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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

Belfrage, Ola LU ; Tägil, Magnus LU ; Sundberg, Martin LU ; Kesteris, Uldis LU and Flivik, Gunnar LU (2019) In HIP International 29(1). p.26-34
Abstract

Background: 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: 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: There were no significant differences neither in bone density, nor in... (More)

Background: 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: 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: 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: Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arthroplasty, bisphosphonates, bone graft, hip, radiostereometric analysis, revision
in
HIP International
volume
29
issue
1
pages
26 - 34
publisher
Wichtig Editore
external identifiers
  • scopus:85052603149
ISSN
1120-7000
DOI
10.1177/1120700018781809
language
English
LU publication?
yes
id
5ad42a11-efce-4549-a842-e03f33488816
date added to LUP
2018-09-28 06:35:18
date last changed
2019-02-20 11:28:10
@article{5ad42a11-efce-4549-a842-e03f33488816,
  abstract     = {<p>Background: 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: 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: 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: Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.</p>},
  author       = {Belfrage, Ola and Tägil, Magnus and Sundberg, Martin and Kesteris, Uldis and Flivik, Gunnar},
  issn         = {1120-7000},
  keyword      = {Arthroplasty,bisphosphonates,bone graft,hip,radiostereometric analysis,revision},
  language     = {eng},
  number       = {1},
  pages        = {26--34},
  publisher    = {Wichtig Editore},
  series       = {HIP International},
  title        = {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},
  url          = {http://dx.doi.org/10.1177/1120700018781809},
  volume       = {29},
  year         = {2019},
}