Systematic analysis of bisphosphonate intervention on periprosthetic BMD as a function of stem design

J Arthroplasty. 2014 Jun;29(6):1292-7. doi: 10.1016/j.arth.2014.01.015. Epub 2014 Jan 21.

Abstract

The purpose of this study was to determine the effects of bisphosphonates periprosthetic BMD in THA patients as a function of stem design. Specifically, the goals were to determine if bisphosphonates as a group could significantly inhibit periprosthetic bone loss, time needed to see an effect, if one drug was more effective than the others, and if there was a difference due to stem design or cement. Thirteen articles met the inclusion criteria. Overall, groups treated with bisphosphonate therapy preserved significantly more BMD than the control groups as early as six months postoperatively, and orally delivered bisphosphonates were most effective. Furthermore, the biggest differences were in patients with non-cemented stems, and of those, the largest differences were seen in patients with fully coated CoCr stems.

Keywords: bisphosphonates; bone mineral density; periprosthetic; total hip arthroplasty.

Publication types

  • Review

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects
  • Bone Cements
  • Bone Density / drug effects*
  • Bone Density Conservation Agents / pharmacology*
  • Bone Resorption / etiology
  • Bone Resorption / prevention & control
  • Diphosphonates / pharmacology*
  • Female
  • Femur / drug effects*
  • Hip Prosthesis / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design

Substances

  • Bone Cements
  • Bone Density Conservation Agents
  • Diphosphonates