Supportive drugs for improved implant healing

Improvement of implant healing in orthopedic and trauma surgery serves to improve the life expectancy of the implant. Good primary stability by clamping is a prerequisite for secondary stability and for the actual integration and healing of the implant. Possible causes of implant loosening are abras...

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Bibliographic Details
Published in:Der Orthopäde 2015-09, Vol.44 (9), p.703-709
Main Authors: Skripitz, R, Kurth, A, Roth, A
Format: Article
Language:ger
Subjects:
Bone Density Conservation Agents - administration & dosage
Bone Morphogenetic Proteins - administration & dosage
Diphosphonates - administration & dosage
Evidence-Based Medicine
Humans
Joint Prosthesis - adverse effects
Osteolysis - etiology
Osteolysis - prevention & control
Treatment Outcome
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Summary:Improvement of implant healing in orthopedic and trauma surgery serves to improve the life expectancy of the implant. Good primary stability by clamping is a prerequisite for secondary stability and for the actual integration and healing of the implant. Possible causes of implant loosening are abrasive particles, which arrive at non-integrated implants at the unsealed prosthesis-bone interface and provoke a macrophage-mediated foreign body reaction, resulting in periprosthetic osteolysis. Numerous animal studies have already described the use of bisphosphonates to inhibit osteolysis induced by abrasion and secondary instability. In patients with total knee arthroplasty, a decrease in prosthetic migration under the influence of bisphosphonates could be shown. The stimulation of bone formation around the implants and the resulting implant healing was demonstrated both in animal experiments for bone morphogenetic proteins (BMP) and in case reports for intermittent parathyroid hormone administration. By using supportive drugs, it is possible to achieve an improvement in the osseointegration of implants; thus, more rapid secondary stability and load-bearing are expected.
ISSN:1433-0431
DOI:10.1007/s00132-015-3136-6