title: A systematic review assessing the effectiveness of alendronate in reducing periprosthetic bone loss after cementless primary THA.
abstract: Periprosthetic bone loss, especially in the proximal part of the femur, is common after cementless total hip arthroplasty (THA). To determine the short- and long-term effect of alendronate on periprosthetic bone mineral density after THA, we conducted computerized searches for randomized, controlled trials evaluating the use of alendronate in patients treated with cementless primary THA. A review of PubMed, the Cochrane Central Register of Controlled Trials, Web of Science, and Embase from their inception to May 2010 was completed, and we assessed methodological quality and abstracted relevant data. Of 310 citations that were initially identified, 5 studies assessing 146 patients were reviewed. Those studies showed that significantly less periprosthetic bone loss had occurred in the alendronate-treated group than in the placebo-treated group during the short-term period after THA. For long-term investigation, the studies reported that the periprosthetic bone density was a bit higher in the alendronate-treated group compared to the placebo-treated group, but the differences did not reach statistical significance.This systematic review suggests that alendronate has a beneficial effect with regard to preservation of periprosthetic bone short-term after cementless THA. However, the studies could not provide enough evidence that the positive effect noted in the early postoperative period is maintained long-term. A longer follow-up with a larger number of participants is needed to confirm the outcome of cementless THA patients treated with alendronate.
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zeng
authors.forename: Oujie
authors.initials: O
authors.lastname: Lai
authors.forename: Bin
authors.initials: B
authors.lastname: Shen
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.forename: Zongke
authors.initials: Z
authors.lastname: Zhou
authors.forename: Pengde
authors.initials: P
authors.lastname: Kang
authors.forename: Fuxing
authors.initials: F
authors.lastname: Pei
mesh_terms: D019386:Alendronate / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002484:Cementation; D006801:Humans; D010014:Osteolysis / Q000209:etiology / Q000517:prevention & control*; D011475:Prosthesis Failure; D016032:Randomized Controlled Trials as Topic
chemical_list: D001843:Bone Cements; D050071:Bone Density Conservation Agents; D019386:Alendronate