Efficacy of Alendronate in Preventing Periprosthetic Bone Loss after Implantation of a Primary Hip Endoprosthesis

Ilir Shabani; Milan Samardziski; Viktor Kamnar; Nenad Atanasov; Milena Bogojevska-Doksevska; Danica Popovska; Anila Belchishta

doi:10.3889/oamjms.2022.6537

Authors

Ilir Shabani Department of Orthopedic Surgery, University Clinic “Mother Theresa”, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
Milan Samardziski Department of Orthopedic Surgery, University Clinic “Mother Theresa”, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
Viktor Kamnar Department of Orthopedic Surgery, University Clinic “Mother Theresa”, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
Nenad Atanasov Department of Orthopedic Surgery, University Clinic “Mother Theresa”, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
Milena Bogojevska-Doksevska Department of Orthopedic Surgery, University Clinic “Mother Theresa”, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
Danica Popovska Department of Orthopedic Surgery, University Clinic “Mother Theresa”, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia
Anila Belchishta Department of Orthopedic Surgery, University Clinic “Mother Theresa”, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2022.6537

Keywords:

Total hip arthroplasty, Alendronate therapy, Dual energy X-ray absorption

Abstract

Total hip arthroplasty (THA) is now the gold standard for the surgical treatment of coxarthrosis. The appearance of bone loss after implantation of the hip endoprosthesis over time reduces the primary stability of the implant and leads to progressive looseningof the implant, or periprosthetic fracture, which are considered to be the most common causes of hip revision.

The aim of this study is to evaluate the value of alendronate application in reducing periprosthetic osteolysis reduction after implantation of total cementless hip endoprosthesis.

The study analyzed 50 patients operated on with implantation of a cementless total hip arthroplasty (THA). The first group of 25 patients recieved oral alendronate, calcium and vitamin D3 postoperatively. The second group of 25 patients were examined and followed postoperatively without any therapy.

Patients were examined by RTG and DXA methods at 6, 12 and 18 months.

The study showed a difference in the values of bone mineral density (BMD) and bone mineral content (BMC) in the interval of 6,12 and 18 months, using the DXA method.

Alendronate therapy after total hip implantation reduces periprosthetic bone loss, maintains bone mineralization and strengthens the implant

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Harris WH, Sledge CB. Total hip and total knee replacement. N Engl J Med. 1990;323(11):7. https://doi.org/10.1056/nejm199009133231106 DOI: https://doi.org/10.1056/NEJM199009133231106

Engh CA, Culpepper WJ, Engh CA, Virginia A. Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg. 1997;79(2):177-84. https://doi.org/10.2106/00004623-199702000-00003 PMid:9052537 DOI: https://doi.org/10.2106/00004623-199702000-00003

Xenos JS, Callaghan JJ, Heekin RD, Hopkinson WJ, Savory CG, Moore MS. The porous-coated anatomic total hip prosthesis, inserted without cement. A prospective study with a minimum of ten years of follow-up. J Bone Joint Surg. 1999;81(1):74-82. https://doi.org/10.2106/00004623-199901000-00011 PMid:9973057 DOI: https://doi.org/10.2106/00004623-199901000-00011

Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780-5. https://doi.org/10.2106/jbjs.f.00222 PMid:17403800 DOI: https://doi.org/10.2106/JBJS.F.00222

Venesmaa PK, Kpoger HP, Miettinen HJ, Jurvelin JS, Suomalainen OT, Alhava EM. Monitoring of periprosthetic BMD after uncemented total hip arthroplasty with dual-energy X-ray absorptiometry a 3-year follow-up study. J Bone Miner Res. 2001;16(6):1056-61. https://doi.org/10.1359/jbmr.2001.16.6.1056 PMid:11393782 DOI: https://doi.org/10.1359/jbmr.2001.16.6.1056

Lindahl H. Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury. 2007;38(6):651-4. https://doi.org/10.1016/j.injury.2007.02.048 PMid:17477925 DOI: https://doi.org/10.1016/j.injury.2007.02.048

Kobayashi S, Saito N, Horiuchi H, Iorio R, Takaoka K. Poor bone quality or hip structure as risk factors affecting survival of total-hip arthroplasty. Lancet. 2000;355(9214):1499-504. https://doi.org/10.1016/s0140-6736(00)02164-4 PMid:10801171 DOI: https://doi.org/10.1016/S0140-6736(00)02164-4

Havelin LI, Engesæter LB, Espehaug B, Furnes O, Lie SA, Vollset SE. The Norwegian arthroplasty register 11 years and 73,000 arthroplasties. Acta Orthop Scand. 2000;71(4):17. https://doi.org/10.1080/000164700317393321 PMid:11028881 DOI: https://doi.org/10.1080/000164700317393321

de Steiger RN, Miller LN, Prosser GH, Graves SE, Davidson DC, Stanford TE. Poor outcome of revised resurfacing hip arthroplasty. Acta Orthop. 2010;81(1):72-6. https://doi.org/10.3109/17453671003667176 PMid:20170416 DOI: https://doi.org/10.3109/17453671003667176

Morris CD, Einhorn TA. Current concepts review-bisphosphonates in orthopaedic surgery. J Bone Joint Surg. 2005;87:10. DOI: https://doi.org/10.2106/JBJS.D.03032

Woolf AD, Åkesson K. Preventing fractures in elderly people. Br Med J. 2003;327(7406):89-95. PMid:12855529 DOI: https://doi.org/10.1136/bmj.327.7406.89

Wells VM, Hearn TC, McCaul KA, Anderton SM, Wigg AE, Graves SE. Changing incidence of primary total hip arthroplasty and total knee arthroplasty for primary osteoarthritis. J Arthroplast. 2002;17(3):267-73. https://doi.org/10.1054/arth.2002.30414 DOI: https://doi.org/10.1054/arth.2002.30414

Sibanda N, Copley LP, Lewsey JD, Borroff M, Gregg P, MacGregor AJ, et al. Revision rates after primary hip and knee replacement in England between 2003 and 2006. PLoS Med. 2008;5(9):11. https://doi.org/10.1371/journal.pmed.0050179 PMid:11938500 DOI: https://doi.org/10.1371/journal.pmed.0050179

Zhao X, Hu D, Qin J, Mohanan R, Chen L. Effect of bisphosphonates in preventing femoral periprosthetic bone resorption after primary cementless total hip arthroplasty: A meta-analysis. J Orthop Surg Res. 2015;10:65. https://doi.org/10.1186/s13018-015-0206-8 PMid:25962791 DOI: https://doi.org/10.1186/s13018-015-0206-8

Knusten AR, Ebramzadeh E, Longjohn DB, Sangiorgio SN. Systematic analysis of bisphosphonate intervention on periprosthetic BMD as a function of stem design. J Arthroplast. 2014;29(6):1292-7. https://doi.org/10.1016/j.arth.2014.01.015 PMid:24703781 DOI: https://doi.org/10.1016/j.arth.2014.01.015

Bhandari M, Bajammal S, Guyatt GH, Griffith L, Busse JW, Schunemann H, et al. Effect of bisphosphonates on periprosthetic bone mineral density after total joint arthroplasty. A meta-analysis. J Bone Joint Surg. 2005;87:10. https://doi.org/10.2106/jbjs.d.01772 PMid:15687150 DOI: https://doi.org/10.2106/00004623-200511000-00037

Lin T, Yan SG, Cai XZ, Ying ZM. Bisphosphonates for periprosthetic bone loss after joint arthroplasty: A meta-analysis of 14 randomized controlled trials. Osteoporos Int. 2012;23(6):1823-34. https://doi.org/10.1007/s00198-011-1797-5 PMid:21932113 DOI: https://doi.org/10.1007/s00198-011-1797-5

Tapaninen TS, Venesmaa PK, Jurvelin JS, Miettinen HJ, Kröger HP. Alendronate reduces periprosthetic bone loss after uncemented primary total hip arthroplasty-a 5-year follow-up of 16 patients. Scand J Surg. 2010;99(1):6. https://doi.org/10.1177/145749691009900108 PMid:20501356 DOI: https://doi.org/10.1177/145749691009900108

Eberhardt C, Habermann B, Muller S, Schwarz M, Bauss F, Kurth AH. The bisphosphonate ibandronate accelerates osseointegration of hydroxyapatite-coated cementless implants in an animal model. J Orthop Sci. 2007;12(1):61-6. https://doi.org/10.1007/s00776-006-1081-2 PMid:17260119 DOI: https://doi.org/10.1007/s00776-006-1081-2

Friedl G, Radl R, Stihsen C, Rehak P, Aigner R, Windhageret R. The effect of a single infusion of zoledronic acid on early implant migration in total hip arthroplasty. A randomized, double-blind, controlled trial. J Bone Joint Surg Am. 2009;91(2):274-81. https://doi.org/10.2106/jbjs.g.01193 PMid:19181970 DOI: https://doi.org/10.2106/JBJS.G.01193

Shabani I, Gavrilovski A, Velkovski V, Atanasov N, Memeti S, Belchishta A. Influence of alendronate therapy on the results of densitometric examination after implantation of total hip endoprosthesis. Arch Public Health. 2021;13(1):5994. https://doi.org/10.3889/aph.2021.5994 DOI: https://doi.org/10.3889/aph.2021.5994