This prospective multicentre study was undertaken to determine whether the timing of the post-operative administration of bisphosphonate affects fracture healing and the rate of complication following an intertrochanteric fracture. Between August 2008 and December 2009, 90 patients with an intertrochanteric fracture who underwent internal fixation were randomised to three groups according to the timing of the commencement of risedronate treatment after surgery: Group A (from one week after surgery), Group B (from one month after surgery), and Group C (from three months after surgery). The radiological time to fracture healing was assessed as the primary endpoint, and the incidence of complications, including excessive displacement or any complication requiring revision surgery, as the secondary endpoint. The mean time to fracture healing post-operatively in groups A, B and C was 10.7 weeks (SD 4.4), 12.9 weeks (SD 6.2) and 12.3 weeks (SD 7.1), respectively (p = 0.420). At 24 weeks after surgery, all fractures had united, except six that had a loss of fixation. Functional outcomes at one year after surgery according to the Koval classification (p = 0.948) and the incidence of complications (p = 0.386) were similar in the three groups. This study demonstrates that the timing of the post-operative administration of bisphosphonates does not appear to affect the rate of healing of an intertrochanteric fracture or the incidence of complications.

A 6-year-old, intact female, Maltese presented with limited movement of the hind limbs and intermittent pruritus for three months. The patient was diagnosed with systemic lupus erythematosus. Conventional immunosuppressive therapy was attempted for 70 days; however, the patient still suffered from life-threatening pancreatitis and hepatopathy. Therefore, we tried canine adipose-derived mesenchymal stem cells for immunomodulation and liver protection. After 6-months of the stem cell therapy, the patient’s walking and hepatopathy improved. These findings indicate that stem cell therapy may be another option for systemic lupus erythematosus in dogs.