title: Surface-bound bisphosphonates enhance screw fixation in rats--increasing effect up to 8 weeks after insertion.
abstract: BACKGROUND
  A bisphosphonate coating improves screw fixation 2 weeks after implantation in cancellous bone. This study on rats examined further development of fixation over time for screws inserted in cancellous and cortical bone.
  
  
  METHODS
  SS screws were coated with a multiple layer of fibrinogen. Half of the screws were coated further with bisphosphonates, which were linked to the fibrinogen. The screws were inserted in cancellous and cortical bone in rats. The rats were killed after 5 h, 4 days, 1, 2, 4, 8, and 24 weeks, and fixation was evaluated by pullout test.
  
  
  RESULTS
  There was a gradual increase in pull-out force over time in both cancellous and cortical bone. The bisphosphonate coating improved fixation. Moreover, the difference between the bisphosphonate and control groups increased with time. The pull-out force was almost twice that of the controls for screws inserted in cancellous bone at 8 weeks. Energy uptake was increased more than 3-fold.
  
  
  CONCLUSIONS
  The energy uptake and pull-out force of a screw depends on the bone engaged with the threads. Thus, the presence of bisphosphonates increased the amount or quality of this bone by affecting the resorption/formation in a positive way. The increased effect of the bisphosphonates with time thus suggests that bisphosphonate is retained within the remodeling bone, with a positive effect on its gradual adaptation to the implant.
authors.affiliation: Orthopedics Section, Department of Neuroscience and Locomotion, Faculty of Health Sciences, Linköping University, Linköping, Sweden. karwe@inr.liu.se
authors.forename: Karin
authors.initials: K
authors.lastname: Wermelin
authors.forename: Pentti
authors.initials: P
authors.lastname: Tengvall
authors.forename: Per
authors.initials: P
authors.lastname: Aspenberg
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D016723:Bone Remodeling / Q000187:drug effects; D001862:Bone Resorption / Q000517:prevention & control; D001863:Bone Screws; D020099:Coated Materials, Biocompatible / Q000378:metabolism / Q000494:pharmacology; D004164:Diphosphonates / Q000378:metabolism / Q000494:pharmacology; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D008422:Materials Testing; D019736:Prostheses and Implants; D051381:Rats; D013193:Stainless Steel; D013314:Stress, Mechanical; D013501:Surface-Active Agents / Q000378:metabolism / Q000494:pharmacology; D013997:Time Factors
chemical_list: D020099:Coated Materials, Biocompatible; D004164:Diphosphonates; D013501:Surface-Active Agents; D013193:Stainless Steel