Clodronate prevents prosthetic migration: A randomized radiostereometric study of 50 total knee patients

Hilding, Maria; Ryd, Leif; Toksvig‐Larsen, Sören; Aspenberg, Per

doi:10.1080/000164700317362163

Cited by 96 publications

(65 citation statements)

References 22 publications

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“…Different studies have shown the positive effect of systemic bisphosphonate treatment in protecting the peri-implant bone, either around cemented [15] or around uncemented implants [42]. However, side effects like fever [29,40], throat, or stomach ulcers [9] as well as a low bioavailability [16] are generally observed for systemic bisphosphonate treatment.…”

Section: Introductionmentioning

confidence: 99%

Calcium phosphate drug delivery system: influence of local zoledronate release on bone implant osteointegration

Peter

Pioletti

Laı̈b

et al. 2005

Bone

252

167

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Despite total hip replacement (THR) gives generally satisfactory results, the quality of outcome in young patients is markedly decreased compared to the average THR outcome. For this population, pharmacological treatment with bisphosphonate would be beneficial to decrease the peri-implant osteolysis. However, as this population does not necessarily suffer from osteoporosis, a nonsystemic treatment would be preferable. Zoledronate was then grafted to hydroxyapatite (HA) coating of titanium implants. The implants were inserted in rat condyles with various zoledronate concentrations. A positive concentration-dependent effect was observed on the peri-implant bone density and on different histomorphometric parameters. Importantly for the outcome of the implants, the mechanical fixation was increased by the local presence of zoledronate.The obtained results open the way of an easy transformation of currently existing HA-coated implants by grafting bisphosphonate onto the coating in order to increase their service life in the patients. D 2004 Elsevier Inc. All rights reserved.

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Section: Introductionmentioning

confidence: 99%

Calcium phosphate drug delivery system: influence of local zoledronate release on bone implant osteointegration

Peter

Pioletti

Laı̈b

et al. 2005

Bone

252

167

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“…The idea to prevent or treat aseptic loosening of prosthetic implants by using bisphosphonates has been addressed by several studies [3,7,15]. Bisphosphonates is a successful treatment against osteoporosis by reducing bone resorption associated with bone remodelling [5].…”

Section: Discussionmentioning

confidence: 99%

Topical, single dose bisphosphonate treatment reduced bone resorption in a rat model for prosthetic loosening

Åstrand

Aspenberg

2004

Journal Orthopaedic Research

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Fluid pressure, instability or particles have been suggested to cause peri-prosthetic bone resorption. High intracapsular pressures have been reported in hip joints with loose prosthetic components, and oscillating fluid pressure has been shown to cause dramatic bone resorption in animal models. Resorption can be reduced by systemic bisphosphonate treatment in rat models with oscillating fluid pressure, but this has required higher doses than needed to inhibit normal remodelling. Bisphosphonates have high affinity to bone mineral. Topical application of the drug is therefore feasible. We used a previously described rat model where oscillating fluid pressure causes bone resorption. Before pressurization, a 1 mg/ml solution of alendronate was applied onto the bone surface for 1 min, after which excess bisphosphonate was rinsed away. Bone resorption was measured on histological slides as soft tissue area at the interface. Rats treated with topical alendronate had soft tissue areas reduced by half. Topical bisphosphonate treatment before cementing a joint implant could possibly reduce the risk of later loosening.

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“…One of the RCTs [9] was issued one year after publication of the meta-analysis in 2005. The other RCT [8] was published in 2000 but was not included in the meta-analysis because the latter focused on studies that used dual energy X-ray absorptiometry (DEXA) to measure BMD changes from baseline, whereas the former employed radiostereometry to evaluate the effect of bisphosphonates on implant migration.…”

Section: Resultsmentioning

confidence: 99%

“…One meta-analysis [7] and two RCTs [8,9] were retrieved from the literature search (Table 1). One of the RCTs [9] was issued one year after publication of the meta-analysis in 2005.…”

Section: Resultsmentioning

confidence: 99%

Do bisphosphonates reduce early micromotion and Periprosthetic bone loss in total knee arthroplasty? A review of the evidence

Calvisi

Lupparelli

Padua

2006

J Orthopaed Traumatol

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Early micromotion of implant components and periprosthetic bone loss in patients undergoing total knee arthroplasty are thought to contribute to late aseptic loosening. In the pursuit of longer implant survival, the administration of bisphosphonates may be advocated as a means to buffer implants against microinstability and periprosthetic bone loss. A bibliographic search identified one metaanalysis and two randomised controlled trials dealing with this topic. Current evidence supports the hypothesis that the inhibiting effects of bisphosphonates on bone resorption reduce implant micromotion and periprosthetic bone loss at the one-year follow-up. Tested bisphosphonates include clodronate, pamidronate and alendronate. However, a decline in periprosthetic BMD is observed at the three-year follow-up following a six-month course of bisphosphonate administration. Length of follow-up in available studies is currently too short to determine whether bisphosphonates increase the longevity of implants. Furthermore, the optimal dose, modality and length of bisphosphonate administration have yet to be determined.

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Clodronate prevents prosthetic migration: A randomized radiostereometric study of 50 total knee patients

Cited by 96 publications

References 22 publications

Calcium phosphate drug delivery system: influence of local zoledronate release on bone implant osteointegration

Calcium phosphate drug delivery system: influence of local zoledronate release on bone implant osteointegration

Topical, single dose bisphosphonate treatment reduced bone resorption in a rat model for prosthetic loosening

Do bisphosphonates reduce early micromotion and Periprosthetic bone loss in total knee arthroplasty? A review of the evidence

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