Jakobsen Thomas, Kold Søren, Shiguetomi-Medina Juan, Baas Jorgen, Soballe Kjeld, Rahbek Ole
Orthopaedic Research Laboratory, Department of Orthopaedics, Aarhus University Hospital, Norrebrogade 44, Building 1A, DK-8000, Aarhus, Denmark.
Department of Orthopaedics, Aalborg University Hospital, Aalborg, Denmark.
BMC Musculoskelet Disord. 2017 Nov 13;18(1):441. doi: 10.1186/s12891-017-1802-z.
Initial micromotion of a total hip replacement is associated with aseptic loosening. The use of bisphosphonates could be one way to reduce peri-implant bone resorption induced by micromotion. Bisphosphonates compounds are inhibitors of bone resorption. The aim of this study was to investigate whether local treatment with bisphosphonate would reduce bone resorption and fibrous tissue around an experimental implant subjected to micromotion.
One micromotion implant were inserted into each medial femoral condyle in ten sheep. During each gait cycle the implant axially piston 0.5 mm. During surgery one of the femoral condyles were locally treated with 0.8 mg zoledronate. The other condyle served as control. Observation period was 12 weeks.
Histological evaluation showed a fibrous capsule around both the control and bisphosphonate implants. Histomorphometrical analysis showed that 97% of the surface on both control and bisphosphonate implants were covered by fibrous tissue. However, the bisphosphonate was able to preserve bone in a 1 mm zone around the implants.
This study indicates that local treatment with bisphosphonate cannot prevent the formation of a fibrous capsule around an implant subjected to micromotion, but bisphosphonate is able to reduce resorption of peri-prosthetic bone.
全髋关节置换术后的初始微动与无菌性松动有关。使用双膦酸盐可能是减少微动引起的种植体周围骨吸收的一种方法。双膦酸盐化合物是骨吸收抑制剂。本研究的目的是调查双膦酸盐局部治疗是否会减少受微动影响的实验性种植体周围的骨吸收和纤维组织。
将一个微动种植体植入十只绵羊的每个内侧股骨髁。在每个步态周期中,种植体轴向活塞移动0.5毫米。在手术过程中,其中一个股骨髁用0.8毫克唑来膦酸进行局部治疗。另一个髁作为对照。观察期为12周。
组织学评估显示对照种植体和双膦酸盐种植体周围均有纤维囊。组织形态计量学分析表明,对照种植体和双膦酸盐种植体表面的97%被纤维组织覆盖。然而,双膦酸盐能够在种植体周围1毫米的区域内保留骨组织。
本研究表明,双膦酸盐局部治疗不能防止受微动影响的种植体周围纤维囊的形成,但双膦酸盐能够减少假体周围骨的吸收。