Influence of alendronate therapy on the results of densitometric examination after implantation of total hip endoprosthesis
Published 2021-06-20
Keywords
- total hip endoprosthesis,
- alendronate therapy,
- DXA
How to Cite
Copyright (c) 2021 Ilir Shabani, Antonio Gavrilovski, Vilijam Velkovsk, Nenad Atanasov, Shaban Memeti, Anila Belchishta

This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
The development of aloarthroplasty of the hip is continuously rising. After implantation of a total cement-free hip endoprosthesis, often there is a periprosthetic femoral bone loss. Alendronate has been shown to be a potent inhibitor of bone resorption activity; it inhibits osteoclastic bone resorption, increases bone mass, and plays a significant role in post-implantation stabilization of the femur. The aim of this study was to determine the effect of alendronate on osteointegration of hip endoprosthesis.Material and methods: The study analyzed 10 patients operated on with implantation of a total cement-free hip endoprosthesis (THP). The included patients were examined by a radiographic method at 6 and 12 months and DXA method at 6 and 12 months. Results: The study showed differences in the values of bone mineral density and bone mineral content in the interval between 6 and 12 months in patients undergoing THP, and hence we can conclude that alendronate therapy after THP implantation reduced periprosthetic loss of bone mass and implant stiffening. Alendronate is a proven inhibitor of periprosthetic bone loss that occurs after prirmary impantation of a total cement-free hip endoprosthesis.
Downloads
References
- Kobayashi S, Saito N, Horiuchi H, Iorio R, Takaoka K. Poor bone quality or hip structure as a risk factors affecting survival of total hip arthroplasty. Lancet 2000;355:1499-1504.
- Taylor M, Tanner KE. Fatigue failure of cancellous bone: a possible cause of implant migration and loosening. J Bone Joint Surg Br 1997;779:181-182. DOI: https://doi.org/10.1302/0301-620X.79B2.0790181
- Bobyn JD, Mortimer ES, Glassman AH, et al. Producing and avoiding stress shielding. Laboratory and Clinical observation of noncemented total hip arthroplasty. Clin Orthop Relat Res 1992;274:79-96.
- Huiskes R. The various stress patterns of press-fit, ingrown, and cemented femoral stems. Clin Orthop Relat Res 1990;(261):27-38. DOI: https://doi.org/10.1097/00003086-199012000-00006
- Sychterz CJ, Engha CA. The influence of clinical factors on periprosthetic bone remodeling Clin Orthop Relat Res 1995;322:285-292. DOI: https://doi.org/10.1097/00003086-199601000-00034
- Kiratli BJ, Checovich MM. Mc Beath AA, Wilson MA, Heiner JP. Measurment of bone mineral density by DEXA in patiens with a Wisconsin hip, an uncemented femoral stem. J Arthroplasty 1996;1(2):184-193
- Hosking D, Chilvers CE, Christiansen C et al. Prevention of bone loss with alendronate in postmenopausal women under 60 years of age. Early Postmenopausal Intervention Cohort Study Group. N Engl J Med 1998;338(8):485–492) 1(2):184-193 DOI: https://doi.org/10.1056/NEJM199802193380801
- McCarthy CK, Steinberg GG, Agren M, Leahey D, Wyman E, Baran DT. Quantifying bone loss from the proximal femur after total hip arthroplasty. J Bone Joint Surg Br 1991; 73(5):774-778. DOI: https://doi.org/10.1302/0301-620X.73B5.1894664
- Kiratli BJ, Checovich MM, McBeath AA, Wilson MA, Heiner JP. Measurement of bone mineral density by dual-energy x-ray absorptiometry in patients with the Wisconsin hip, an uncemented femoral stem. J Arthroplasty 1996; 11(2):184-193. DOI: https://doi.org/10.1016/S0883-5403(05)80015-4
- Kröger H, Venesmaa P, Jurvelin J, Miettinen H, Suomalainen O, Alhava E. Bone density at the proximal femur after total hop arthroplasty. Clin Orthop Relat Res 1998; (352):66-74. DOI: https://doi.org/10.1097/00003086-199807000-00009
- Brodner W, Bitzan P, Lomoschitz F, et al. Changes in bone mineral density in the proximal femur after cementless total hip arthroplasty. A five-year longitudinal study. J Bone Joint Surg Br 2004; 86(1):20-26. DOI: https://doi.org/10.1302/0301-620X.86B1.14637
- Braun A, Papp J, Reiter A. The periprosthetic bone remodeling process—signs of vital bone reaction. Int Orthop 2003; 27(Suppl 1):S7-10.
- Kobayashi S, Saito N, Horiuchi H, Iorio R, Takaoka K. Poor bone quality or hip structure as risk factors affecting survival of total-hip arthroplasty. Lancet 2000; 355(9214):1499-1504. DOI: https://doi.org/10.1016/S0140-6736(00)02164-4
- Woolf AD, Akesson K. Preventing fractures in elderly people. BMJ 2003; 327(7406):89-95. DOI: https://doi.org/10.1136/bmj.327.7406.89
- Shanbhag AS. Use of bisphosphonates to improve the durability of total joint replacements. J Am Acad Orthop Surg 2006; 14(4):215-225. DOI: https://doi.org/10.5435/00124635-200604000-00003
- Charnley J.Low Friction Arthroplasty of the hip theory and practice. New York ,NY:Spingr Verlog;1979 DOI: https://doi.org/10.1007/978-3-642-67013-8
- Older J.Charnley low-friction arthroplasty: a worldwide retrospective review at 15 to 20 yars. J Arthroplasty 2002;17:675-680 DOI: https://doi.org/10.1054/arth.2002.31973
- Wroblewski BM, Charnley J. Radiographic morphology of the osteoarthritis hip. J Bone Joint Surg Br1982;64:568-569. DOI: https://doi.org/10.1302/0301-620X.64B5.7142263
- Tapaninen TS, Venesmaa PK, Jurvelin JS, Miettinen HJ, Kröger HP. Alendronate reduces periprosthetic bone loss after uncemented primary total hip arthroplasty—a 5-year follow-up of 16 patients. Scand J Surg 2010; 99(1):32-37. DOI: https://doi.org/10.1177/145749691009900108
- Arabmotlagh M, Rittmeister M, Hennigs T. Alendronate prevents femoral periprosthetic bone losss following total hip arthroplasty: prospective randomized double-blind study. J Orthop Res 2004; 24(7):1336-1341. DOI: https://doi.org/10.1002/jor.20162
- Venesmaa PK, Kröger HP, Miettinen HJ, Jurvelin JS, Suomalainen OT, Alhav EM. Alendronate reduces periprosthetic bone loss after uncemented primary total hip arthroplasty: a prospective randomized study. J Bone Miner Res 2001; 16(11):2126-21.
- Petri K.Venesmaa, Heikki P.J.Kroger, Hannu J. A.Miettinen et al. Alendronate reduces periprosthetic Bone Loss after uncemented primary Hip arthroplasty. Journal of bone and mineral research 2001;16(11)2126-2131 DOI: https://doi.org/10.1359/jbmr.2001.16.11.2126
- Nehme A, Maalouf G, Tricoire JL, Giordano G, Chiron P, Puget J. Effect of alendronate on periprosthetic bone loss after uncemented primary total hip arthroplasty :a prospective randomized study. Rev Chir Orthoped Reparatrice Appar Mot.2003.
- Nishioka T, Yagi S, Mitsuhashi T, et al. Alendronate inhibits periprosthetic bone loss around uncemented femoral components. J Bone Miner Metab 2007; 25(3):179-183. DOI: https://doi.org/10.1007/s00774-006-0743-7
- Wilkinson JM, Stockley I, Peel NF, et al. Effect of pamidronate in preventing local bone loss after total hip arthroplasty: a randomized, double-blind, controlled trial. J Bone Miner Res 2001; 16(3):556-564. DOI: https://doi.org/10.1359/jbmr.2001.16.3.556
- Bobyn JD, Mortimer ES, Glassman AH, Engh CA, Miller JE, Brooks CE. Producing and avoiding stress shielding. Laboratory and clinical observations of noncemented total hip. Clin Orthop Relat Res 1992; (274):79-96. DOI: https://doi.org/10.1097/00003086-199201000-00010
- Nakamura K. Measurement of periprosthetic bone mineral density after cementless hip arthroplasty by dual energy X-ray absorptiometry:Longitudinal and cross-sectional evaluation. J Orthop Sci 1996; 1:113-122. DOI: https://doi.org/10.1007/BF02348802
- Venesmaa PK, Kroger 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 Miner Res200;1 16:1056-1061. DOI: https://doi.org/10.1359/jbmr.2001.16.6.1056
- Engh CA, McGovern TF, Bobyn JD, Harris WH. A quantitative evaluation of periprosthetic bone –remodeling after cementless total hip arthroplasty. J Bone Joint Surg Am 1992;74:1009-1020. DOI: https://doi.org/10.2106/00004623-199274070-00007