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Clinical Orthopaedics and Related Research®

Published in:

01-02-2014 | Symposium: 2013 Hip Society Proceedings

Local Alendronic Acid Elution Increases Net Periimplant Bone Formation: A Micro-CT Analysis

Authors: J. Dennis Bobyn, PhD, Rebecca Thompson, MEng, Letitia Lim, MD, Jenny Ann Pura, BSc, Kristian Bobyn, BA, Michael Tanzer, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2014

Abstract

Background

Fixation of cementless orthopaedic implants is not always achieved, particularly in challenging scenarios such as revision surgery, trauma, and tumor reconstruction. An adjunct therapy for improving implant fixation would improve the reliability and durability of certain reconstructive procedures.

Questions/purposes

The purpose of this study was to determine the effect of local elution of the bisphosphonate alendronic acid on bone formation around porous titanium implants in an animal model.

Methods

Porous-coated cylindrical rods were coated with either 0.2 mg or 1.0 mg alendronic acid before bilateral surgical implantation into the femoral intramedullary canals of 10 experimental dogs. Twelve weeks after surgery, the femora were harvested and scanned with micro-CT to quantify the percentage volume of bone within the immediate periimplant space. Four femora from two dogs were also processed for undecalcified thin-section histology and analysis with backscattered scanning electron microscopy. Three histologic sections from each of these four femora were anatomically matched with transverse micro-CT sections to enable direct comparison of the area fraction of bone within the periimplant space.

Results

Compared with paired controls, micro-CT analysis showed that local elution of alendronic acid increased periimplant bone at both doses of 0.2 mg (+52%, p = 0.01) and 1.0 mg (+152%, p = 0.004) with 1.0 mg resulting in a 2.9-fold greater mean relative increase compared with 0.2 mg (p = 0.002). Micro-CT measurements of periimplant bone formation correlated very strongly with the backscattered scanning electron microscopy measurements (R = 0.965, p < 0.001).

Conclusions

Local elution of alendronic acid causes a dose-dependent net increase in periimplant bone formation in an animal model.

Clinical Relevance

This concept has potential to improve the biologic fixation of porous reconstructive implants.

Level of Evidence

Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Local Alendronic Acid Elution Increases Net Periimplant Bone Formation: A Micro-CT Analysis
Authors: J. Dennis Bobyn, PhD
Rebecca Thompson, MEng
Letitia Lim, MD
Jenny Ann Pura, BSc
Kristian Bobyn, BA
Michael Tanzer, MD
Publication date: 01-02-2014
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 2/2014
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-013-3120-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Local Alendronic Acid Elution Increases Net Periimplant Bone Formation: A Micro-CT Analysis

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Clinical Relevance

Level of Evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Clinical Relevance

Level of Evidence

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