Prevention of strain-related osteopenia in aseptic loosening of hip prostheses using perioperative bisphosphonate

Allen E Goodship, Gordon W Blunn, Jonathan Green, Melanie J Coathup

Research output: Contribution to journalArticlepeer-review


The hypothesis tested in this study was that perioperative administration of the bisphosphonate zoledronate will reduce strain protection-related calcar osteopenia and maintain functional integration of the femoral component in an ovine hemiarthroplasty model. Twelve sheep received a unilateral cemented hemiarthroplasty where six animals were given nine intravenous infusions of zoledronate (10 microg/kg) pre-, peri-, and postsurgery over 8 months. Control animals received physiological saline only. Implants remained in vivo for 9 months. Ground reaction force (GRF) was used to assess functional loading of the implanted limb, bone mineral density (BMD) was quantified using dual energy X-ray absorptiometry (DEXA). Cortical bone area, thickness, and viable osteocytes were assessed histologically. No significant differences in GRF data between groups was identified. Results demonstrated a significant drop in BMD values in the control group (9.7%) when compared with the bisphosphonate-treated group (3.2%) (p = 0.0159). Histological results showed that cortical area, thickness, and the percentage of lacunae with viable osteocytes was significantly greater in the bisphosphonate-treated group when compared with control (p = 0.002, p = 0.001, p = 0.003, respectively). The administration of zoledronate reduced cortical osteopenia in the calcar region of the proximal femur and this therapy could be used as a preventive measure to combat strain protection osteopenia and its contribution to associated aseptic loosening in total hip replacement surgery.

Original languageEnglish
Pages (from-to)693-703
Number of pages11
JournalJournal of Orthopaedic Research
Issue number5
Publication statusPublished - May 2008


  • Animals
  • Arthroplasty, Replacement, Hip
  • Bone Density
  • Bone Density Conservation Agents
  • Bone Diseases, Metabolic
  • Diphosphonates
  • Female
  • Hip Joint
  • Imidazoles
  • Locomotion
  • Microradiography
  • Prosthesis Failure
  • Random Allocation
  • Sheep
  • Stress, Mechanical
  • Research Support, Non-U.S. Gov't


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