatase (ALP) activity, and the activation of relevant signaling pathways. TCs stimulated actin remodeling processes, inducing morphological shifts consistent with osteogenic differentiation. Osteogenic gene expression and ALP activity supported the osteoinduction by TCs, demonstrating significant increases in ALP levels and the upregulation of RUNX2, SP7, and SPARC genes. Minocycline and sarecycline exhibited the most potent osteogenic induction, comparable to conventional osteogenic inducers. Signaling pathway analysis revealed that tetracycline and doxycycline activate the Wnt pathway, while minocycline and sarecycline upregulated Hedgehog signaling. Overall, the present findings suggest that TCs promote osteogenic differentiation through distinct pathways, making them promising candidates for targeted therapy in specific bone-related disorders.

Topics: Anti-Bacterial Agents; Bone Diseases; Doxycycline; Hedgehog Proteins; Heterocyclic Compounds; Humans; Immunologic Factors; Mesenchymal Stem Cells; Minocycline; Osteogenesis; Tetracycline

Black bone disease refers to the hyperpigmentation of bone secondary to prolonged usage of minocycline. We present a report of a 34-year-old man who underwent femoral shaft fracture fixation complicated by deep infection requiring debridement. The implants were removed 10 months later after long-term treatment with minocycline and fracture union. A refracture of the femoral shaft occurred 2 days after implant removal and repeat fixation was required. Intraoperatively, abundant heavily pigmented and dark brown bone callus was noted over the old fracture site. There was no evidence of other bony pathology and the appearance was consistent with minocycline-associated pigmentation. As far as we are aware, this is the first case of black bone disease affecting callus within the interval period of bone healing. We also discuss the relevant literature on black bone disease to bring light on this rare entity that is an unwelcomed surprise to operating orthopaedic surgeons.

Topics: Adult; Anti-Bacterial Agents; Bone Diseases; Bony Callus; Debridement; Femoral Fractures; Fracture Fixation, Internal; Fracture Healing; Humans; Hyperpigmentation; Male; Minocycline; Reoperation; Surgical Wound Infection; Treatment Outcome

Black bone disease has been recognised as a potential consequence of long-term treatment with tetracycline antibiotics. Largely documented affecting structures in the head and skull, there are few reported cases of black bone disease in the foot and ankle. The case of a 55 years old patient, who as a teenager, had undergone treatment with minocycline hydrochloride for chronic acne, and was found to have bone discolouration consistent with minocycline induced black bone disease (MIBBD) during the course of hallux valgus corrective surgery some 40 years later, is presented. In spite of the intraoperative findings, the patient's post-operative recovery and bone healing was uneventful. The literature on minocycline induced black bone disease is reviewed.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Bone Diseases; Female; Hallux Valgus; Humans; Intraoperative Period; Middle Aged; Minocycline

Finding discolored bone intraoperatively can be confusing and concerning to orthopedic surgeons. Multiple causes of pigmented bone exist, including ochronosis, metabolic bone diseases, metal deposits, sequestrum, metastatic disease, and minocycline use. Bone quality is an important consideration in intraoperative decision making with respect to components and fixation options in total joint arthroplasty. Abnormal bone encountered in routine arthroplasty can raise concerns over the integrity and healing potential of the bone when the etiology is uncertain.Minocycline is a drug routinely used for the treatment of acne, rosacea, and rheumatoid arthritis. Pigmentation is a commonly recognized adverse reaction associated with most of the drugs in the tetracycline family, affecting the skin, nails, teeth, oral mucosa, bones in the oral cavity, ocular structures, cartilage, thyroid, and other visceral structures.This article describes a case of pigmented bone secondary to minocycline use in a 55-year-old woman undergoing total knee arthroplasty. This entity has rarely been documented in the orthopedic literature; however, orthopedic surgeons should be aware of this side effect secondary to the widespread use of minocycline. Questions concerning the effect of minocycline on bone metabolism and structural integrity have yet to be fully answered, but an understanding and recognition of the entity will help guide surgeons with intraoperative decision making.

Topics: Anti-Bacterial Agents; Arthroplasty, Replacement, Knee; Bone and Bones; Bone Diseases; Female; Humans; Incidental Findings; Middle Aged; Minocycline; Pigmentation Disorders; Treatment Outcome

Black bone disease is a rare manifestation of long term treatment with tetracyclines. We report the case of a patient who underwent surgery for bilateral hallux valgus and was found to have black discolouration of both first rays. This was subsequently related to previous long term Minocycline use. The unique features of this case relate to the location of the discolouration and the normal physical properties of the bone and soft tissues at surgery despite heavy pigmentation. Healing is now complete and follow-up at two years confirmed excellent clinical and radiological outcomes.

Topics: Anti-Bacterial Agents; Bone Diseases; Female; Hallux Valgus; Humans; Hyperpigmentation; Incidental Findings; Metatarsal Bones; Middle Aged; Minocycline; Toe Phalanges

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Bone Diseases; Humans; Male; Metacarpal Bones; Minocycline; Pigmentation Disorders

We report the case of a patient with a craniofacial black bone disease. This was discovered accidentally during a coronal approach.. A 38-year-old patient was referred to our unit for facial palsy having appeared 10 years before. Rehabilitation of the facial palsy was performed with a lengthening temporal myoplasty and lengthening of the upper eyelid elevator. An unusual black color of the skull was observed at incision of the coronal approach. Subperiostal dissection of skull and malars confirmed the presence of a black bone disease. A postoperative history revealed minocycline intake (200mg per day) during 3 years.. This craniofacial black bone disease was caused by minocycline intake. The originality of this case is to see directly the entire craniofacial skeleton black. This abnormal pigmentation may affect various organs or tissues. Bone pigmentation is irreversible unlike that of the mouth mucosa or of the skin. This abnormal pigmentation is usually discovered accidentally.

Topics: Adult; Anti-Bacterial Agents; Bone Diseases; Facial Bones; Humans; Male; Minocycline; Pigmentation Disorders; Skull

Topics: Adult; Anti-Bacterial Agents; Bone Diseases; Bone Plates; Color; Female; Femoral Fractures; Humans; Methicillin Resistance; Minocycline; Staphylococcal Infections

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Arthroplasty, Replacement, Knee; Bone Diseases; Diagnosis, Differential; Humans; Male; Minocycline; Osteoarthritis, Knee; Pigmentation Disorders

Minocycline-induced dark pigmentation has been described affecting the oral cavity (teeth, mucosa, alveolar bone), skin, nails, eyes and thyroid. To date, there is no report of other bones being affected. We report a case of black pigmentation of the acromian in a patient who had used minocycline on a long-term basis for acne rosecea. Biopsy of the iliac crest revealed that the pelvis was also affected.

Topics: Anti-Bacterial Agents; Bone Diseases; Diagnosis, Differential; Humans; Humerus; Male; Middle Aged; Minocycline; Pigmentation Disorders; Rosacea

The association of bone, tooth, nail and scleral pigmentation in a patient treated for acne with minocycline was noted. Hyperpigmentation appeared in old scar tissue, but not that present from recent surgical procedures.

Topics: Bone Diseases; Humans; Male; Middle Aged; Minocycline; Nail Diseases; Pigmentation Disorders; Skin Pigmentation; Tetracyclines; Tooth Discoloration