Action de l'Alendronate sur l'état osseux péri-prothétique après prothèse totale de hanche cimentée: étude prospective randomisée en double aveugle.

摘要: PURPOSE OF THE STUDY Bone remodeling and osteolysis around total hip prostheses, with its inevitable corollary, prosthesis loosening, remains a difficult problem in orthopedic surgery. Alendronate (bisphosphonate) has proven efficacy for the treatment of osteoporosis lumbar spine femoral neck. A few vitro studies have pointed out inhibiting effect on particle-induced osteolysis. In vivo, one study demonstrated usefulness preventing non-cemented arthroplasties (THA). The purpose this work was to agent prevention changes peri-prosthetic bone mineral density (BMD) after primary THA. MATERIAL AND METHODS series included 38 patients degenerative disease who underwent were randomized double-blind fashion two arms: 10 alendronate 600 mg calcium per day 2 years (20 patients) or placebo (18 patients). Conventional x-rays x-ray biphotonic absorptiometry (DPX) performed four postop at 3, 6, 12, 24 months postop. periprosthetic zones described by Gruen used analysis. RESULTS DPX significant reduction BMD all study. loss same both groups during early postoperative period reaching maximum 3 months. Differences observed time. group, reached plateau 6 then started increase progressively, 12.7% follow-up (p<0.002). there no plateau, increased continuously starting from three 6.857% (p<0.003). DISCUSSION Administration led follow-up. These results are first our knowledge demonstrating beneficial vivo behavior cemented THAs. CONCLUSION This should be confirmed further including larger number longer action could facilitate even retard revision surgery preserving stock.