Three-Year Changes in Bone Mineral Density Around the Knee After a Six-Month Course of Oral Alendronate Following Total Knee Arthroplasty

Wang, Ching‐Jen; Wang, Junwen; Ko, Jih‐Yang; Weng, Li‐Chueh; Huang, Chi-Hsien

doi:10.2106/jbjs.e.00051

Cited by 35 publications

(31 citation statements)

References 32 publications

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“…Although speculative, a lower initial BMD brought about by stress shielding may lead to earlier symptomatic loosening when particulate debris increases with time. This is important, as there is evidence that initial BMD may be maintained by intervention with bisphosphonates [27]. At 2 years, there was no difference in BMD change between the rotating-and fixed-platform knees.…”

Section: Discussionmentioning

confidence: 95%

Loss of Tibial Bone Density in Patients with Rotating- or Fixed-platform TKA

Munro

Pandit

Walker

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Little is known about tibial bone remodeling with TKA and its clinical relevance. We performed a randomized clinical trial to compare tibial bone density changes in cemented components with different bearing designs. Bone density changes were assessed using quantitative computed tomography (qCT)-assisted osteodensitometry. Twenty-eight rotating-platform and 26 fixed-platform cemented TKAs were included. The nonoperated contralateral side was used as a control. CT scans were performed postoperatively and 1 year and 2 years after the index operation. Cancellous bone density loss (up to 12.6% at 2 years) was observed in all proximal tibial regions in both cohorts. In contrast, we found lower cortical bone density loss (up to 3.6% at 2 years). We found no differences in bone loss between fixed-and rotating-platform implants. The decrease of cancellous bone density after TKA suggests stress transfer to the cortical bone.

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Section: Discussionmentioning

confidence: 95%

Loss of Tibial Bone Density in Patients with Rotating- or Fixed-platform TKA

Munro

Pandit

Walker

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…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%

“…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%

“…The RCT by Wang and associates [9] published in 2006 enrolled 60 female patients undergoing cemented TKA who were randomised to receive either peroral alendronate (10 mg/day) for six months after surgery or no medication at all. BMD at the femoral and tibial levels was assessed by DEXA, six, twelve and thirty-six months after surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, the RCT by Wang et al [9] conveys important information by showing that the effects of a 6-month course of alendronate on periprosthetic BMD were timedependent and were lost at the three-year follow-up. This finding indicates that the optimal duration of alendronate therapy required to stably prevent periprosthetic bone loss has yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

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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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A cemented mobile-bearing total knee prosthesis prevents peri-prosthetic bone mineral density loss around the femoral component: a consecutive follow-up at a mean of 11 years

Minoda

Ikebuchi

Kobayashi

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose Research has shown that a cemented mobile-bearing component has a favorable efect on the bone mineral density (BMD) of the distal femur at 2 years after total knee arthroplasty (TKA). This study was performed to determine whether the advantage on BMD of a cemented mobile-bearing TKA over a conventional cemented ixed-bearing TKA changes with time. This report is an update of a matched cohort study initiated in 2004 and for which the 2-year results have been published. Methods Twenty-eight knees that were treated with a ixed-bearing posterior stabilized (PS) prosthesis and 28 matched knees from a database of 76 knees that were treated with a mobile-bearing PS prosthesis in the same period were investigated. All knees underwent dual-energy X-ray absorptiometry (DEXA) scans around the femoral component preoperatively, 2 weeks postoperatively, 5 years postoperatively, and annually thereafter. Eighteen knees with a cemented mobile-bearing PS prosthesis and 20 knees with a cemented ixed-bearing PS prosthesis were investigated for more than 6 years. The mean follow-up period was 11 years. ResultsThe range of motion, Knee Society Score, BMD of the lumbar spine, and follow-up period were not signiicantly diferent preoperatively and postoperatively in the two groups. In the ixed-bearing group, the BMD of the anterior part of the femoral condyle decreased postoperatively. In the mobile-bearing group, the BMD of the posterior part of the femoral condyle increased postoperatively. The postoperative change in the BMD at 5 years and the latest follow-up period was statistically signiicant in the two groups. Conclusions This DEXA study revealed that a cemented mobile-bearing component had a favorable efect on the BMD of the distal femur after TKA even at a mean of 11 years postoperatively. Level of evidence Therapeutic study, level II, prospective comparative study. Keywords Total knee arthroplasty • Bone mineral density • Mobile-bearing total knee prosthesis • Fixed-bearing total knee prosthesis • Posterior stabilized total knee prosthesis * Yukihide Minoda

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Three-Year Changes in Bone Mineral Density Around the Knee After a Six-Month Course of Oral Alendronate Following Total Knee Arthroplasty

Cited by 35 publications

References 32 publications

Loss of Tibial Bone Density in Patients with Rotating- or Fixed-platform TKA

Loss of Tibial Bone Density in Patients with Rotating- or Fixed-platform TKA

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

A cemented mobile-bearing total knee prosthesis prevents peri-prosthetic bone mineral density loss around the femoral component: a consecutive follow-up at a mean of 11 years

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