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A single bisphosphonate infusion does not accelerate fracture healing in high tibial osteotomies.

Harding, Anna Kajsa LU ; W-Dahl, Annette LU ; Geijer, Mats LU ; Toksvig-Larsen, Sören LU and Tägil, Magnus LU (2011) In Acta Orthopaedica 82(4). p.465-470
Abstract
Background Bisphosphonates increase the callus size and strength in animal fracture studies. In a human non-randomized pilot study of high tibial osteotomies in knee osteoarthritis, using the hemicallotasis (HCO) technique, bisphosphonates shortened the healing time by 12 days. In the present randomized study, we wanted to determine whether a single infusion of zoledronic acid reduces the time to clinical osteotomy healing. Results from the same trial, showing improved pin fixation with zoledronate, have been published separately. Methods 46 consecutive patients (aged 35-65 years) were operated. At 4 weeks postoperatively, the patients were randomized to an intravenous infusion of either zoledronic acid or sodium chloride. Dual-energy... (More)
Background Bisphosphonates increase the callus size and strength in animal fracture studies. In a human non-randomized pilot study of high tibial osteotomies in knee osteoarthritis, using the hemicallotasis (HCO) technique, bisphosphonates shortened the healing time by 12 days. In the present randomized study, we wanted to determine whether a single infusion of zoledronic acid reduces the time to clinical osteotomy healing. Results from the same trial, showing improved pin fixation with zoledronate, have been published separately. Methods 46 consecutive patients (aged 35-65 years) were operated. At 4 weeks postoperatively, the patients were randomized to an intravenous infusion of either zoledronic acid or sodium chloride. Dual-energy X-ray absorptiometry (DEXA) was performed 10 weeks postoperatively. Radiographs were taken at 10 weeks and every second week until there was radiographic and clinical healing. Healing was evaluated blind, with extraction of the external fixator as the endpoint. At 1.5 years, an additional radiograph was taken and the hip-knee-ankle (HKA) angle measured to evaluate whether correction had been retained. Results All osteotomies healed with no difference in healing time between the groups (77 (SD 7) days). Bone mineral density and bone mineral content, as assessed with DEXA, were similar between the groups. Radiographically, both groups had retained the acquired correction at the 1.5-year follow-up. Interpretation In this randomized comparison, a single infusion of zoledronic acid increased the pin fixation of the external frame but did not shorten the healing time. In both groups, the external fixator was extracted almost 2 weeks earlier than in previous studies. The early extraction did not cause a loss of correction in either group. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
82
issue
4
pages
465 - 470
publisher
Taylor & Francis
external identifiers
  • wos:000294851100013
  • pmid:21689069
  • scopus:80052444061
ISSN
1745-3682
DOI
10.3109/17453674.2011.594231
language
English
LU publication?
yes
id
9306c171-d9aa-4e76-a775-07518886f3f9 (old id 2007907)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21689069?dopt=Abstract
date added to LUP
2011-07-06 10:16:14
date last changed
2017-01-01 06:18:15
@article{9306c171-d9aa-4e76-a775-07518886f3f9,
  abstract     = {Background Bisphosphonates increase the callus size and strength in animal fracture studies. In a human non-randomized pilot study of high tibial osteotomies in knee osteoarthritis, using the hemicallotasis (HCO) technique, bisphosphonates shortened the healing time by 12 days. In the present randomized study, we wanted to determine whether a single infusion of zoledronic acid reduces the time to clinical osteotomy healing. Results from the same trial, showing improved pin fixation with zoledronate, have been published separately. Methods 46 consecutive patients (aged 35-65 years) were operated. At 4 weeks postoperatively, the patients were randomized to an intravenous infusion of either zoledronic acid or sodium chloride. Dual-energy X-ray absorptiometry (DEXA) was performed 10 weeks postoperatively. Radiographs were taken at 10 weeks and every second week until there was radiographic and clinical healing. Healing was evaluated blind, with extraction of the external fixator as the endpoint. At 1.5 years, an additional radiograph was taken and the hip-knee-ankle (HKA) angle measured to evaluate whether correction had been retained. Results All osteotomies healed with no difference in healing time between the groups (77 (SD 7) days). Bone mineral density and bone mineral content, as assessed with DEXA, were similar between the groups. Radiographically, both groups had retained the acquired correction at the 1.5-year follow-up. Interpretation In this randomized comparison, a single infusion of zoledronic acid increased the pin fixation of the external frame but did not shorten the healing time. In both groups, the external fixator was extracted almost 2 weeks earlier than in previous studies. The early extraction did not cause a loss of correction in either group.},
  author       = {Harding, Anna Kajsa and W-Dahl, Annette and Geijer, Mats and Toksvig-Larsen, Sören and Tägil, Magnus},
  issn         = {1745-3682},
  language     = {eng},
  number       = {4},
  pages        = {465--470},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {A single bisphosphonate infusion does not accelerate fracture healing in high tibial osteotomies.},
  url          = {http://dx.doi.org/10.3109/17453674.2011.594231},
  volume       = {82},
  year         = {2011},
}