Delayed Administration of Risedronate Does Not Restore Bone Loss In Patients Following Total Hip Arthroplasty - A randomized, double blinded clinical study
DOI:
https://doi.org/10.15438/rr.v3i2.32Abstract
Background: Periprosthetic bone loss after total hip arthroplasty (THA) increases the risk of serious post-operative complications. Previous studies have reported the beneficial effect of risedronate therapy to improve periprosthetic bone mineral density (BMD) around new implants. The current study is to evaluate the effect of risedronate treatment in enhancing mature well fixed THA implants one year or more after implantation.
Methods and Results: A total of 32 osteoarthritic patients received total hip replacement surgeries and were enrolled from the primary investigator’s clinical practice between February and September 2007. All eligible patients who met the inclusion criteria underwent total hip arthroplasty for reasons other than low traumatic hip fracture due to osteoporosis with normal or osteopenic lumbar spine BMD scores. Subjects received oral risedronate or a placebo with daily calcium plus Vitamin D. DEXA BMD scanning and bone-specific biomarkers, NTx and ALK phosphatase were collected at 6 and 12 months post-surgery. The result showed that risedronate did not increase BMD values of operative femur nor levels in NTx or ALK phosphatase.
Conclusions: This study suggests that risedronate treatment is not effective in preventing periprosthetic bone loss nor enhancing existing density in well fixed osteointegrated following total hip arthroplasty.
Key words: risedronate, bisphosphonate therapy, total hip arthroplasty
References
Aldinger PR, Sabo D, Pritsch M, Thomsen M, Mau H, Ewerbeck V, Breusch SJ. Pattern of periprosthetic bone remodeling around stable uncemented tapered hip stems: a prospective 84-month follow-up study and a median 156-month cross-sectional study with DXA. Calcif Tissue Int. 2003;73:115-21
Tsiridis E, Gamie Z, Conaghan PG, Giannoudis PV. Biological Options to enhance periprosthetic bone mass. Injury 2007;38:704-13
Silverman SL, Watts NB, Deimas PD, Lange JL, Lindsay R.. Effectiveness of bisphosphonates on nonvertebral and hip fractures in the first year of therapy: The risedronate and alendronate (REAL) cohort study. Osteoporosis Int. 2007;18:25-34
Venesmaa PK, Kröger HPJ, Miettinen HJ, Suomalainen OT, Alhava EM. Periprosthetic bone loss after cemented total hip arthroplasty, a prospective 5-year dual energy radiographic absorptiometry study of 15 patients. Acta Orthop. Scand. 2003;74:31-6
Peter B, Ramaniraka N, Rakotomanana LR, Zambelli PY, Pioletti DP. Peri-implant bone remodeling after total hip replacement combined with systemic alendronate treatment: a finite element analysis. Comput Methods Biomech Biomed Engin. 2004;7:73-78
Scott DF, Jaffe WL. Host-bone response to porous-coated cobalt-chrome and hydroxyapatite-coated titanium femoral components in hip arthroplasty, Dual-energy x-ray absorptiometry analysis of paired bilateral cases at 5 to 7 years. J Arthroplasty. 1996;11:429-37.
Spittlehouse AJ, Smith TW, Eastell R. Bone loss around 2 different types of hip prostheses. J Arthroplasty. 1998;13:422-7
Granchi D, Pellacani A, Spina M, Serum levels of osteoprotregrin and receptor activator of nuclear factor-κΒ ligand as markers of periprosthetic osteolysis. J Bone Joint Surg. 2006;88-A:1501
Lohmann CH, Dean DD, Bonewald LF, Schwartz Z, Boyan BD. Nitric oxide and prostaglandin E2 production in response to ultra-high molecular weight polyethylene particles depends on osteoblast maturation state. J Bone Joint Surg. 2002;84-A:411-9
Maciel FMB, Sarrazin P, Morisset S, Lora M, Patry C, Dumais R, de Brum-Fernandes AJ. Induction of cycloxygenase-2 by parathyroid hormone in human osteoblasts in culture. J Rheumatology. 1997;24:2429-35.
Sabokbar A, Fujikawa Y, Neale S, Murray DW, Athanasou NA. Human arthroplasty derived macrophages differentiate into osteoclastic bone resorbing cells. Ann Rheum Dis. 1997;56:414-20
Vermes C, Chandrasekaran R, Jacobs JJ, Galante JO, Roebuck KA, Glant TT. The effects of particulate wear debris, cytokines, and growth factors on the functions of MG-63 osteoblasts. J Bone Joint Surg. 2001;83-A:201-11
Aspenberg P, Van der Vis H. Migration, particles, and fluid pressure: a discussion of causes of prosthetic loosening. Clin Orthop Relat Res. 1998;352:75 -80
Fokter SK, Komadina R, Repše-Fokter A. Effect of etidronate in preventing periprosthetic bone loss following cemented hip arthroplasty: a randomized, double blind, controlled trial. Wien Klin Wochenschr. 2006;118:23-8
Fokter SK, Komadina R, Repše-Fokter A, Yerby SA, Kocijancic A, Marc J. Etidronate does not suppress periprosthetic bone loss following cemented hip arthroplasty. Int Orthop. 2005;29:362-7
Knoch F, Jaquiery C, Kowalsky M, Schaeren S, Alabre C, Martin I, Rubash HE, Shanbhag AS. Effects of bisphosphonates on proliferation and osteoblast differentiation of human bone marrow stromal cells. Biomaterials. 2005;26:6941-9
Bhandari M, Bajammal S, Guyatt GH, Griffith L, Busse JW, Schünemann H, Einhorn TA. Effect of bisphosphonates on periprosthetic bone mineral density after total joint arthroplasty. J Bone Joint Surg. 2005;87:293-301
Im GI, Qureshi SA, Kenney J, Rubash HE, Shanbhag AS. Osteoblast proliferation and maturation by bisphosphonates. Biomaterials. 2004;25:4105-15
Digas G, Kärrholm J. Five-year DEXA study of 88 hips with cemented femoral stem. Int Orthop. 2009;33:1495-500
Soininvarra TA, Jurvelin JS, Miettinen JH, Suomalainen OT, Alhava EM, Kröger PJ. Effect of alendronate on periprosthetic bone loss after total knee arthroplasty: a one-year, randomized, controlled trial of 19 patients. Calcif Tissue Int. 2002;71:472-7
Venesmaa PK, Kröger HPJ, Miettinen HJA, Jurvelin JS, Suomalainen OT, Alhava EM. Monitoring of periprosthetic BMD after uncemented total hip arthroplasty with dual-energy x-ray absorptiometry - a 3-year follow-up study. J Bone Mineral Res. 2001;16:1056-61
Ringe JD, Farahmand P, Faber H, Dorst A. Sustained efficacy of risedronate in men with primary and secondary osteoporosis: results of a 2-year study. Rheumatol Int. 2009; 29:311-5
Pazianas M, Epstein S, Zaidi M. Evaluating the antifracture efficacy of bisphosphonates. Rev Recent Clin Trials. 2009; 4:122-30
Bell NH, Johnson RH. Bisphosphonates in the treatment of osteoporosis. Endocrine. 1997;6:203-206
Clemens JD, Herrick MV, Singer FR, Eyre DR. Evidence that serum NTx (collagen-type I N-telopeptides) can act as an immunochemical marker of bone resorption. Clin Chem. 1997;43:2058-63
2Ross PD, Kress BC, Parson RE, Wasnich RD, Armour KA, Mizrahi IA. Serum bone alkaline phosphatase and calcaneus bone density predict fractures: a prospective study. Osteoporos Int. 2000;11:76-82
Jevon M, Hirayama T, Brown MA, Wass JA, Sabokbar A, Ostelere S, Athenasou NA. Osteoclast formation from circulating precursors in osteoporosis. Scand J Reumatol. 2003;32:95-100
Steinberg JJ, Sledge CB. Chondrocyte mediated cartilage degradation: regulation by prostaglandin E2, cyclic AMP and interferon α. J Rheumatology Suppl. 1991;18:63-5
McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, Adami S, Fogelman I, Diamond T, Eastell R, Meunier PJ, Reginster JY; Hip Intervention Program Study Group. Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med. 2001;344:333-40
Theis JC, Beadel G. Changes in proximal femoral bone mineral density around a hydroxyapatite-coated hip joint arthroplasty. J Orthop Surg. 2003;11:48-52
Venesmaa PK, Kroger HPJ, Miettinen HJA, Jurvelin JS, Suomalainen OT, Alhav EM. Alendronate reduces periprosthetic bone loss after uncemented primary total hip arthroplasty: a prospective randomized study. J Bone Mineral Res. 2001;16:2126-31
Yamasaki S, Masuhara K, Yamaguchi K, Nakai T, Fuji T, Seino Y. Risedronate reduces postoperative bone resorption after cementless total hip arthroplasty. Osteoporos Int. 2007;18:1009-15
Arabmotlagh M, Rittmeister M, Hennigs T. Alendronate prevents femoral periprosthetic bone loss following total hip arthroplasty: prospective randomized double-blind study. J Orthop Res. 2006;24:1336-41
Yamaguchi K, Mashuhara K, Yamasaki S, Fuji T, Seino Y. Effects of discontinuation as well as intervention of cyclic therapy with etidronate on bone remodeling after cementless total hip arthroplasty. Bone. 2004;35:217-23
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2014 David Lionberger, MD, Joshua Liao, Mitchell Eggers, PhD, Sahar Bawkher, BS
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright and License Agreement:
Authors who publish with the Reconstructive Review agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work. Reconstructive Review follows the Creative Commons Attribution-NonCommercial CC BY-NC. This license allows anyone to download works, build upon the material, and share them with others for non-commercial purposes as long as they credit the senior author, Reconstructive Review, and the Joint Implant Surgery & Research Foundation (JISRF). An example credit would be: "Courtesy of (senior author's name), Reconstructive Review, JISRF, Chagrin Falls, Ohio". While works can be downloaded and shared they cannot be used commercially.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
