[Effects of bisphosphonates in arthroplasty]

Abstract

Aim: This study presents an overview of the general effects of bisphosphonates and in particular of their effects on different problems in joint arthroplasty.

Method: First the chemical properties are described, then the biological effects. It is already known that bisphosphonates have effects on orthopaedic diseases and an increasing number of studies are investigating what effects can be achieved in joint arthroplasty with these substances.

Results: The bisphosphonates group was derived from industrial pyrophosphate which is used to prevent calcification. Bisphosphonates inhibit bone mineralisation and resorption. Several direct and indirect mechanisms are responsible for these effects. The inhibition of bone resorption is used to benefit patients suffering from various diseases causing increased bone resorption. Treatment with bisphosphonates results in greater bone density and improved mechanical bone quality. Indications for this treatment include osteoporosis, tumour-associated osseo-destruction, fibrous dysplasia and Paget's disease. Recent studies have shown that osseo-integration of metal implants is accelerated and periprosthetic bone loss, which is caused by various different mechanisms during the lifetime of an implant, can be reduced.

Conclusion: Bisphosphonates have been an established element in the treatment of bone metabolic disorders for many years. Their use in joint arthroplasty could become increasingly important.