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Peri-operative zoledronic acid attenuates peri-prosthetic osteolysis in a rat model of cemented knee replacement.
Mann, Kenneth A; Miller, Mark A; Gandhi, Sachin A; Kusler, Jace E; Tatusko, Megan E; Biggs, Amy E; Oest, Megan E.
Afiliação
  • Mann KA; Department of Orthopedic Surgery, Institute for Human Performance, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Miller MA; Department of Orthopedic Surgery, Institute for Human Performance, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Gandhi SA; Department of Orthopedic Surgery, Institute for Human Performance, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Kusler JE; Department of Orthopedic Surgery, Institute for Human Performance, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Tatusko ME; Department of Orthopedic Surgery, Institute for Human Performance, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Biggs AE; Department of Orthopedic Surgery, Institute for Human Performance, SUNY Upstate Medical University, Syracuse, New York, USA.
  • Oest ME; Department of Orthopedic Surgery, Institute for Human Performance, SUNY Upstate Medical University, Syracuse, New York, USA.
J Orthop Res ; 2024 Jul 20.
Article em En | MEDLINE | ID: mdl-39032112
ABSTRACT
Progressive osteolysis can occur at the cement-bone interface of joint replacements and the associated loss of fixation can lead to clinical loosening. We previously developed a rat hemiarthroplasty model that exhibited progressive loss of fixation with the development of cement-bone gaps under the tibial tray that mimicked patterns found in human arthroplasty retrievals. Here we explored the ability of a bisphosphonate (zoledronic acid, ZA) to attenuate cement-bone osteolysis and maintain implant stability. Sprague-Dawley rats (n = 59) received a poly(methylmethacrylate) cemented tibial component and were followed for up to 12 weeks. Treatment groups included peri-operative administration of ZA (ZA group), administration of ZA at 6 weeks postop (late ZA group), or vehicle (Veh group). There was a 60% reduction in the rate of cement-bone gap formation for the ZA group (0.15 mm3/week) compared to Veh group (0.38 mm3/week, p = 0.016). Late ZA prevented further progression of gap formation but did not reverse bone loss to the level achieved in the ZA group. Micromotion from five times body weight toggle loading was positively correlated with cement-bone gap volume (p = 0.009) and negatively correlated with the amount of cement in the metaphysis (p = 0.005). Reduced new bone formation and enduring nonviable bone in the epiphysis for the ZA group were found. This suggests that low bone turnover in the epiphysis may suppress the early catabolic response due to implantation, thereby maintaining better fixation in the epiphysis. This preclinical model presents compelling supporting data documenting improved maintenance of the cement-bone fixation with the use of peri-operative bisphosphonates.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Orthop Res Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Orthop Res Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos