Kost a hormonální vlivy v průběhu životaMain theme

prof. MUDr. Tomáš Fait, Ph.D.

Clin Osteol 2026; 31(2): 72

Několik slov úvodemEditorial

prof. MUDr. Vladimír Palička, CSc., Dr.h.c.

Clin Osteol 2026; 31(2): 71

Latest research and news in osteologyLiterature

Emőke Šteňová

Clin Osteol 2026; 31(2): 117-118

Lesions of the anterior cruciate ligament in children and adolescentsReview articles

Matúš Halas, Pavol Rendek, Paulína Kubíčková, Jana Bevilaqua, Martina Frištáková, Milan Kokavec

Clin Osteol 2026; 31(2): 111-115 | DOI: 10.36290/clo.2026.017

Anterior cruciate ligament (ACL) injuries in children and adolescents are among the most common types of knee injuries associated with dynamic sports activities. Incorrect treatment and inappropriate choice of surgical technique can lead to further damage to the knee joint, possibly to the development of secondary osteoarthritis. This work is based on the author's dissertation and the aim of this work is to summarize current knowledge and options for surgical treatment of ACL lesions in children and adolescents.

Spinal fractures in ankylosing spondylitisReview articles

Luděk Ryba, Richard Chaloupka, Dominik Parížek

Clin Osteol 2026; 31(2): 105-110 | DOI: 10.36290/clo.2026.016

Ankylosing spondylitis (AS, Morbus Bechterew) is a chronic inflammatory disease of the axial skeleton leading to progressive spinal ankylosis and secondary osteoporosis. The combination of a rigid spine and impaired bone quality markedly increases the risk of spinal fractures, which often occur even after low-energy trauma. These fractures are typically highly unstable, involve all three spinal columns, and are associated with a significant risk of neurological complications and increased mortality. Conservative treatment is frequently burdened by secondary displacement and failure of immobilization, therefore surgical stabilization represents the...

The impact of patient adherence on the efficacy of osteoporosis pharmacotherapyOriginal contributions

Mária Kolesárová, Ľudmila Pavlíková, Dana Marcinčáková, Zuzana Mačeková, Dalibor Kolesár, Ladislav Seman, Ján Kyselovič

Clin Osteol 2026; 31(2): 97-104 | DOI: 10.36290/clo.2026.015

Background: Clinical trials demonstrate that osteoporosis pharmacotherapy reduces fracture incidence by approximately 50%. However, this therapeutic benefit may be severely compromised by sub-optimal patient adherence in real-world clinical practice. The primary objective of this retrospective study was to evaluate the long-term efficacy of osteoporosis pharmacotherapy and assess patient adherence levels using the ADEOS-12 questionnaire, with a specific focus on analysing the correlation between adherence scores and objective clinical outcomes, including bone mineral density (BMD) and biochemical bone turnover markers. Methods: Medication adherence...

Gynecologists in caring for bone health in women with breast cancerMain theme

Stefánia Faitová, Tomáš Fait

Clin Osteol 2026; 31(2): 91-96 | DOI: 10.36290/clo.2026.014

Breast cancer is the most common malignancy in women. Therapeutically induced hypoestrogenism may lead to significant bone loss and a consequent increase in fracture risk. Antiresorptive treatment of osteoporosis (bisphosphonates and denosumab) plays an important role in mitigating bone loss induced by anticancer therapy. Currently, evidence supports the use of bisphosphonates as adjuvant therapy to prevent metastasis and recurrence of the disease. Unfortunately, bone health care in women with breast cancer is often not prioritized, leaving this group of patients vulnerable to significant bone loss and subsequent fractures.

Anorexia nervosa and bone healthMain theme

Pavla Jelínková

Clin Osteol 2026; 31(2): 87-90 | DOI: 10.36290/clo.2026.013

Mental anorexia represents a serious psychiatric disorder with significant somatic complications. One of the most serious is a disorder of bone metabolism leading to a decrease in bone mineral density, disruption of bone microarchitecture, and an increased risk of fractures. Adolescence is a critical period for the accumulation of bone mass and the achievement of peak bone density. Energy deficit and hormonal dysregulation lead to disruption of the physiological process of bone formation and remodeling, resulting in a lifelong increased risk of osteoporosis. The aim of this review article is to summarize current knowledge on the pathophysiology of...

Tibolone and the bone healthMain theme

Tomáš Fait

Clin Osteol 2026; 31(2): 84-86 | DOI: 10.36290/clo.2026.012

Hormone replacement therapy is the most effective treatment for acute climacteric syndrome and prevention of chronic changes from estrogen deficiency. Tibolone as a selective regulator of tissue estrogenic activity is the only alternative of comparable efficacy with an excellent safety profile. It achieves better results in the area of influencing the psyche and sexuality of postmenopausal women and in some safety parameters (reduces mammographic density). Its effect on bone health is comparable to hormone replacement therapy.

Menopausal hormone therapy and bone healthMain theme

Lukrécia Tatárová

Clin Osteol 2026; 31(2): 78-82 | DOI: 10.36290/clo.2026.011

Menopause is a physiological phase in a woman's life that is associated not only with the occurrence of vasomotor and urogenital symptoms, but also with significant long term health consequences, particularly affecting skeletal, cardiovascular, and cognitive health. Declining estrogen levels lead to accelerated bone loss, which may result in the development of osteoporosis. Menopausal hormone therapy (MHT) represents the most effective treatment for vasomotor symptoms and the genitourinary syndrome of menopause, while also serving as an effective strategy for the prevention of postmenopausal bone loss. Numerous randomized controlled trials and metaanalyses...

Progestin only contraception and bone healthMain theme

Vlasta Dvořáková

Clin Osteol 2026; 31(2): 76-77 | DOI: 10.36290/clo.2026.010

Progestin only contraception is often chosen for women with a higher cardiovascular risk. The intrauterine system with levonorgestrel is completely neutral to bone metabolism. Progestin only pills with desogestrel or drospirenone also have no negative effect on bone health. In contrast the use of depot medroxyprogesterone acetate reduces bone mineral density.

Onkologie a kostMain theme

prof. MUDr. Pavel Horák, CSc.

Clin Osteol 2026; 31(1): 06

Několik slov úvodemEditorial

prof. MUDr. Vladimír Palička, CSc., Dr.h.c.

Clin Osteol 2026; 31(1): 03

Latest research and news in osteologyLiterature

Emőke Šteňová

Clin Osteol 2026; 31(1): 65-66

Diagnosis and treatment of osteoporotic vertebral fracturesReview articles

Martin Bibza, Michal Božík, Mário Malina, Boris Šteňo

Clin Osteol 2026; 31(1): 55-64 | DOI: 10.36290/clo.2026.008

Osteoporotic vertebral compression fractures represent the most common clinical manifestation of osteoporosis and a major cause of morbidity in the elderly population. Successful management requires accurate identification of fractures, differentiation between acute and chronic fractures, assessment of stability, and comprehensive evaluation of functional status and frailty. The AO Spine-DGOU classification and Osteoporotic Fracture (OF) score provide a structured framework for assessing fracture morphology and guide decision-making between conservative treatment and surgical procedures. Conservative therapy is appropriate for stable fractures without...

Importance of B vitamins for the neuromusculoskeletal systemReview articles

Milan Grofik, Katarína Kramár

Clin Osteol 2026; 31(1): 49-52 | DOI: 10.36290/clo.2026.007

The B vitamins represent a chemically heterogeneous group of eight hydrophilic essential compounds. In the human body, they play an important role as coenzymes in various cellular reactions. The B vitamins have long been known for their irreplaceable role in the proper functioning of the nervous system, but in recent years, scientific knowledge has been increasing supporting their important role in maintaining the physiological functions of the muscular and skeletal systems. They are also necessary for adequate regeneration of damaged musculoskeletal tissues in various disease states. Data from "Evidence-Based Medicine" postulate them as effective...

An optimized protocol for RNA and microRNA isolation from human mineralized femoral neck bone tissueOriginal contributions

Květa Vrablíková, Marcela Slavíčková, Helena Párová, Petr Hoza

Clin Osteol 2026; 31(1): 45-48 | DOI: 10.36290/clo.2026.006

Low-trauma proximal femur fractures are among the most serious complications of osteoporosis. MicroRNAs regulate bone remodeling and cellular senescence, yet extracting high-quality RNA from mineralized human bone remains technically challenging and insufficiently standardized. This study aimed to develop and optimize a reproducible protocol for collecting and processing femoral neck bone biopsies obtained during total hip arthroplasty, enabling isolation of total RNA including the small RNA fraction (< 200 nt) and subsequent targeted expression analysis of specific microRNAs. Forty-six patients were enrolled (21 osteoporotic fractures, 25 osteoarthritis)....

Tumor-induced osteomalacia - a rare cause of hypophosphatemia in patients at an osteology clinicMain theme

Henrieta Halmová, Filip Halm, Peter Sečník, Andrej Vondrák, Ján Koreň, Mojmír Ducár

Clin Osteol 2026; 31(1): 36-44 | DOI: 10.36290/clo.2026.005

Tumour-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by benign tumours of the mesenchymal origin. It is characterized by the excessive production of fibroblast growth factor 23 (FGF23), which subsequently leads to hypophosphatemia and osteomalacia. In the article, we present a case report of the 57-year-old female patient who, after a relatively protracted diagnostic process, was diagnosed with TIO caused by the benign tumor of mesenchymal origin, called sinonasal glomangiopericytoma. In this case report, we further discuss the pathophysiology of a hypophosphatemic osteomalacia, its differential diagnosis and the treatment options...

Comprehensive overview of bone disease in oncology patientsMain theme

Beata Špániková

Clin Osteol 2026; 31(1): 26-34 | DOI: 10.36290/clo.2026.004

The issue of bone changes in cancer patients an interesting and important part of supportive care for cancer patients. The incidence of many cancers is increasing, thanks to advances in treatment options, many cancer patients are surviving for a long time. Decrease in bone density is often result of the cancer disease itself and/or adverse event of anticancer therapy. Therefore, solving this problem is of great importance for the quality of life of long-term survivors. In this article we present an overview of the most common skeletal complications, their underlying pathophysiological mechanisms, diagnostic and differential diagnostic and the therapeutic...

Management of osteoporosis and fracture risk in women with hormone-sensitive breast cancer treated with aromatase inhibitors: a working draft of updated clinical practice recommendationsMain theme

Dana Michalská, Martina Zimovjanová, Jana Přibylová, Dominika Svobodová, Vít Zikán

Clin Osteol 2026; 31(1): 16-24 | DOI: 10.36290/clo.2026.003

Adjuvant therapy with aromatase inhibitors (AIs) is a standard component of treatment for hormone-sensitive breast cancer; however, it is associated with accelerated bone mineral density loss and an increased risk of osteoporosis and fractures. Current international recommendations emphasize the need for systematic fracture risk assessment both at the initiation of AI therapy and throughout its course, as well as for the timely implementation of preventive and therapeutic measures. In all patients, lifestyle and nutritional interventions are recommended, including regular physical activity, adequate calcium intake, and vitamin D supplementation. Antiresorptive...

Bone mestastases - a comprehensive overviewMain theme

Martin Marhefka, Aviv Philip Goncharov, Elad Ben Aharon Farzalla, Martina Spisarová, Bohuslav Melichar

Clin Osteol 2026; 31(1): 12-15 | DOI: 10.36290/clo.2026.002

Bone is one of the organs most commonly affected in patients with cancer. The skeletal involvement can be primary or secondary (metastatic), with bone metastases present in up to 70-80 % of all malignancies. In approximately 80 % of patients, bone metastases are caused by four primary tumours: breast, lung, renal and prostatic carcinoma. That is due to both the high incidence and the preference of these tumours to invade into the skeleton. The diagnosis of bone metastases is based on the clinical presentation, laboratory parameters, and confirmatory imaging methods. Subsequent therapy which includes chemotherapy, immunotherapy, hormone therapy, supportive...

Primary bone tumours: An Orthopaedic PerspectiveMain theme

Jiří Gallo, Tomáš Tomáš

Clin Osteol 2026; 31(1): 7-11 | DOI: 10.36290/clo.2026.001

Primary bone tumors represent a heterogeneous and relatively rare group of lesions whose biological behavior ranges from benign incidental findings to highly malignant sarcomas. The WHO classification (2020) categorizes tumors according to histogenesis (osteogenic, chondrogenic, etc.); however, for clinical practice, the key distinction is between benign, intermediate (locally aggressive and, in rare cases, metastasizing), and malignant lesions. A crucial clinical task is early triage: to distinguish lesions suitable for observation or elective treatment from suspected malignancies requiring urgent further evaluation and management in a specialized...

Kostní metabolismus u chorob gastrointestinálního traktu – váhový úbytek a střevní mikrobiom v centru pozornostiEditorial

doc. MUDr. Ludmila Brunerová, Ph.D.

Clin Osteol 2025; 30(4): 187

Několik slov úvodemEditorial

Vladimír Palička

Clin Osteol 2025; 30(4): 190

Latest research and news in osteologyLiterature

Emőke Šteňová

Clin Osteol 2025; 30(4): 232-233

Biosimilar denosumab - a new chapter in the treatment of bone diseasesSaid at the congress

doc. MUDr. Karel Urbánek, Ph.D., prof. MUDr. Vladimír Palička, CSc., dr.h.c., prof. MUDr. Karel Pavelka, DrSc.

Clin Osteol 2025; 30(4): 226-231

Biosimilar medicines, which are biologically similar to the reference product, although not identical copies, reduce the cost of biological treatment and make it possible to expand the number of patients who can receive it. There is sufficient evidence that the efficacy of biosimilar medicines does not differ from that of the original biological products and that switching from the original medicine to a biosimilar, as well as between biosimilars, is not only feasible but also safe.

An unusual cause of hypercalcemia from an endocrinologist's perspectiveCase reports

Lucie Lysková, Daniela Číhalíková, David Karásek, Jaroslav Michálek

Clin Osteol 2025; 30(4): 221-224 | DOI: 10.36290/clo.2025.036

Calcium is an essential element that plays a crucial role in bone mineralization, neuromuscular transmission, and is involved in many cellular signaling processes. Its serum concentration (total albumin-corrected concentration) should range between 2.15 and 2.55 mmol/L and is strictly regulated by several mechanisms. Hypercalcemia is defined as an elevated level of serum calcium above 2.55 mmol/L. It has various causes, ranging from parathyroid gland dysfunction, most commonly in the form of primary hyperparathyroidism, through granulomatous diseases, to serious malignancies with skeletal invasion or paraneoplastic syndromes, such as ectopic production...

Bone in the gynecology clinicReview articles

Tomáš Fait, Vlasta Dvořáková

Clin Osteol 2025; 30(4): 216-220 | DOI: 10.36290/clo.2025.035

The logical reason for linking gynecology with bone health care is the importance of estrogen for achieving optimal bone density and its dominant role in the prevention of postmenopausal osteoporosis. Bone health can thus be influenced by the choice of contraception, proper care for women with premature ovarian failure, rational choice of hormone replacement therapy during menopause, and early calcium and vitamin D supplementation in women at risk of osteoporosis. The role of gynecologists in bone health care has been confirmed by their current involvement in the screening and treatment of osteoporosis as primary care physicians.

Pain management in patients with osteoporosisReview articles

Jana Hrubešová, Pavel Ryška

Clin Osteol 2025; 30(4): 210-215 | DOI: 10.36290/clo.2025.034

Osteoporosis is characterized by the loss of bone mass, increased bone fragility, and a higher risk of fractures. It can remain asymptomatic for a long time, but once musculoskeletal changes develop, pain often occurs. Pain is one of the most distressing symptoms of osteoporosis and, if not properly managed, can significantly reduce a patient's quality of life and limit their functional abilities. Effective pain management should be an essential part of a comprehensive treatment plan for patients with this condition. When standard analgesic treatments are insufficient, minimally invasive techniques may be considered, offering rapid and effective pain...

Management of osteoporosis in childrenReview articles

Ľubica Tichá, Ľudmila Podracká

Clin Osteol 2025; 30(4): 203-208 | DOI: 10.36290/clo.2025.033

Osteoporosis in childhood is a rare but serious condition characterized by reduced bone density and increased susceptibility to fractures. Primary (genetically determined) disorders account for only a small proportion of cases, while up to 98% develop secondarily in association with another underlying disease. Diagnosis is based on clinical presentation, fracture history, and measurement of bone mineral density using Dual Energy X-ray Absorptiometry (DXA). In children, it is essential to adjust the Z-score for current height to ensure accurate interpretation of the results. Treatment requires a multidisciplinary approach focused on managing the underlying...