Osteoporosis Drug May Delay Implant Failures

According to a study at Oxford University, patients who undergo knee or hip replacement (arthroplasty), those who use a class of prescription drugs known as bisphosphonates may wind up having fewer revision surgeries.

Bisphosphonates are used to treat osteoporosis, a degenerative disease associated with aging. Normally, bone cells are continually renewed. With younger people in good health, bone is replaced at the same rate that it is lost.  When this process is out of balance, it can result in a number of disorders, including bone loss. Medical studies indicate that the use of bisphophsonates can strengthen bone tissue and reduce the risk of fractures.

Bone fractures are also a problem that occurs in patients who undergo joint replacement surgery. According to the results of the study, which took place over a twenty year period between 1986 and 2006, patients who were treated with bisphosphonates had less than half the number of revision surgeries than those who did not take the medication.

A recent response to the study, originally published in the British Medical Journal, was critical of the study, however. Noting that neither of the researchers were actually involved in treating bone fractures, the critics - one of whom was an orthopedic surgeon - noted that

            "patients given bisphosphonates in this study from 1986 onwards were, not                                     surprisingly, lighter, and more female, and thus probably less active, with less                           muscle and bone mass."

Another article published at The Doctors' Lounge pointed out that patients who had received joint replacements before the age of forty as well as those with rheumatoid arthritis or had a prior hip fractures had been excluded from the study. In the original paper, three authors of the study disclosed that they had "received honorariums, held advisory board positions (which involved receipt of fees), and received consortium research grants" from major pharmaceutical corporations, the list of which includes:

- Novartis

- GlaxoSmithKline

- Eli Lily

- Pfizer

- Merck

However, the authors assure readers that the researchers "have no other relationships or activities that could appear to have influenced the submitted work."

Those relationships would be enough, however.

Sources

Prieto-Alhambra, Daniel, et. al. "Association Between Bisphosphonate Use and Implant Survival After Primary Total Arthroplasty of the Knee or Hip: Population Based Retrospective Cohort Study." British Medical Journal, 6 December 2011

Cobb, Justin P. and Barry Andrews.  "Bisphosphonates and Atypical Fractures: the Elephant in the Room." Response published online at http://www.bmj.com/rapid-response/2011/12/12/re-association-between-bisphosphonate-use-and-implant-survival-after-prima, 13 December 2011

N/A. "Bisphosphonate Use Ups Knee, Hip Implant Survival." Originally published in Health Day, 7 December 2011. Available at http://www.doctorslounge.com/index.php/news/pb/25134 

Learn more about DePuy Hip Implant Recall