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Alendronate Improves Bone Mineral Density After Total Knee Arthroplasty
A DGReview of :"The effect of alendronate on bone mineral density in the distal part of the femur and proximal part of the tibia after total knee arthroplasty"
Journal of Bone and Joint Surgery. American Volume
12/11/2003
By Emma Hitt, PhD
Oral administration of alendronate for 6 months after total knee arthroplasty appears to improve bone mineral density significantly in the distal part of the femur and proximal part of the tibia, new research suggests.
The mechanical properties of the trabecular bone in the proximal part of the tibia and the distal part of the femur are considered to be an important predictor of failure after total knee arthroplasty.
Ching-Jen Wang, MD, with the Kaohsiung Medical Center, Niao-Sung Hsiang, Taiwan, and colleagues hypothesised that alendronate, an antiresorptive bisphosphonate effective for treating osteoporosis, could decrease bone loss and improve outcomes after total knee arthroplasty.
In their study, 96 women, average age 70 years, who were undergoing total knee arthroplasty were randomised to receive oral alendronate at a dose of 10 mg/day for 6 months or no alendronate (controls).
The researchers determined bone mineral density in the distal part of the femur and proximal part of the tibia preoperatively and at 6 and 12 months postoperatively.
In the control group, bone mineral density decreased by 13.8% (P < .001) and 7.8% (P = .003) in the distal part of the femur and by 6.5% (P = .002) and 3.6% (P = .141) in the proximal part of the tibia at 6 and 12 months, respectively.
In contrast, the bone mineral density of the study group increased by 10.0% (P = .010) and 1.9% (P = .049) in the distal part of the femur and by 9.4% (P < .001) and 5.4% (P = .032) in the proximal part of the tibia at 6 and 12 months, respectively.
According to Dr. Wang and colleagues, the overall differences in bone mineral density between the study and control groups were significant (P = .011 for the proximal part of the tibia, and P = .033 for the distal part of the femur).
"The bone mineral density changes beyond one year are unknown at the present time, and additional studies are needed to determine the long-term effects of alendronate," the researchers note.
"The better bone density that was found after treatment with alendronate may lead to better fixation of prosthetic components, increased longevity of total knee prostheses, and a reduced risk of periprosthetic fracture," they suggest.
J Bone Joint Surg Am 2003;85:2121-2126.
"The effect of alendronate on bone mineral density in the distal part of the femur and proximal part of the tibia after total knee arthroplasty"
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