Journal of Orthopaedics and Traumatology

Official Journal of the Italian Society of Orthopaedics and Traumatology

Journal of Orthopaedics and Traumatology Cover Image
Open Access

Do bisphosphonates reduce early micromotion and Periprosthetic bone loss in total knee arthroplasty? A review of the evidence

Journal of Orthopaedics and TraumatologyOfficial Journal of the Italian Society of Orthopaedics and Traumatology20067:150

Received: 6 November 2006

Accepted: 20 November 2006

Published: 18 December 2006


Early micromotion of implant components and periprosthetic bone loss in patients undergoing total knee arthroplasty are thought to contribute to late aseptic loosening. In the pursuit of longer implant survival, the administration of bisphosphonates may be advocated as a means to buffer implants against microinstability and periprosthetic bone loss. A bibliographic search identified one metaanalysis and two randomised controlled trials dealing with this topic. Current evidence supports the hypothesis that the inhibiting effects of bisphosphonates on bone resorption reduce implant micromotion and periprosthetic bone loss at the one-year follow-up. Tested bisphosphonates include clodronate, pamidronate and alendronate. However, a decline in periprosthetic BMD is observed at the three-year follow-up following a sixmonth course of bisphosphonate administration. Length of follow-up in available studies is currently too short to determine whether bisphosphonates increase the longevity of implants. Furthermore, the optimal dose, modality and length of bisphosphonate administration have yet to be determined.

Key words

BisphosphonatesTotal knee arthroplastyTotal knee replacementBone lossEvidence