Table 1 Studies exploring the use of medical therapy in osteoporotic patients undergoing total knee arthroplasty (BMD = Bone Mineral Density)
From: Osteoporosis in the setting of knee arthroplasty: a narrative review
Drug | Author | Year | Results |
|---|---|---|---|
Vitamin D | Barker et al. | 2021 | Multivitamin supplement containing 900Â IU of vitamin D significantly decreased postoperative inflammatory response. |
Bischoff-Ferrari et al. | 2018 | No difference was found in the rate of postoperative falls or WOMAC index when comparing postoperative 800 to 2000 IU of vitamin D. | |
Bisphosphonate containing cement | Mastuszewska et al. | 2022 | Increased levels of osteoprotegerin and decreased RANKL and therefore decreased bone resorption |
Alendronate | Wang et al. | 2003 | Reduced BMD loss at the distal femur and proximal tibia |
Soininvaara et al. | 2002 | Alendronate reduced early BMD loss at the metaphyseal anterior, posterior, diaphyseal, and metaphyseal regions of the femur. | |
Wang et al. | 2006 | A six-month course of alendronate increased BMD at 6 (4.8%) and 12 (1.6%) months. No significant difference was noted after 36 months when compared to controls (−3.9% vs. −12.2%, respectively; P = 0.08). | |
Jaroma et al. | 2015 | Lateral tibial metaphysis was increased with Alendronate until seven years (P = 0.002), and was significantly higher than that observed in the control group throughout (P = 0.024). No significant differences were found between the groups in the central femoral metaphyseal, tibial medial metaphyseal, or diaphyseal regions of either the femur or tibia. | |
Teng et al. | 2015 | Long-term use of bisphosphonates was correlated with a significantly decreased risk of implant revision after total knee arthroplasty (TKA) | |
Denosumab | Murahashi et al. | 2019 | Improvement in BMD decreased at around 3Â months postoperatively compared to 6Â months with bisphosphonates and reduced tibial bone atrophy 12Â months postoperatively |
Ledin et al. | 2019 | Denosumab reduced early migration of the tibial component. | |
Teriparatide | Suzuki et al. | 2018 | Increased periprosthetic BMD in the posterior and lateral regions of the condyles at 6Â months and in the anterior and posterior regions of the condyles and the tibial diaphysis at 12Â months |
Kaneko et al. | 2016 | Weekly injection of teriparatide after cementless TKA promoted bone ingrowth mostly in the medial aspect of the bone-prosthesis interface. |