title: No effect of risedronate on femoral periprosthetic bone loss following total hip arthroplasty. A 4-year follow-up of 61 patients in a double-blind, randomized placebo-controlled trial.
abstract: OBJECTIVE
  We have previously shown that during the first 2 years after total hip arthroplasty (THA), periprosthetic bone resorption can be prevented by 6 months of risedronate therapy. This follow-up study investigated this effect at 4 years.
  
  
  METHODS
  A single-center, double-blind, randomized placebo-controlled trial was carried out from 2006 to 2010 in 73 patients with osteoarthritis of the hip who were scheduled to undergo THA. The patients were randomly assigned to receive either 35 mg risedronate or placebo orally, once a week, for 6 months postoperatively. The primary outcome was the percentage change in bone mineral density (BMD) in Gruen zones 1 and 7 in the proximal part of the femur at follow-up. Secondary outcomes included migration of the femoral stem and clinical outcome scores.
  
  
  RESULTS
  61 of the 73 patients participated in this 4-year (3.9- to 4.1-year) follow-up study. BMD was similar in the risedronate group (n = 30) and the placebo group (n = 31). The mean difference was -1.8% in zone 1 and 0.5% in zone 7. Migration of the femoral stem, the clinical outcome, and the frequency of adverse events were similar in the 2 groups.
  
  
  CONCLUSIONS
  Although risedronate prevents periprosthetic bone loss postoperatively, a decrease in periprosthetic BMD accelerates when therapy is discontinued, and no effect is seen at 4 years. We do not recommend the use of risedronate following THA for osteoarthritis of the hip.
authors.affiliation: a Division of Orthopedics , Department of Clinical Sciences, Danderyd Hospital and the Karolinska Institute, Stockholm, Sweden.
authors.forename: Olle
authors.initials: O
authors.lastname: Muren
authors.affiliation: a Division of Orthopedics , Department of Clinical Sciences, Danderyd Hospital and the Karolinska Institute, Stockholm, Sweden.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Akbarian
authors.affiliation: a Division of Orthopedics , Department of Clinical Sciences, Danderyd Hospital and the Karolinska Institute, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Salemyr
authors.affiliation: a Division of Orthopedics , Department of Clinical Sciences, Danderyd Hospital and the Karolinska Institute, Stockholm, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Bodén
authors.affiliation: a Division of Orthopedics , Department of Clinical Sciences, Danderyd Hospital and the Karolinska Institute, Stockholm, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Eisler
authors.affiliation: a Division of Orthopedics , Department of Clinical Sciences, Danderyd Hospital and the Karolinska Institute, Stockholm, Sweden.
authors.forename: André
authors.initials: A
authors.lastname: Stark
authors.affiliation: a Division of Orthopedics , Department of Clinical Sciences, Danderyd Hospital and the Karolinska Institute, Stockholm, Sweden.
authors.forename: Olof
authors.initials: O
authors.lastname: Sköldenberg
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D016723:Bone Remodeling / Q000187:drug effects*; D001862:Bone Resorption / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D000068296:Risedronic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D000068296:Risedronic Acid