Risedronate reduces postoperative bone resorption after cementless total hip arthroplasty

Area of Science:

• Orthopedic surgery
• Bone metabolism
• Pharmacology

Background:

• Periprosthetic bone resorption around the femoral stem is a common complication after cementless total hip arthroplasty (THA), potentially leading to late stem loosening.
• Previous studies demonstrated the efficacy of etidronate in reducing periprosthetic bone resorption.
• Risedronate, a bisphosphonate, has shown promise in managing osteoporosis and is being investigated for its effects on bone loss post-THA.

Purpose of the Study:

• To evaluate the efficacy of oral risedronate in preventing periprosthetic bone loss following cementless total hip arthroplasty (THA).

Main Methods:

• A randomized controlled trial involving 43 patients undergoing cementless THA.
• Patients were assigned to receive either oral risedronate (2.5 mg/day) or no osteoactive drug for 6 months.
• Bone mineral density (BMD) in seven Gruen zones was measured using dual-energy X-ray absorptiometry at 3 weeks and 6 months postoperatively.

Main Results:

• The risedronate group exhibited a significantly lower postoperative decrease in BMD compared to the control group in multiple periprosthetic regions (zones 1, 2, 3, 6, and 7) at 6 months.
• Statistical significance (p < 0.05 or p < 0.01) was observed in these zones, indicating a protective effect of risedronate.

Conclusions:

• Risedronate administration may effectively reduce periprosthetic bone resorption after cementless total hip arthroplasty.
• These findings suggest risedronate as a potential therapeutic agent to improve bone integration and long-term outcomes of cementless THA.