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Risedronate reduces postoperative bone resorption after cementless total hip arthroplasty
S Yamasaki1, K Masuhara, K Yamaguchi
1Department of Orthopaedic Surgery, Nishinomiya Municipal Central Hospital, Nishinomiya, Hyogo, Japan. s-yamasaki@umin.ac.jp
Insights
Risedronate significantly reduced bone loss around the femoral stem after cementless total hip arthroplasty (THA). This bisphosphonate therapy offers a potential strategy to improve long-term implant survival by mitigating periprosthetic bone resorption.
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.
Unlabelled:
Forty-three patients who had undergone cementless THA were randomly assigned to receive no osteoactive drug or oral risedronate for 6 months. Postoperative decrease of BMD in the risedronate group was significantly lower than that seen in the control group in zones 1, 2, 3, 6, and 7.
Introduction:
Proximal bone resorption around the femoral stem often has been observed after total hip arthroplasty (THA), could lead to late stem loosening. We previously reported the efficacy of etidronate on periprosthetic bone resorption after cementless THA. Recently risedronate is suggested to be effective for the prevention and treatment of for osteoporosis. The purpose of the present study was to evaluate the effects of risedronate on periprosthetic bone loss after cementless THA.
Methods:
Forty-three patients who had undergone cementless THA were randomly assigned to receive no osteoactive drug (21 patients) or oral risedronate 2.5 mg/day (22 patients) for 6 months. Three patients were eliminated from the risedronate group because of dyspepsia. Periprosthetic bone mineral density (BMD) in seven regions of interest based on the zones of Gruen et al. was measured with dual energy X-ray absorptiometry at 3 weeks and 6 months postoperatively.
Results:
At 6 months after surgery, postoperative decrease of BMD in the risedronate group was significantly lower than that seen in the control group in zones 1, 2, 3, 6, and 7 (p < 0.05, p < 0.01, p < 0.01, p < 0.05, and p < 0.05, respectively).
Conclusion:
These outcomes suggested that risedronate might reduce the periprosthetic bone resorption after cementless THA.
