Document Detail

Cyclic therapy with etidronate has a therapeutic effect against local osteoporosis after cementless total hip arthroplasty.
MedLine Citation:
PMID:  12919709     Owner:  NLM     Status:  MEDLINE    
Proximal bone resorption around the femoral stem is one of the major complications of cementless total hip arthroplasty (THA). The potential complications resulting from proximal bone resorption include femoral fracture and late stem loosening. The purpose of this study was to evaluate the effects of cyclic therapy with etidronate on periprosthetic bone mineral density (BMD) after cementless THA. Fifty-two patients who had undergone cementless THA were randomized for this study. Group A consisted of 30 hips in 29 patients without osteoactive drugs. Group B consisted of 23 hips in 23 patients with cyclic therapy with etidronate (i.e., 400 mg/day of oral etidronate for 2 weeks followed by 12 weeks of 500 mg/day of calcium lactate and repeated every 14 weeks), one of whom was excluded from the study because of side effects attributed to the drug. Periprosthetic BMD in seven regions of interest based on the zones of Gruen et al. (Clin. Orthop. 141 (1979), 17-27) was measured with dual energy X-ray absorptiometry (DXA) at 3 weeks, 6 months, and 12 months postoperatively. The postoperative decreases of BMD in group B were significantly lower than those in group A in zones 1 and 7 (P < 0.05 and P < 0.05, respectively) at 6 months and in zones 1, 2, 6, and 7 (P < 0.05, P < 0.05, P < 0.05, and P < 0.001, respectively) at 12 months. The BMD change appeared to be stabilized at 6 months in all zones in group B, while in group A there was a progressive decrease of average BMD (6.1%) in zone 7 between 6 months and 12 months. These findings suggested that cyclic therapy with etidronate may help to reduce the resorptive changes in the proximal part of the femur after cementless THA. Further follow-up study with larger populations will be required to define the potential efficacy of intermittent cyclic etidronate therapy on postoperative bone loss.
Katsuyuki Yamaguchi; Kensaku Masuhara; Satoshi Yamasaki; Tsuyoshi Nakai; Takeshi Fuji
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Bone     Volume:  33     ISSN:  8756-3282     ISO Abbreviation:  Bone     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-08-15     Completed Date:  2004-04-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8504048     Medline TA:  Bone     Country:  United States    
Other Details:
Languages:  eng     Pagination:  144-9     Citation Subset:  IM    
Department of Orthopaedic Surgery, Kaizuka City Hospital, 3-10-20, Hori, Kaizuka, Osaka 597-0015, Japan.
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MeSH Terms
Analysis of Variance
Arthroplasty, Replacement, Hip / adverse effects*
Biological Markers / blood,  urine
Chi-Square Distribution
Drug Administration Schedule
Etidronic Acid / administration & dosage*
Middle Aged
Osteoporosis / drug therapy*,  metabolism,  prevention & control
Prospective Studies
Statistics, Nonparametric
Reg. No./Substance:
0/Biological Markers; 2809-21-4/Etidronic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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