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Prevention of Periprosthetic Bone Loss After Total Hip Replacement by Annual Bisphosphonate Therapy

M

Mel Shiuann-Sheng Lee

Status and phase

Completed
Phase 3

Conditions

Functional Outcomes
Serum Markers of Bone Turnover
Prevention of BMD Loss After THR

Treatments

Drug: Aclasta
Drug: Placebo

Study type

Interventional

Funder types

Other
Industry

Identifiers

NCT02838121
98-1150A3

Details and patient eligibility

About

Periprosthetic bone loss caused by stress-shielding effect, a phenomenon of bone atrophy under mechanical unloading after THR implantation, further compromises the longevity of implant. The prospective randomized study is aimed to investigate the periprosthetic bone loss after primary total hip replacements.

Full description

This study is a prospective, randomized, open-label clinical trial. The study will be performed in patients after obtaining informed consent. Group assignment is by drawing a sealed envelops based on random table. (1) Group 1: Experimental group 30 cases, Aclasta® (Zoledronic acid 5mg/100ml) is given intravenously on the 4th postoperative day and one year after the total hip replacement, (2) Group 2: Control group, 30 cases, no bisphosphonate is given to the patients. Only the unilateral coxarthrosis will be recruited for the study. Patients will be analyzed with (1) DXA study (2) Clinical assessment (Harris hip score and SF-12) (3) X-ray (4) serum marker of bone turnover. Patients will be scheduled for specified examinations preoperatively, postoperatively 6 weeks, 3 months, 6 months, 12 months, and 24 months.

Enrollment

62 patients

Sex

All

Ages

35 to 85 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  1. Male or female,between 35 and 85 years of age
  2. Indicated for Total hip replacement for various hip diseases
  3. Has preoperative DXA study within 3 months before the total hip replacement procedure or willing to receive preoperative DXA study as a baseline comparison
  4. Signed written informed consent
  5. Standard transgluteal approach for total hip replacement using Zimmer Triology Cup and Versys Fiber Metal Taper Stem with metal to highly cross-linked polyethylene bearing surface

Exclusion criteria

  1. Any prior use of intravenous bisphosphonate within the last 2 years
  2. Uncontrolled seizure disorders associated with falls
  3. A history of invasive malignancy of any organ system, treated or untreated, within the past five years; excluding, basal cell or squamous cell carcinoma of the skin, colonic polyps with non-invasive malignancy which have been removed
  4. Carcinoma in situ of the uterine cervix
  5. History of osteogenesis imperfecta, multiple myeloma, or Paget's disease
  6. Active primary hyperparathyroidism
  7. History of iritis or uveitis
  8. Self-reported history of diabetic nephropathy or retinopathy
  9. AST or ALT more than twice the upper limit of normal
  10. Alkaline phosphatase more than twice the upper limit of normal
  11. Serum calcium 2.75 mmol/L (11.0 mg/dL)
  12. Baseline renal insufficiency (calculated creatinine clearance 35 ml/min)
  13. History of hypersensitivity to bisphosphonates
  14. Use of any investigational drug(s) and/or devices within 30 days prior to randomization
  15. Any medical or psychiatric condition which, in the Investigator's opinion, would preclude the participant from adhering to the Protocol or completing the trial per protocol
  16. Use of hip protectors
  17. With implant or prosthesis on the contralateral hip joint

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

62 participants in 2 patient groups, including a placebo group

Aclasta
Experimental group
Description:
Aclasta IV once annual for 2 years
Treatment:
Drug: Aclasta
Placebo
Placebo Comparator group
Description:
Placebo group
Treatment:
Drug: Placebo

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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