title: Alendronate prevents femoral periprosthetic bone loss following total hip arthroplasty: prospective randomized double-blind study.
abstract: Following total hip arthroplasty (THA), femoral periprosthetic bone undergoes a remodeling process that results in bone loss in its proximal regions that may compromise the long-term outcome of THA. Periprosthetic bone loss mainly occurs during the first postoperative months. The question is whether a postoperative treatment with alendronate is effective in reducing periprosthetic bone loss and which doses and duration of treatment are required. In a 12-month prospective, randomized double-blind study, 51 patients undergoing cementless THA were treated postoperatively either with a daily dose of 20 mg alendronate for 2 months and 10 mg for 2 months thereafter (group I), with 20 mg of alendronate for 2 months and 10 mg for 4 months thereafter (group II), or treated with placebo (group III). Proximal femoral bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry (DEXA) and serum biochemical markers of bone turnover bone specific alkaline phosphatase, osteocalcin, and C-terminal telopeptides (CTX-I) were assayed. Six months of alendronate treatment significantly reduced (p<0.001) bone loss in proximal medial region (-10%) compared with placebo (-26%). All biochemical markers of bone turnover were suppressed by alendronate. These data suggest that alendronate administered for the first 6 postoperative months following THA was effective in preventing early periprosthetic bone loss.
authors.affiliation: Department of Orthopaedic Surgery, Orthopädische Universitätsklinik Frankfurt - Stiftung Friedrichsheim, Marienbburg Str. 2, 60528 Frankfurt am Main, Germany. m.arabmotlagh@t-online.de
authors.forename: Mohammad
authors.initials: M
authors.lastname: Arabmotlagh
authors.forename: Markus
authors.initials: M
authors.lastname: Rittmeister
authors.forename: Thorsten
authors.initials: T
authors.lastname: Hennigs
mesh_terms: D000328:Adult; D000368:Aged; D019386:Alendronate / Q000008:administration & dosage / Q000627:therapeutic use*; D000469:Alkaline Phosphatase / Q000097:blood; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000517:prevention & control*; D024042:Collagen Type I / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000378:metabolism*; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010010:Osteoclasts / Q000378:metabolism; D010455:Peptides / Q000097:blood; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011859:Radiography
chemical_list: D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D000469:Alkaline Phosphatase; D019386:Alendronate