Bisphosphonate treatment for osteolysis in total hip arthroplasty. A report of four cases

Trevisan, Carlo and Nava, Veronica and Mattavelli, Marta and Garcia Parra, Cleber (2013) Bisphosphonate treatment for osteolysis in total hip arthroplasty. A report of four cases. Clinical cases in mineral and bone metabolism, 10 (1). pp. 61-64. ISSN 1971-3266

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Aseptic loosening due to wear debris is the most frequent modality of failure in total hip arthroplasty. Bisphosphonates, a class of molecules which inhibit bone resorption showed an inhibitory effects on particles-induced osteolysis in vitro and in animal models. We report the clinical, radiographic and densitometric outcome of four postmenopausal women with total hip arthroplasty affected by periprosthetic osteolysis treated with neridronate due to their unwillingness to be operated. After neridronate treatment, there was general improvement in pain and function: VAS decrease 13 points (15%), the Harris Hip Score increase 9 points (15%). An average number of 3.3 x-ray per patients with an average follow-up of 23 months (range 12-34) were collected and evaluated. In all the patients except one, serial radiographs didn’t show any progression of radioluciencies lines or periprosthetic osteolysis. Bone density was evaluated by Dual energy X-ray absorptiometry after an average follow-up of 21 months (range 6-46 mo): periprosthetic BMD around the whole stem and the cup increased respectively 2.4% and 7.1%. Treatment was well tolerated and no significant side effects were registered. This retrospective collection of a small group of patients suggest that bisphosphonates should be clinically useful in preventing periprosthetic wear debris mediated osteolysis and claim for dedicated clinical trials

Item Type: Article
Uncontrolled Keywords: Aseptic loosening, total hip arthroplasty, bisphosphonates, osteolysis, bone mineral density
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 611 Anatomia; Citologia; Istologia umana > 611.7 Sistema muscoloscheletrico, tegumento
Depositing User: Danilo Dezzi
Date Deposited: 28 Nov 2013 11:47
Last Modified: 28 Nov 2013 11:47

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