Peri-prosthetic bone mineral density after simultaneous bilateral total knee arthroplasty under oral bisphosphonate therapy - A comparison between mobile- and fixed-bearing prostheses.
Absorptiometry, Photon
Administration, Oral
Aged
Arthroplasty, Replacement, Knee
/ instrumentation
Bone Density
Bone Density Conservation Agents
/ administration & dosage
Diphosphonates
/ administration & dosage
Female
Femur
/ surgery
Humans
Knee Prosthesis
Lumbar Vertebrae
Male
Middle Aged
Osteoarthritis, Knee
/ surgery
Postoperative Period
Prospective Studies
Prosthesis Design
Tibia
/ surgery
Time Factors
Bisphosphonate
Bone mineral density
Fixed-bearing
Mobile-bearing
Total knee arthroplasty
Journal
The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
25
12
2019
revised:
17
03
2020
accepted:
10
04
2020
entrez:
22
6
2020
pubmed:
22
6
2020
medline:
1
1
2021
Statut:
ppublish
Résumé
Peri-prosthetic bone mineral density (BMD) decreases after total knee arthroplasty (TKA). We aimed to specifically compare peri-prosthetic BMD changes between mobile- and fixed-bearing prostheses in patients undergoing oral bisphosphonate therapy, hypothesizing that mobile-bearing components would have a favorable effect on postoperative peri-prosthetic BMD. This prospective cohort study investigated 30 patients who underwent simultaneous bilateral TKA for primary knee osteoarthritis between December 2007 and September 2012. All patients underwent mobile-bearing TKA in one knee and fixed-bearing TKA in the other and received oral alendronate therapy at a dosage of 35 mg/week. Peri-prosthetic and lumbar spine BMDs were measured using dual X-ray absorptiometry scans, with peri-prosthetic BMD changes being compared between the two prostheses in each patient at six months and one, two, three, and five years post-operation. Clinical results did not significantly differ between two prostheses. Relative change of lumbar spine BMD was significantly greater at five years post-operation than at one year post-operation (p = 0.01), and was significantly correlated at five years post-operation with peri-prosthetic BMD in the central femur (r = 0.39, p = 0.002), posterior femur (r = 0.39, p = 0.002), and medial tibia (r = 0.42, p = 0.007). There was no difference in peri-prosthetic BMD changes between two prostheses in patients undergoing oral bisphosphonate therapy. Our results suggest that the influence of oral bisphosphonate therapy might offset the influence of prosthetic design. Thus, oral bisphosphonate therapy may be more effective than prosthetic design selection in preventing post-TKA peri-prosthetic BMD loss. II.
Sections du résumé
BACKGROUND
BACKGROUND
Peri-prosthetic bone mineral density (BMD) decreases after total knee arthroplasty (TKA). We aimed to specifically compare peri-prosthetic BMD changes between mobile- and fixed-bearing prostheses in patients undergoing oral bisphosphonate therapy, hypothesizing that mobile-bearing components would have a favorable effect on postoperative peri-prosthetic BMD.
METHODS
METHODS
This prospective cohort study investigated 30 patients who underwent simultaneous bilateral TKA for primary knee osteoarthritis between December 2007 and September 2012. All patients underwent mobile-bearing TKA in one knee and fixed-bearing TKA in the other and received oral alendronate therapy at a dosage of 35 mg/week. Peri-prosthetic and lumbar spine BMDs were measured using dual X-ray absorptiometry scans, with peri-prosthetic BMD changes being compared between the two prostheses in each patient at six months and one, two, three, and five years post-operation.
RESULTS
RESULTS
Clinical results did not significantly differ between two prostheses. Relative change of lumbar spine BMD was significantly greater at five years post-operation than at one year post-operation (p = 0.01), and was significantly correlated at five years post-operation with peri-prosthetic BMD in the central femur (r = 0.39, p = 0.002), posterior femur (r = 0.39, p = 0.002), and medial tibia (r = 0.42, p = 0.007).
CONCLUSIONS
CONCLUSIONS
There was no difference in peri-prosthetic BMD changes between two prostheses in patients undergoing oral bisphosphonate therapy. Our results suggest that the influence of oral bisphosphonate therapy might offset the influence of prosthetic design. Thus, oral bisphosphonate therapy may be more effective than prosthetic design selection in preventing post-TKA peri-prosthetic BMD loss.
LEVEL OF EVIDENCE
METHODS
II.
Identifiants
pubmed: 32563435
pii: S0968-0160(20)30106-X
doi: 10.1016/j.knee.2020.04.011
pii:
doi:
Substances chimiques
Bone Density Conservation Agents
0
Diphosphonates
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
767-776Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest There were no direct conflicts of interest to report with regard to this study. The other potential conflicts of interests are declared below: Yukihide Minoda: Paid presenter or speaker of Aesculap, Biomet, DePuy, Kyocera, Smith & Nephew, Microport, and Stryker. Other authors: None.