title: Perioperative alendronate, risedronate, calcitonin and indomethacin treatment alters femoral stem fixation and periprosthetic bone mineral density in ovariectomized rats.
abstract: BACKGROUND
  Many factors affect implant stability and periprosthetic bone mineral density (BMD) following total joint arthroplasty. We asked whether perioperative alendronate, risedronate, calcitonin and indomethacine administration altered (1) femoral stem shear strength and periprosthetic bone mineral density BMD in ovariectomized rats and (2) whether there were differences in the effect of these drugs.
  
  
  METHODS
  Thirty overiectomized rats were divided into five groups and implanted with intramedullary mini-cortical screws in the femur. Four groups were treated with alendronate, risedronate, salmon calcitonin and indomethacin for 4 weeks preoperatively and 8 weeks postoperatively.
  
  
  RESULTS
  Although alendronate and risedronate increased the periprosthetic BMD more than calcitonin, they did not alter implant fixation compared to calcitonin. Indomethacin significantly decreased the BMD around the stem and implant stability compared to all other groups.
  
  
  CONCLUSIONS
  This study showed that perioperative treatment with bisphosphonates and calcitonin improved the BMD around the stems and implant stability. Although bisphosphonates increased the BMD more than calcitonin, there was no difference in implant stability. Indomethacin markedly decreased the periprosthetic BMD and implant stability. The main clinical significance of our study was the finding about the need to strictly avoid long-term use of high-dose nonsteroidal antiinflammatory drugs for patients who have major joint arthritis and a previous history of arthroplasty.
authors: Department of Orthopaedic and Traumatology, Ankara Numune Training and Research Hospital, 06100, Altindag, Ankara, Turkey, cankayadeniz78@gmail.com.
authors: Deniz
authors: D
authors: Cankaya
authors: Yalcin
authors: Y
authors: Tabak
authors: Akif Muhtar
authors: AM
authors: Ozturk
authors: Muhammed Cuneyd
authors: MC
authors: Gunay
mesh_terms: D015502:Absorptiometry, Photon; D019386:Alendronate / Q000008:administration & dosage*; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D002116:Calcitonin / Q000008:administration & dosage*; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D007213:Indomethacin / Q000008:administration & dosage*; D010024:Osteoporosis / Q000209:etiology / Q000517:prevention & control; D010052:Ovariectomy / Q000009:adverse effects; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D051381:Rats; D017208:Rats, Wistar; D000068296:Risedronic Acid / Q000008:administration & dosage*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D050071:Bone Density Conservation Agents; D002116:Calcitonin; D000068296:Risedronic Acid; D019386:Alendronate; D007213:Indomethacin