A long-lasting bisphosphonate partially protects periprosthetic bone, but does not enhance initial stability of uncemented femoral stems: A randomized placebo-controlled trial of women undergoing total hip arthroplasty

Journal of Biomechanics
Erik AroHannu T Aro

Abstract

Low bone quality may compromise the success of cementless total hip arthroplasty in high-risk patients such as elderly women. Zoledronic acid is a long-lasting antiresorptive agent, which is known to reduce short-term periprosthetic bone loss. However, its effect on femoral stem stability is not well known. Forty-nine female patients with a mean age of 68 years (range, 51-85 years) scheduled to undergo cementless total hip arthroplasty due to osteoarthritis were randomized in this double-blind, placebo-controlled trial to receive a single postoperative infusion of zoledronic acid or placebo. Patients were evaluated for up to four years postoperatively for femoral stem migration measured by radiostereometric analysis, bone mineral density (BMD) measured by dual X-ray absorptiometry, functional recovery, and patient-reported outcome scores. Implant survival was determined at nine years postoperatively. Zoledronic acid did not reduce the femoral stem migration that occurred predominantly during the settling period of the first 3-6 months. Subsequently, all femoral stems were radiographically osseointegrated. Zoledronic acid maintained periprosthetic BMD, while the expected loss of periprosthetic bone during the first 12 months was...Continue Reading

Citations

Jul 2, 2020·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Hannu T AroEliisa Löyttyniemi
Aug 1, 2020·Current Osteoporosis Reports·Kyle D AndersonRyan D Ross
Sep 30, 2020·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·K ZhuJ Guan
Dec 14, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Du Hyun RoHyuk-Soo Han
May 13, 2020·Acta Orthopaedica·Hannu T Aro, Sanaz Nazari-Farsani
Sep 12, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Klemens VertesichXu Yang

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