Local bisphosphonate treatment increases fixation of hydroxyapatite-coated implants inserted with bone compaction

Thomas Jakobsen, Jørgen Baas, Søren Kold, Joan E. Bechtold, Brian Elmengaard, Kjeld Søballe

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

It has been shown that fixation of primary cementless joint replacement can independently be enhanced by either: (1) use of hydroxyapatite (HA) coated implants, (2) compaction of the peri-implant bone, or (3) local application of bisphosphonate. We investigated whether the combined effect of HA coating and bone compaction can be further enhanced with the use of local bisphosphonate treatment. HA coated implants were bilaterally inserted into the proximal tibiae of 10 dogs. On one side local bisphosphonate was applied prior to bone compaction. Saline was used as control on the contralateral side. Implants were evaluated with histomorphometry and biomechanical pushout test. We found that bisphosphonate increased the peri-implant bone volume fraction (1.3-fold), maximum shear strength (2.1-fold), and maximum shear stiffness (2.7-fold). No significant difference was found in bone-to-implant contact or total energy absorption. This study indicates that local alendronate treatment can further improve the fixation of porous-coated implants that have also undergone HA-surface coating and peri-implant bone compaction.

Original languageEnglish (US)
Pages (from-to)189-194
Number of pages6
JournalJournal of Orthopaedic Research
Volume27
Issue number2
DOIs
StatePublished - Feb 2009

Keywords

  • Bisphosphonate
  • Bone compaction
  • Canines
  • Implant fixation

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