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Aledronate Tied to Less BMD Loss Around Femoral Implants

Decreased bone mineral density loss in lumbar spine with alendronate or alfacalcidol treatment

TUESDAY, July 12 (HealthDay News) -- Bone mineral density (BMD) is maintained in all regions around femoral implants in patients undergoing hip arthroplasty who are treated with alendronate, whereas in the lumbar spine, BMD is higher in patients treated with alendronate or alfacalcidol, according to a study published in the July 6 issue of The Journal of Bone & Joint Surgery.

Naoyuki Iwamoto, M.D., from the Yokohama City University School of Medicine in Japan, and colleagues compared the effects of alendronate and alfacalcidol on BMD around the femoral implant and in the lumbar spine after total hip arthroplasty in 60 patients with osteoarthritis of the hip. Patients were treated with alendronate, alfacalcidol, or no medication. Biochemical markers were measured before surgery, and periprosthetic and lumbar spine BMD was measured one week after surgery and again at 12, 24, and 48 weeks. The periprosthetic measurement area in the femur was defined as Regions 1 to 7, sequentially positioned around the implant.

The investigators found that the alendronate group maintained BMD in all regions; whereas, in the alfacalcidol and no-medication groups, BMD in Region 7 was lower than in Regions 3 to 6. At 48 weeks, the alendronate and alfacalcidol groups had higher BMD in the lumbar spine than the no-medication group. The alendronate group had significantly lower serum N-terminal telopeptides of type-1 collagen levels than the no-medication group.

"Alendronate prevented bone mineral density loss around femoral implants, particularly in Region 7 (calcar), but alfacalcidol did not show any effects in any regions. However, bone mineral density losses in the lumbar spine were effectively prevented by either alendronate or alfacalcidol," the authors write.

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