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Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials

BACKGROUND: Aseptic loosening and osteolysis are the most common indications after TKA for revision surgery. This meta-analysis which included high-quality randomized controlled trials (RCTs) aimed to analyze the effect of bisphosphonates (BPs) on maintaining periprosthetic bone mineral density (BMD...

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Autores principales: Shi, Mingmin, Chen, Lei, Wu, Haobo, Wang, Yangxin, Wang, Wei, Zhang, Yujie, Yan, Shigui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977548/
https://www.ncbi.nlm.nih.gov/pubmed/29848366
http://dx.doi.org/10.1186/s12891-018-2101-z
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author Shi, Mingmin
Chen, Lei
Wu, Haobo
Wang, Yangxin
Wang, Wei
Zhang, Yujie
Yan, Shigui
author_facet Shi, Mingmin
Chen, Lei
Wu, Haobo
Wang, Yangxin
Wang, Wei
Zhang, Yujie
Yan, Shigui
author_sort Shi, Mingmin
collection PubMed
description BACKGROUND: Aseptic loosening and osteolysis are the most common indications after TKA for revision surgery. This meta-analysis which included high-quality randomized controlled trials (RCTs) aimed to analyze the effect of bisphosphonates (BPs) on maintaining periprosthetic bone mineral density (BMD) after total knee arthroplasty. METHODS: PubMed, AMED, EMBASE, the Cochrane library, ISI Web of Science, and China National Knowledge Infrastructure were systematically searched, five RCTs were included and the total number of participants was 188. The weighted mean differences with 95% confidence interval were calculated to evaluate the efficacy of BPs on total BMD of knee and the BMD of different periprosthetic regions. A descriptive review was performed for BP-related adverse effects. RESULTS: The BPs group presented significantly higher total BMD in proximal part of the tibia than the control group at 3 and 6 months (P < 0.05), but no significant difference at 12 months (P = 0.09). The BPs group presented significantly higher BMD in the distal aspect of the femur than that in the control group at 3, 6, 12 months. The BPs group presented significantly higher periprosthetic BMD than that in the control group at 3, 6 and 12 months in tibial medial and lateral metaphyseal region, and femoral anterior, central and posterior metaphyseal region (p < 0.05), but no significant difference for tibial diaphyseal region at 3, 6, and 12 months. None of the included studies described severe or fatal adverse effects related to BPs. CONCLUSION: BPs have a short-term effect on reducing periprosthetic bone loss after total knee arthroplasty. Compared with diaphyseal region, BPs are more effective on the preservation of BMD in medial lateral metaphyseal regions of proximal tibia and in anterior, central, and posterior metaphyseal region of distal femur.
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spelling pubmed-59775482018-06-06 Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials Shi, Mingmin Chen, Lei Wu, Haobo Wang, Yangxin Wang, Wei Zhang, Yujie Yan, Shigui BMC Musculoskelet Disord Research Article BACKGROUND: Aseptic loosening and osteolysis are the most common indications after TKA for revision surgery. This meta-analysis which included high-quality randomized controlled trials (RCTs) aimed to analyze the effect of bisphosphonates (BPs) on maintaining periprosthetic bone mineral density (BMD) after total knee arthroplasty. METHODS: PubMed, AMED, EMBASE, the Cochrane library, ISI Web of Science, and China National Knowledge Infrastructure were systematically searched, five RCTs were included and the total number of participants was 188. The weighted mean differences with 95% confidence interval were calculated to evaluate the efficacy of BPs on total BMD of knee and the BMD of different periprosthetic regions. A descriptive review was performed for BP-related adverse effects. RESULTS: The BPs group presented significantly higher total BMD in proximal part of the tibia than the control group at 3 and 6 months (P < 0.05), but no significant difference at 12 months (P = 0.09). The BPs group presented significantly higher BMD in the distal aspect of the femur than that in the control group at 3, 6, 12 months. The BPs group presented significantly higher periprosthetic BMD than that in the control group at 3, 6 and 12 months in tibial medial and lateral metaphyseal region, and femoral anterior, central and posterior metaphyseal region (p < 0.05), but no significant difference for tibial diaphyseal region at 3, 6, and 12 months. None of the included studies described severe or fatal adverse effects related to BPs. CONCLUSION: BPs have a short-term effect on reducing periprosthetic bone loss after total knee arthroplasty. Compared with diaphyseal region, BPs are more effective on the preservation of BMD in medial lateral metaphyseal regions of proximal tibia and in anterior, central, and posterior metaphyseal region of distal femur. BioMed Central 2018-05-30 /pmc/articles/PMC5977548/ /pubmed/29848366 http://dx.doi.org/10.1186/s12891-018-2101-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Shi, Mingmin
Chen, Lei
Wu, Haobo
Wang, Yangxin
Wang, Wei
Zhang, Yujie
Yan, Shigui
Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials
title Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials
title_full Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials
title_fullStr Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials
title_full_unstemmed Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials
title_short Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials
title_sort effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977548/
https://www.ncbi.nlm.nih.gov/pubmed/29848366
http://dx.doi.org/10.1186/s12891-018-2101-z
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