title: Once-weekly oral medication with alendronate does not prevent migration of knee prostheses: A double-blind randomized RSA study.
abstract: OBJECTIVE
  Early migration of joint replacements is an effect of poor fixation and can predict late loosening. By reducing the bone resorption after implantation of a joint replacement, it should be possible to enhance the initial fixation of the implant. We studied the effect of once-weekly treatment with alendronate after knee replacement.
  
  
  METHODS
  We recruited 60 patients (60 knees) with gonarthrosis who were scheduled for a total knee replacement. They were operated on with identical implants and uncemented fixation. 30 patients were treated with a bisphosphonate (alendronate) and 30 patients underwent placebo treatment. The treatment started postoperatively and continued on a weekly basis for 6 months. The fixation of the implants was measured with repeated radiostereometry for 2 years.
  
  
  RESULTS
  There was no difference in migration of implants between the two groups.
  
  
  CONCLUSIONS
  With uncemented fixation of knee implants, no benefit of once-weekly treatment with alendronate, starting postoperatively, could be seen during a 2-year follow-up period.
authors.affiliation: Department of Orthopedics, Lund University Hospital, Lund, Sweden. ulrik.hansson@med.lu.se
authors.forename: Ulrik
authors.initials: U
authors.lastname: Hansson
authors.forename: Sören
authors.initials: S
authors.lastname: Toksvig-Larsen
authors.forename: Leif
authors.initials: L
authors.lastname: Ryd
authors.forename: Per
authors.initials: P
authors.lastname: Aspenberg
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D016723:Bone Remodeling / Q000187:drug effects; D001862:Bone Resorption / Q000000981:diagnostic imaging; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D011475:Prosthesis Failure; D011859:Radiography
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate