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Local Alendronic Acid Elution Increases Net Periimplant Bone Formation: A Micro-CT Analysis

  • Symposium: 2013 Hip Society Proceedings
  • Published:
Clinical Orthopaedics and Related Research®

An Erratum to this article was published on 26 November 2013

Abstract

Background

Fixation of cementless orthopaedic implants is not always achieved, particularly in challenging scenarios such as revision surgery, trauma, and tumor reconstruction. An adjunct therapy for improving implant fixation would improve the reliability and durability of certain reconstructive procedures.

Questions/purposes

The purpose of this study was to determine the effect of local elution of the bisphosphonate alendronic acid on bone formation around porous titanium implants in an animal model.

Methods

Porous-coated cylindrical rods were coated with either 0.2 mg or 1.0 mg alendronic acid before bilateral surgical implantation into the femoral intramedullary canals of 10 experimental dogs. Twelve weeks after surgery, the femora were harvested and scanned with micro-CT to quantify the percentage volume of bone within the immediate periimplant space. Four femora from two dogs were also processed for undecalcified thin-section histology and analysis with backscattered scanning electron microscopy. Three histologic sections from each of these four femora were anatomically matched with transverse micro-CT sections to enable direct comparison of the area fraction of bone within the periimplant space.

Results

Compared with paired controls, micro-CT analysis showed that local elution of alendronic acid increased periimplant bone at both doses of 0.2 mg (+52%, p = 0.01) and 1.0 mg (+152%, p = 0.004) with 1.0 mg resulting in a 2.9-fold greater mean relative increase compared with 0.2 mg (p = 0.002). Micro-CT measurements of periimplant bone formation correlated very strongly with the backscattered scanning electron microscopy measurements (R = 0.965, p < 0.001).

Conclusions

Local elution of alendronic acid causes a dose-dependent net increase in periimplant bone formation in an animal model.

Clinical Relevance

This concept has potential to improve the biologic fixation of porous reconstructive implants.

Level of Evidence

Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Pipeline Biotechnology for providing the implants.

Author information

Authors and Affiliations

  1. Jo Miller Orthopaedic Research Laboratory, Montreal General Hospital, 1650 Cedar Avenue, Room LS1-409, Montreal, QC, H3G1A4, Canada

    J. Dennis Bobyn PhD, Rebecca Thompson MEng, Letitia Lim MD, Jenny Ann Pura BSc, Kristian Bobyn BA & Michael Tanzer MD

  2. Division of Orthopaedic Surgery, Faculty of Medicine, McGill University, Montreal, QC, Canada

    J. Dennis Bobyn PhD & Michael Tanzer MD

Authors
  1. J. Dennis Bobyn PhD
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  2. Rebecca Thompson MEng
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  3. Letitia Lim MD
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  4. Jenny Ann Pura BSc
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  5. Kristian Bobyn BA
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  6. Michael Tanzer MD
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Corresponding author

Correspondence to J. Dennis Bobyn PhD.

Additional information

The institution of one or more of the authors (JDB, MT) has received, during the study period, funding from the Canadian Institutes of Health Research and Pipeline Biotechnology. Two of the authors (JDB, MT) certify that they each received payments or benefits, during the study period, an amount of USD 10,000 to USD 100,000 from Pipeline Biotechnology (Cedar Knolls, NJ, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Bobyn, J.D., Thompson, R., Lim, L. et al. Local Alendronic Acid Elution Increases Net Periimplant Bone Formation: A Micro-CT Analysis. Clin Orthop Relat Res 472, 687–694 (2014). https://doi.org/10.1007/s11999-013-3120-6

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  • DOI: https://doi.org/10.1007/s11999-013-3120-6

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