Prevention of strain-related osteopenia in aseptic loosening of hip prostheses using perioperative bisphosphonate.

Abstract

The hypothesis tested in this study was that perioperative administration of the bisphosphonate zoledronate will reduce strain protection-related calcar osteopenia and maintain functional integration of the femoral component in an ovine hemiarthroplasty model. Twelve sheep received a unilateral cemented hemiarthroplasty where six animals were given nine intravenous infusions of zoledronate (10 microg/kg) pre-, peri-, and postsurgery over 8 months. Control animals received physiological saline only. Implants remained in vivo for 9 months. Ground reaction force (GRF) was used to assess functional loading of the implanted limb, bone mineral density (BMD) was quantified using dual energy X-ray absorptiometry (DEXA). Cortical bone area, thickness, and viable osteocytes were assessed histologically. No significant differences in GRF data between groups was identified. Results demonstrated a significant drop in BMD values in the control group (9.7%) when compared with the bisphosphonate-treated group (3.2%) (p = 0.0159). Histological results showed that cortical area, thickness, and the percentage of lacunae with viable osteocytes was significantly greater in the bisphosphonate-treated group when compared with control (p = 0.002, p = 0.001, p = 0.003, respectively). The administration of zoledronate reduced cortical osteopenia in the calcar region of the proximal femur and this therapy could be used as a preventive measure to combat strain protection osteopenia and its contribution to associated aseptic loosening in total hip replacement surgery.

• Authors: Allen E Goodship, Gordon W Blunn, Jonathan Green, Melanie J Coathup
• Journal: Journal of orthopaedic research : official publication of the Orthopaedic Research Society (J Orthop Res) Vol. 26 Issue 5 Pg. 693-703 (May 2008) ISSN: 1554-527X [Electronic] United States
• PMID: 18050308 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: (c) 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Chemical References

• Bone Density Conservation Agents
• Diphosphonates
• Imidazoles
• Zoledronic Acid

Topics

• Animals
• Arthroplasty, Replacement, Hip (adverse effects)
• Bone Density (drug effects)
• Bone Density Conservation Agents (pharmacology, therapeutic use)
• Bone Diseases, Metabolic (diagnosis, etiology, prevention & control)
• Diphosphonates (pharmacology, therapeutic use)
• Female
• Hip Joint (pathology)
• Imidazoles (pharmacology, therapeutic use)
• Locomotion (drug effects)
• Microradiography
• Prosthesis Failure
• Random Allocation
• Sheep
• Stress, Mechanical
• Zoledronic Acid