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The effectiveness of mono or combined osteoporosis drug therapy against bone mineral density loss around femoral implants after total hip arthroplasty

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Abstract

Several previous studies have reported that bone mineral density (BMD) loss around femoral implants is a common outcome, particularly in the proximal femur, after total hip arthroplasty (THA). The purpose of this study was to investigate the effectiveness of alendronate monotherapy and combined therapy using alendronate and alfacalcidol for BMD preservation around femoral implants after primary THA. This study series included 60 patients who were classified into monotherapy (alendronate alone) (n = 18), combined-therapy (alendronate and alfacalcidol) (n = 20) or non-medication (n = 22) groups. The periprosthetic BMD and profile of the biochemical markers such as bone-specific alkaline phosphatase and serum N-terminal telopeptides of type-1 collagen (NTX) were measured at 1, 12, 24 and 48 weeks after surgery. The BMD values in the region of the calcar of monotherapy and combined-therapy patients were maintained and were significantly higher than those of non-medication patients at each measurement period. The plasma levels of NTX in the monotherapy and combined-therapy groups were found to be significantly lower than those in the non-medication group at each measurement period. In conclusion, the monotherapy and combined-therapy regimens significantly prevent periprosthetic BMD loss around femoral implants, most notably in the calcar, compared to no medication.

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Acknowledgments

We thank the following people for their contributions: Chie Aoki, Hiroshi Fujimaki, Taro Tezuka, Yasuhide Hirata, Takako Momose, Yushi Miyamae, and all the orthopedic surgeons who participated at Yokohama City University.

Conflict of interest

All authors have no conflicts of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan

    Naoyuki Iwamoto, Yutaka Inaba, Naomi Kobayashi, Yohei Yukizawa, Hiroyuki Ike, Takashi Ishida & Tomoyuki Saito

Authors
  1. Naoyuki Iwamoto
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  2. Yutaka Inaba
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  3. Naomi Kobayashi
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  4. Yohei Yukizawa
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  5. Hiroyuki Ike
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  6. Takashi Ishida
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  7. Tomoyuki Saito
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Correspondence to Yutaka Inaba.

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Iwamoto, N., Inaba, Y., Kobayashi, N. et al. The effectiveness of mono or combined osteoporosis drug therapy against bone mineral density loss around femoral implants after total hip arthroplasty. J Bone Miner Metab 32, 539–544 (2014). https://doi.org/10.1007/s00774-013-0526-x

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  • DOI: https://doi.org/10.1007/s00774-013-0526-x

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