Alendronate prevents femoral periprosthetic bone loss following total hip arthroplasty: prospective randomized double-blind study.

Author(s): Arabmotlagh M, Rittmeister M, Hennigs T

Affiliation(s): Department of Orthopaedic Surgery, Orthopadische Universitatsklinik Frankfurt - Stiftung Friedrichsheim, Marienbburg Str. 2, 60528 Frankfurt am Main, Germany. m.arabmotlagh@t-online.de

Publication date & source: 2006-07, J Orthop Res., 24(7):1336-41.

Publication type: Randomized Controlled Trial

Following total hip arthroplasty (THA), femoral periprosthetic bone undergoes a remodeling process that results in bone loss in its proximal regions that may compromise the long-term outcome of THA. Periprosthetic bone loss mainly occurs during the first postoperative months. The question is whether a postoperative treatment with alendronate is effective in reducing periprosthetic bone loss and which doses and duration of treatment are required. In a 12-month prospective, randomized double-blind study, 51 patients undergoing cementless THA were treated postoperatively either with a daily dose of 20 mg alendronate for 2 months and 10 mg for 2 months thereafter (group I), with 20 mg of alendronate for 2 months and 10 mg for 4 months thereafter (group II), or treated with placebo (group III). Proximal femoral bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry (DEXA) and serum biochemical markers of bone turnover bone specific alkaline phosphatase, osteocalcin, and C-terminal telopeptides (CTX-I) were assayed. Six months of alendronate treatment significantly reduced (p<0.001) bone loss in proximal medial region (-10%) compared with placebo (-26%). All biochemical markers of bone turnover were suppressed by alendronate. These data suggest that alendronate administered for the first 6 postoperative months following THA was effective in preventing early periprosthetic bone loss. Copyright (c) 2006 Orthopaedic Research Society.