Prevention of early bone loss around the prosthesis by administration of anti-osteoporotic agents and influences of collared and non-collared femoral stem prostheses on early periprosthetic bone loss

Abstract

The current study aims to investigate the effect of anti-osteoporotic agents of collared and non-collared femoral stem prostheses on periprosthetic bone mineral density (BMD) after total hip arthroplasty (THA). 80 patients who received THA due to femur neck subcapital fractures were involved. The treatment groups were given fosamax, caltrate D and Xianlinggubao for oral administration, whereas the control groups were only given caltrate D. BMD at the greater trochiter around the femoral stem prosthesis and at the femoral shaft 1.5-1.0 cm away from the distal femoral stem was tested using dual-energy X-ray absorptiometry (DEXA) scan. Meanwhile, BMD at the same sites on the uninjured side was also tested. The BMD at both sites in all groups decreased after implantation. In the collared groups, no significant difference was shown between the injured and uninjured sides at 12 days or 3 months (p > 0.001). At 6 months after implantation, significant differences were displayed at both sites between the treatment and control groups (p < 0.001). In the non-collared groups, significant differences were displayed at both sites between the treatment and control groups at 6-months postimplantation (p < 0.001). No significant difference showed between the collared and non-collared groups show any at either site on either side (p > 0.05). DEXA scan can quantitatively determine bone loss around the prosthesis after THA. BMD around the prosthesis is correlated with administration of anti-osteoporotic agents. Fosamax + caltrate D + Xianlinggubao can prevent early bone loss around the prosthesis.

Clodronate in the management of different musculoskeletal conditions

“…the anabolic recovery, as demonstrated in experimental models and in clinical trials. 79 In vitro studies in ovariectomized rats 80 have demonstrated that pre-surgery treatment with BPs increases the BMd of the cancellous bone and the stability of hydroxyapatite-coated implants. in the dog model, the early administration of BPs had no significant influence on the extent of bone apposition, the extent or thickness of the hydroxyapatite coating, or the cortical or trabecular bone area around the implants.…”

Outcomes of total hip arthroplasty using collared versus collarless uncemented HA-coated stems: a meta-analysis

“…A total of 446 records were excluded by examining their titles and/or abstracts, leaving 40 records for full-text review. Twenty-nine studies were excluded after full-text review: ten because they reported on non-conventional-length (short, long) or non-HA-coated stems ( 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ), eight because they compared collared versus collarless stems with different designs or coatings ( 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ), five because they were letters to the editor, technical notes, or correspondence ( 38 , 39 , 40 , 41 , 42 ), three because they did not report on any outcomes ( 14 , 43 , 44 ), one because it compared hemiarthroplasty versus THA ( 45 ), one because it was a cadaveric study ( 46 ), and one because it was a non-comparative study ( 47 ). A further three articles were excluded because the outcomes of interest were not presented separately for collared versus collarless stems (the authors were contacted at least three times but none responded) ( 4 , 6 , 48 ).…”

Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials

“…High BMD supports bone-implant fixation, and there have been several attempts to improve the quality of the primary arthroplasty and to reduce the incidence of failures caused by loss of BMD [ 29 , 30 ]. A large population-based parallel-cohorts study [ 31 ] found that bisphosphonates could decrease the risk of periprosthetic fractures after THA.…”