Once-weekly oral medication with alendronate does not prevent migration of knee prostheses: A double-blind randomized RSA study

Acta Orthop. 2009 Feb;80(1):41-5. doi: 10.1080/17453670902804968.

Abstract

Background and purpose: 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.

Patients and 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.

Conclusion: 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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Alendronate / administration & dosage*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Bone Density / drug effects
  • Bone Density Conservation Agents / administration & dosage*
  • Bone Remodeling / drug effects
  • Bone Resorption / diagnostic imaging
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Prosthesis*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / surgery
  • Prosthesis Failure*
  • Radiography

Substances

  • Bone Density Conservation Agents
  • Alendronate