Belfrage Ola, Tägil Magnus, Sundberg Martin, Kesteris Uldis, Flivik Gunnar
1 Orthopaedics, Skåne University Hospital, Lund, Sweden.
2 Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Hip Int. 2019 Jan;29(1):26-34. doi: 10.1177/1120700018781809. Epub 2018 Jun 22.
: Bisphosphonates have previously been shown to increase the density of impacted graft bone. In the present study we hypothesise that bisphosphonates also reduce early stem subsidence. We examined the effect of locally applied bisphosphonate to allografts on prosthetic micromotion and bone density in femoral stem revision with impaction grafting.
: 37 patients were randomised to either clodronate or saline as local adjunct to the morsellised allograft bone. 24 patients were finally analysed per protocol and evaluated by dual-energy x-ray absorptiometry (DXA) during the first year and with radiostereometric analysis (RSA) for 5 years.
: There were no significant differences neither in bone density, nor in migratory behaviour between the groups. The femoral stems had subsided 3.6 mm in both groups (p = 0.99) at 5 years and there was no difference as measured over time with mixed models analysis. The clinical outcome was good in both groups.
: Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.
双膦酸盐先前已被证明可增加植入骨块的骨密度。在本研究中，我们假设双膦酸盐还可减少早期假体下沉。我们研究了在股骨柄翻修术中局部应用双膦酸盐于同种异体骨上对假体微动和骨密度的影响。
37例患者被随机分为接受氯膦酸盐或生理盐水作为碎骨同种异体骨的局部辅助用药。最终按方案分析24例患者，并在第一年通过双能X线吸收法（DXA）进行评估，并用放射立体测量分析（RSA）进行5年评估。
两组之间在骨密度和迁移行为方面均无显著差异。5年时两组股骨柄均下沉3.6毫米（p = 0.99），混合模型分析显示随时间测量无差异。两组临床结果均良好。
在髋关节翻修术中，氯膦酸盐作为同种异体骨的局部添加剂，并未增加骨密度或减少植入物的微动。
