Effect of implanted bisphosphonate-enriched cement on the trabecular microarchitecture of bone in a rat model using micro-computed tomography

Abstract

PurposeBisphosphonates (BPs) are antiresorptive drugs typically used to inhibit bone resorption. The latest reports show that BPs play an important role in not only achieving better bone mineral density but also in improving bone microarchitecture. The mechanism of action of the BPs is complex and multifactorial. We tried to determine whether there are any changes in the microarchitectural bone structure during local use of BP (Pamifos 60). The aim of this study was to see if BP-enriched cement used in rat models had positive effects on bone formation.MethodsResearch was performed on 40 adult male Wistar rats that were divided into four groups: two control groups and two experimental groups. Rats in the experimental groups were implanted with BP-enriched cement into the bone, while the control group rats were implanted with clean bone cement (without BP). Micro-computed tomography was applied for the investigation of trabecular microarchitecture of the proximal physis of the tibial bone in all animals three and six weeks after surgery. In all microCT images variables such as bone volume density (BV/TV), trabecular thickness (TbTh), trabecular separation (TbSp) and trabecular number (TbN) were used to describe trabecular bone morphometry.ResultsThe major finding of this study is that using BP-enriched cement results in distinct changes in bone microarchitecture. We showed that local use of pamidronate (Pamifos 60) in orthopaedic cement had a positive effect on bone formation. It significantly changed three variables. We noticed increasing bone volume fraction and trabecular thickness together with decreasing trabecular separation.ConclusionIn this paper we demonstrate the efficacy of using BP-enriched cement in vitro in the tibiae of rats. Our most significant finding based on micro-CT picture analysis allows us to start further work on more suitable applications of BP-enriched cement in humans. We believe that future successful experiments will facilitate potential use of BP-enriched cement in clinical applications.

Determination of Pamidronate in Bisphosphonate-Enriched Bone Cement by Ion-Pair Hplc and Capillary Electrophoresis

“…The main reason for a high efficacy of pamidronate is that it acts directly on bone tissue, therefore, the local use of pamidronate provides regulation of the secretion of various serum bone turnover markers, growth factors, or cytokines, such as osteprotegrin (OPG), receptor activator of NF-κB ligand (RANKL), and tumour necrosis factor (TNF-α). In previous in vivo studies, where the BP-enriched bone cement was implanted into the tibia of rats, it was revealed that local use of pamidronate led to an increase in the quality of bone density, improved bones' microstructure, and might have had an influence on some bones' turnover markers (20,21). Therefore, such findings might have an important effect on bone implant osteointegration in the prevention of bone collapse and also in the enhancement of implant fixation (8,25).…”

The presence of pamidronate in bone cement affects serum biochemical markers in the rat

“…Our next micro-CT study showed some beneficial effects on the bone's microarchitecture (21). Implanted BP-enriched cement simply changes the bone turnover in normal rats' bone toward a positive balance between bone formation and bone resorption.…”

“…These results may explain the changes in the level of cytokines in rats' serum. The release of pamidronate with BPenriched cement also explains enhancement of the microstructure of bones in rats treated with BPenriched cement (21,22). The surgical procedure is usually connected with several stress symptoms in the animal organism.…”

Preoperative and Postoperative Medical Management for Rheumatoid Hand Surgery

“…Treatment often consists of vitamin D and calcium supplementation, along with anti resorptive therapy, most commonly bisphos phonates. Bisphosphonates do not appear to be detrimental to arthroplasty outcome [ 49 ] and may be benefi cial in improving the arthroplasty durability [ 50 ] and in preventing osteoclast-induced osteolysis [ 51 ].…”