title: Effect of combined treatment with alendronate and calcitriol on femoral neck strength in osteopenic rats.
abstract: BACKGROUND
  Hip fracture is associated with pronounced morbidity and excess mortality in elderly women with postmenopausal osteoporosis. Many drugs have been developed to treat osteoporosis and to reduce the risk of osteoporotic fractures. We investigated the effects of combined alendronate and vitamin D3 treatment on bone mass and fracture load at the femoral neck in ovariectomized (OVX) rats, and evaluated the relationship between bone mass parameters and femoral neck strength.
  
  
  METHODS
  Thirty 12-week-old female rats underwent either a sham-operation (n = 6) or OVX (n = 24). Twenty weeks later, OVX rats were further divided into four groups and received daily doses of either saline alone, 0.1 mg/kg alendronate, 0.1 microg/kg calcitriol, or a combination of both two drugs by continuous infusion via Alzet mini-osmotic pumps. The sham-control group received saline alone. After 12 weeks of treatment, femoral necks were examined using peripheral quantitative computed tomography (pQCT) densitometry and mechanical testing.
  
  
  RESULTS
  Saline-treated OVX rats showed significant decreases in total bone mineral content (BMC) (by 28.1%), total bone mineral density (BMD) (by 9.5%), cortical BMC (by 26.3%), cancellous BMC (by 66.3%), cancellous BMD (by 29.0%) and total cross-sectional bone area (by 30.4%) compared with the sham-control group. The combined alendronate and calcitriol treatments improved bone loss owing to estrogen deficiency. On mechanical testing, although OVX significantly reduced bone strength of the femoral neck (by 29.3%) compared with the sham-control group, only the combined treatment significantly improved the fracture load at the femoral neck in OVX rats to the level of the sham-controls. The correlation of total BMC to fracture load was significant, but that of total BMD was not.
  
  
  CONCLUSIONS
  Our results showed that the combined treatment with alendronate and calcitriol significantly improved bone fragility of the femoral neck in OVX osteopenic rats.
authors.affiliation: Department of Orthopaedic Surgery, Fukuoka University School of Medicine, Fukuoka, Japan. y.nakamura725@moon.email.ne.jp
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Naito
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hayashi
authors.forename: Abbas
authors.initials: A
authors.lastname: Fotovati
authors.forename: Samah
authors.initials: S
authors.lastname: Abu-Ali