METHODS article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicDiagnosis and Treatment in Age-related musculoskeletal disordersView all 19 articles
The Minimally Invasive Surgical Local Osteo-Enhancement Procedure (LOEP) to Deliver a Resorbable, Tri-phasic Calcium-Based Implant Material to Address Bone Loss and Strengthen the Proximal Femur
Provisionally accepted
- 1Wermelskirchen Hospital, Department of Orthopaedics and Trauma Surgery, Wermelskirchen, Germany
- 2VITAZ Sint-Niklaas, Sint-Niklaas, Belgium
- 3Aarhus University Hospital, Department of Orthopaedics and Traumatology, Aarhus, Denmark
- 4Hospital Clinico Universitario de Valladolid, Department of Orthopedics and Trauma, Valladolid, Spain
- 5Agnovos Healthcare LLC, Rockville MD, United States
- 6AgNovos Healthcare, Rockville, United States
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With global population growth and advancing age, fragility fractures present a major healthcare challenge that current approaches have not resolved. Although pharmacological agents have been shown to reduce fragility fracture risk, there remain unmet needs in clinical care, especially for patients at imminent risk of hip fracture, given the delay between treatment initiation and observed protective effect. This gap suggests a need for novel approaches, including hip procedures that strengthen bone locally and quickly. The purpose of this report is to describe a procedural technique that has been shown in ex vivo and clinical studies to rapidly enhance proximal femur biomechanical properties and leads to new bone formation. Local osteo-enhancement procedure (LOEP) is a minimally invasive surgical procedure to address bone voids in the pelvis and extremities, including in the proximal femur, due to trauma and disease such as osteoporosis. After surgical preparation of voids within the femoral neck and intertrochanteric regions of the proximal femur, a resorbable, triphasic, calcium-based implant material, AGN1, is delivered to that site. Clinical studies demonstrate consistent implant material resorption, concurrent replacement of the material with bone, and a significant, durable increase in areal bone mineral density (aBMD). The procedural technique has been studied as a standalone procedure and as concomitant surgery taking place in the same operative session as the surgical treatment of a contralateral index hip fragility fracture. In the study of concomitant use, LOEP was reported not to disrupt the standard of care for mobilization and rehabilitation for hip fracture. The clinical studies completed suggest that the procedure demonstrates an acceptable safety profile and has the potential to reduce the incidence of hip fragility fractures.
Keywords: Osteoporosis, augmentation, osteo-enhancement, Biomechanics, Femoroplasty, Hip fracture, prevention, LOEP
Received: 07 Jul 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Goost, De Schepper, Rölfing, Aguado, Howe and Huber. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hans Goost
Jo De Schepper
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