Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study
- PMID: 15572396
- DOI: 10.1093/rheumatology/keh481
Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study
Erratum in
- Rheumatology (Oxford). 2005 Apr;44(4):569
Abstract
Objective: To study the efficacy of alendronate, in the treatment of avascular necrosis (AVN) of the hip.
Methods: Sixty patients with AVN of the hip (100 hips with AVN) were studied. The follow-up period ranged from 3 months to 5 yr. The most common cause of AVN was steroids. Parameters studied were walking time, standing time, pain and disability on a visual analogue scale (VAS), range of motion of the hip, X-ray and MRI of the hip. All patients were treated with alendronate 10 mg/day (or 70 mg/week) along with 500-1000 mg of daily calcium and vitamin D supplements, and were advised to avoid weight-bearing. NSAIDs and analgesics were permitted as needed and were recorded.
Results: Forty-one patients (71 AVN hips) with AVN have been followed up for a minimum of 1 yr, 24 patients (42 AVN hips) for 2 yr and 21 patients (37 AVN hips) for more than 2 yr (average 37 month). Fourteen patients have been followed up for less than 1 yr (3-9 months). Significant reduction in pain and disability scores (P < 0.001) and significant increase in standing and walking time (P < 0.001) were observed. All hip movements improved at 1 yr (P value 0.000-0.009) with an insignificant decline after that (P > 0.001). Radiologically, the hips either stabilized in the same grade or progressed by one grade. MRI showed a decrease in marrow oedema in most cases at the 1-yr follow-up. Six patients (10 hips) required surgery and there were two (three hips) dropouts. The drug was well tolerated and there was a reduction in NSAID requirement.
Conclusion: Alendronate reduces pain, improves function and retards AVN progression. Early surgical intervention can be avoided in most patients.
Comment in
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Efficacy of alendronate in the treatment of avascular necrosis of the hip.Rheumatology (Oxford). 2005 Oct;44(10):1331-2; author reply 1332. doi: 10.1093/rheumatology/kei003. Epub 2005 Jun 21. Rheumatology (Oxford). 2005. PMID: 15972347 No abstract available.
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