Risedronate reduces postoperative bone resorption after cementless total hip arthroplasty
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.
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.
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.
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).
These outcomes suggested that risedronate might reduce the periprosthetic bone resorption after cementless THA.
KeywordsBisphosphonate Bone mineral density Dual energy X-ray absorptiometry Risedronate Stress shielding Total hip arthroplasty
- 2.Xenos JS, Callaghan JJ, Heekin RD et al (1999) The porous-coated anatomic total hip prosthesis, inserted without cement. A prospective study with a minimum of ten years of follow-up. J Bone Jt Surg (Am) 81:74–82Google Scholar
- 9.Harris ST, Watts NB, Genant HK et al (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA 282:1344–1352PubMedCrossRefGoogle Scholar
- 17.Kim YH, Kim VE (1992) Results of the Harris-Galante cementless hip prosthesis. J Bone Jt Surg Br 74:83–87Google Scholar
- 18.Wixson RL, Stulberg SD, Mehlhoff M (1991) Total hip replacement with cemented, uncemented, and hybrid prostheses. A comparison of clinical and radiographic results at two to four years. J Bone Jt Surg (Am) 73:257–270Google Scholar
- 22.Yamaguchi K, Masuhara K, Ohzono K et al (2000) Evaluation of periprosthetic bone-remodeling after cementless total hip arthroplasty. J Bone Jt Surg 82-A:1426–1431Google Scholar
- 32.Fogelman I, Moreland L, Woodson G et al (2000) Gastrointestinal side effects and endoscopic findings similar between risedronate and placebo-treated patients. Osteoporos Int 11(Suppl 2):S179Google Scholar
- 33.Hosking D, Beckman R, Glowinski J et al (2000) Similar gastrointestinal side effects and endoscopic findings between risedronate and placebo-treated patients. J Bone Miner Res 15:S428Google Scholar