Locally administered bisphosphonate in hip stem revisions using the bone impaction grafting technique: a randomised, placebo-controlled study with DXA and five-year RSA follow-up.
Absorptiometry, Photon
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip
/ methods
Bone Density
Bone Density Conservation Agents
/ administration & dosage
Bone Transplantation
/ methods
Diphosphonates
/ administration & dosage
Double-Blind Method
Female
Femur
/ surgery
Follow-Up Studies
Hip Prosthesis
Humans
Male
Middle Aged
Prosthesis Failure
Radiostereometric Analysis
Reoperation
/ methods
Transplantation, Homologous
Arthroplasty
bisphosphonates
bone graft
hip
radiostereometric analysis
revision
Journal
Hip international : the journal of clinical and experimental research on hip pathology and therapy
ISSN: 1724-6067
Titre abrégé: Hip Int
Pays: United States
ID NLM: 9200413
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
pubmed:
23
6
2018
medline:
4
12
2019
entrez:
23
6
2018
Statut:
ppublish
Résumé
Bisphosphonates have previously been shown to increase the density of impacted graft bone. In the present study we hypothesise that bisphosphonates also reduce early stem subsidence. We examined the effect of locally applied bisphosphonate to allografts on prosthetic micromotion and bone density in femoral stem revision with impaction grafting. 37 patients were randomised to either clodronate or saline as local adjunct to the morsellised allograft bone. 24 patients were finally analysed per protocol and evaluated by dual-energy x-ray absorptiometry (DXA) during the first year and with radiostereometric analysis (RSA) for 5 years. There were no significant differences neither in bone density, nor in migratory behaviour between the groups. The femoral stems had subsided 3.6 mm in both groups (p = 0.99) at 5 years and there was no difference as measured over time with mixed models analysis. The clinical outcome was good in both groups. Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.
Sections du résumé
BACKGROUND:
UNASSIGNED
Bisphosphonates have previously been shown to increase the density of impacted graft bone. In the present study we hypothesise that bisphosphonates also reduce early stem subsidence. We examined the effect of locally applied bisphosphonate to allografts on prosthetic micromotion and bone density in femoral stem revision with impaction grafting.
METHODS:
UNASSIGNED
37 patients were randomised to either clodronate or saline as local adjunct to the morsellised allograft bone. 24 patients were finally analysed per protocol and evaluated by dual-energy x-ray absorptiometry (DXA) during the first year and with radiostereometric analysis (RSA) for 5 years.
RESULTS:
UNASSIGNED
There were no significant differences neither in bone density, nor in migratory behaviour between the groups. The femoral stems had subsided 3.6 mm in both groups (p = 0.99) at 5 years and there was no difference as measured over time with mixed models analysis. The clinical outcome was good in both groups.
CONCLUSION:
UNASSIGNED
Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.
Identifiants
pubmed: 29932001
doi: 10.1177/1120700018781809
doi:
Substances chimiques
Bone Density Conservation Agents
0
Diphosphonates
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM