Systemic zoledronate treatment both prevents resorption of allograft bone and increases the retention of new formed bone during revascularization and remodelling. A bone chamber study in rats

Abstract

Background: In osteonecrosis the vascular supply of the bone is interrupted and the living cells die. The inorganic mineral network remains intact until ingrowing blood vessels invade the graft. Accompanying osteoclasts start to resorb the bone trabeculae and gradually replace the bone. If the osteonecrosis occurs in mechanically loaded parts, like in the subchondral bone of a loaded joint, the remodelling might lead to a weakening of the bone and, in consequence to a joint collapse. Systemic bisphosphonate treatment can reduce the resorption of necrotic bone. In the present study we investigate if zoledronate, the most potent of the commercially available bisphosphonates, can be used to reduce the amount or speed of bone graft remodeling.

Does locally delivered Zoledronate influence peri-implant bone formation? – Spatio-temporal monitoring of bone remodeling in vivo

“…Several in vivo studies have shown that a local delivery of BPs can enhance peri-implant bone density [16,17], implant fixation [18e22], and the repair of bony defects [23,24] in animal models and humans. Furthermore BPs have been shown to preserve bone allografts [25,26] as well as bone sites affected by osteonecrosis [27].…”

Preclinical Evaluation of Zoledronate to Maintain Bone Allograft and Improve Implant Fixation in Revision Joint Replacement

“…We could not demonstrate any anabolic effect of zoledronate, as has been suggested by other authors 21 . We chose to soak the allograft in zoledronate even though studies have also shown that a local effect on bone allograft can be achieved by systemic administration of bisphosphonate 22,23 .…”

Zoledronate reduces unwanted bone resorption in intercalary bone allografts

“…Cancellous allograft bone pretreated with alendronate did not undergo resorption in the distal femur in a rodent model [1]. Zoledronate, the most potent of the commercially available BPs when given systemically through subcutaneous injections, decreased the resorption of both allograft and newly formed host bone during bone graft remodelling in a rat model [2]. In another study, morselised bone allografts presoaked in an ibandronate solution during revision THA [12] increased BMD in patients at a two-year follow-up.…”