title: Rinsing morcellised bone grafts with bisphosphonate solution prevents their resorption. A prospective randomised double-blinded study.
abstract: During revision total hip replacement using morcellised compacted bone allograft, 16 patients were randomised to receive a graft which had been rinsed in either an ibandronate solution or in saline. Patients were assessed by dual energy x-ray absorptiometry after operation and at 3, 6, 12 and 24 months. A region of interest between the tip of the femoral stem and the distal plastic plug was chosen to measure the changes in bone density over time. The study was double-blinded. In all the control patients the bone density decreased during the first three months and then remained constant at this lower level. A large proportion of the mass of the bone graft was lost. In contrast, all patients with grafts treated with bisphosphonate showed a slight increase in bone density. The difference between the groups was highly significant at all points in time. We conclude that rinsing the graft in a bisphosphonate solution prevents its resorption and may therefore reduce the risk of mechanical failure. The treatment is simple, inexpensive, and appears virtually free of risk.
authors.affiliation: Department of Orthopedics, Lund University Hospital, SE-221 85 Lund, Sweden. uldis.kesteris@med.lu.se
authors.forename: U
authors.initials: U
authors.lastname: Kesteris
authors.forename: P
authors.initials: P
authors.lastname: Aspenberg
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D001862:Bone Resorption / Q000517:prevention & control*; D016025:Bone Transplantation / Q000379:methods*; D004164:Diphosphonates / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D000077557:Ibandronic Acid; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation; D012996:Solutions / Q000008:administration & dosage; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D012996:Solutions; D000077557:Ibandronic Acid