The Use of Alendronate to Prevent Early Collapse of the Femoral Head in Patients With Nontraumatic Osteonecrosis

Lai, Kuo-An; Shen, Wun-Jer; Yang, Chyun-Yu; Shao, Chung-Jung; Hsu, Jui‐Ting; Lin, Ruey‐Mo

doi:10.2106/00004623-200510000-00001

Cited by 123 publications

(189 citation statements)

References 15 publications

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“…Bisphosphonates reduce pain, extension of BMLs and improve functional outcomes in benign condition like osteonecrosis, 51,52 regional transient osteoporosis, 53 enthesopathy in spondyloarthritis 54 and regional pain syndromes. 55 Most of the studies have been open label or interventional, but for osteonecrosis and regional pain syndrome significant effects have been demonstrated in randomised prospective trials.…”

Section: Pharmaceutical Optionsmentioning

confidence: 99%

Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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Bone marrow lesions (BMLs) or using older terminology 'Bone marrow edema' is characterised by excessive water signals in the marrow space on magnetic resonance imaging or ultrasound; BMLs constitute a central component of a wide variety of inflammatory and non-inflammatory rheumatologic conditions affecting the musculoskeletal system: BMLs are not only considered significant sources of pain but also linked to increased disease activity in many musculoskeletal conditions (for example, osteoarthritis, rheumatoid arthritis). The purpose of this review is to summarise current knowledge about the treatment of BMLs, with an emphasis on the clinical and histological features of this entity in inflammatory and non-inflammatory disease. We also try to pair this hypothesis with the apparent beneficial effects of various treatment regimens, mainly within the group of bone antiresorptive drugs (calcitonin, bisphosphonates) on symptoms associated with BMLs.

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Section: Pharmaceutical Optionsmentioning

confidence: 99%

Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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“…142 In studies of the osseointegration of metal implants in ovariectomized rats, treatment with ibandronate resulted in improved osseointegration rather than impairment of the healing process. 143 Potential applications of bisphosphonates in orthopedics include protection against loosening of prostheses, 144 better integration of biomaterials and implants, improved healing in distraction osteogenesis, 145 and conserving bone architecture after osteonecrosis 146,147 and in Perthes disease. 148 There are potentially important differences between clinically useful bisphosphonates regarding their potency and duration of action.…”

Section: Some Current Issues With Bisphosphonates: Bone Architecturementioning

confidence: 99%

Bisphosphonates: Mode of Action and Pharmacology

2007

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The profound effects of the bisphosphonates on calcium metabolism were discovered over 30 years ago, and they are now well established as the major drugs used for the treatment of bone diseases associated with excessive resorption. Their principal uses are for Paget disease of bone, myeloma, bone metastases, and osteoporosis in adults, but there has been increasing and successful application in pediatric bone diseases, notably osteogenesis imperfecta. Bisphosphonates are structural analogues of inorganic pyrophosphate but are resistant to enzymatic and chemical breakdown. Bisphosphonates inhibit bone resorption by selective adsorption to mineral surfaces and subsequent internalization by bone-resorbing osteoclasts where they interfere with various biochemical processes. The simpler, non-nitrogen-containing bisphosphonates (eg, clodronate and etidronate) can be metabolically incorporated into nonhydrolysable analogues of adenosine triphosphate (ATP) that may inhibit ATP-dependent intracellular enzymes. In contrast, the more potent, nitrogen-containing bisphosphonates (eg, pamidronate, alendronate, risedronate, ibandronate, and zoledronate) inhibit a key enzyme, farnesyl pyrophosphate synthase, in the mevalonate pathway, thereby preventing the biosynthesis of isoprenoid compounds that are essential for the posttranslational modification of small guanosine triphosphate (GTP)-binding proteins (which are also GTPases) such as Rab, Rho, and Rac. The inhibition of protein prenylation and the disruption of the function of these key regulatory proteins explains the loss of osteoclast activity. The recently elucidated crystal structure of farnesyl diphosphate reveals how bisphosphonates bind to and inhibit at the active site via their critical nitrogen atoms. Although bisphosphonates are now established as an important class of drugs for the treatment of many bone diseases, there is new knowledge about how they work and the subtle but potentially important differences that exist between individual bisphosphonates. Understanding these may help to explain differences in potency, onset and duration of action, and clinical effectiveness.www.pediatrics.org/cgi

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“…Detail of specimen (right) with the ingrowth front of new bone with the normal cellular marrow (M) below and the fibrotic marrow distally (F) (hematoxylin-eosin, ×40). deformation of joints due to osteonecrosis (Little et al 2003a), or stress shielding in distraction osteogenesis (Little et al 2003b, Lai et al 2005. The bisphosphonates can be administered systemically, either intravenously or perorally, and bind to the bone mineral to such an extent that the binding can practically be considered to be permanent until the bone is resorbed (Rogers et al 2000).…”

Section: Discussionmentioning

confidence: 99%

Systemic zoledronate precoating of a bone graft reduces bone resorption during remodeling

2006

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Background Cartilage degeneration often occurs after osteosynthesis of a devascularized intermediary fragment in a joint fracture, in mosaic-plasty or in wholejoint toe-to-finger transplantation. Hypothetically, the degeneration is secondary to a collapse of the transferred subchondral bone as it remodels during high mechanical load. Bisphosphonates are used to reduce resorption of necrotic bone. We tested a systemic pretreatment before harvesting the graft in order to protect the bone and cartilage against collapse and secondary arthrosis.Methods Rats were given one zoledronate injection and bone grafts were harvested. The grafts were frozen, thawed and placed into bone chambers, and implanted into another batch of rats. Graft resorption and new bone formation was measured by histomorphometric analysis and compared with untreated grafts.Results In the remodeled area of the controls, the graft was almost totally resorbed and replaced by bone marrow. In the zoledronate-treated specimens, the graft remained and the graft trabeculas were lined with new bone. By histomorphometry, the total amount of bone (graft plus new bone) within the remodeled area was 16% in the zoledronate-treated grafts and 5% in the controls (p = 0.003).Interpretation A bone graft can be pretreated with bisphosphonate and remain protected against resorption once implanted again.

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The Use of Alendronate to Prevent Early Collapse of the Femoral Head in Patients With Nontraumatic Osteonecrosis

Cited by 123 publications

References 15 publications

Treatment of bone marrow lesions (bone marrow edema)

Treatment of bone marrow lesions (bone marrow edema)

Bisphosphonates: Mode of Action and Pharmacology

Systemic zoledronate precoating of a bone graft reduces bone resorption during remodeling

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