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Systemic and Local Ibandronate Enhance Screw Fixation
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
2004 (English)In: Journal of Orthopaedic Reserach, ISSN 0736-0266, Vol. 22, no 5, 1108-1113 p.Article in journal (Refereed) Published
Abstract [en]

The trauma involved with inserting implants into bone leads to an activation of the inflammatory response and an activation of osteoclasts. In addition, apoptosis of osteocytes in the surrounding area has been implicated in further activation of osteoclasts. If the balance between resorption and bone formation shortly after implantation favours resorption, an impairment of early fixation might ensue.Because bisphosphonates inhibit resorption, this study analyses whether they can improve early fixation. Stainless steel screws (M 1.7) were inserted into the tibiae of 76 male Sprague-Dawley rats. Daily subcutaneous injections of ibandronate (3 μg) or saline were given to 20 rats. The remaining rats received ibandronate or saline directly applied into the drill hole before the screw was inserted. Tibiae were harvested at 14 days. Mechanical tests were performed on 50 tibiae. Systemically treated tibiae were tested for pull-out strength alone. Locally treated tibiae were tested for either pull-out or torque resistance. The remaining 18 tibiae were prepared for histology.Systemic ibandronate increased the pull-out force at failure by 30% (p=0.04). Local treatment increased the force at failure by 15% (p=0.02) and stiffness by 28% (p=0.01). In the removal torque measurements, local ibandronate increased the torque-moment at failure by 60% (p=0.04), and the maximum friction moment by 51% (p=0.04). Energy for turning the screw 1/4 revolution was increased by 68% (p=0.02).These results demonstrate that early remodeling events plays an important role in screw fixation, and that systemic or local bisphosphonate treatment could be an effective pharmacological path to improve early implant fixation.

Place, publisher, year, edition, pages
2004. Vol. 22, no 5, 1108-1113 p.
Keyword [en]
Bisphosphonates, Implant, Fixation, Resorption
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13039DOI: 10.1016/j.orthres.2003.12.015OAI: oai:DiVA.org:liu-13039DiVA: diva2:17706
Available from: 2008-03-14 Created: 2008-03-14 Last updated: 2009-08-21
In thesis
1. Following the mevalonate pathway to bone heal alley
Open this publication in new window or tab >>Following the mevalonate pathway to bone heal alley
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The mevalonate pathway is an important biosynthetic pathway, found in all cells of virtually all known pro- as well as eukaryotic organisms. This thesis is an investigation into the use of two drugs, originally developed for different applications, but both affecting the mevalonate pathway, in to models of fracture repair.

Using two different rodent models of fracture repair, a commonly used cholesterol lowering drug (statin) and two drugs used to treat osteoporosis (bisphosphonate) were applied both systemically as well as locally in order to enhance fracture repair.

Papers I and II investigate the potential of simvastatin to improve the healing of femoral fractures in mice. Papers III and IV explore the use of two bisphosphonates to improve early fixation of stainless steel screws into rat bone.

The statin simvastatin lead to an increased strength of the healing cellus. The application of bisphosphonates increased early screw fixation.

It seems clear that both drugs have uses in orthopaedic applications. One interesting avenue of further research would be to combine the two classes of drugs and see if we can get the benefits while at the same time diminishing the drawbacks.

Place, publisher, year, edition, pages
Acta Orthopaedica, Volume 78, No. 328, 2007
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1033
Keyword
Bone screws, coated materials, biocompatible, chemistry, diphosphonates, pharmacology, Equipment failure analysis methods, Femoral fractures, drug therapy, fracture fixation, instrumentation, Fracture fixation, fracture healing, drug effects, simvastatin, tibial fractures, physiopathologyial fractures, surgery
National Category
Medicinal Chemistry Other Veterinary Science
Identifiers
urn:nbn:se:liu:diva-11282 (URN)978-91-85895-30-4 (ISBN)
Public defence
2007-12-12, Linden, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Available from: 2008-03-14 Created: 2008-03-14 Last updated: 2009-08-21

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Skoglund, BjörnHolmertz, JonasAspenberg, Per

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