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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 8, 1013-1018.
doi: 10.1302/0301-620X.91B8.21518  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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The use of alendronate in the treatment of avascular necrosis of the femoral head

FOLLOW-UP TO EIGHT YEARS

S. Agarwala, MS(Orth), MCh(Orth), Chief of Surgery, Head of Orthopedics and Traumatology1; S. Shah, MS(Orth), Associate Consultant Orthopaedic Surgeon1; and V. R. Joshi, MD, FRCP, Consultant Physician and Rheumatologist1

1 P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai 400016, India.

Correspondence should be sent to Dr S. Agarwala; e-mail: drsa{at}rediff.com

The use of bisphosphonates in the treatment of avascular necrosis of the femoral head is an encouraging but relatively new option with most published data being derived from small trials with limited follow-up. We present a clinicoradiological analysis of 395 hips with avascular necrosis which were treated with oral alendronate for three years with a mean follow-up of four years (1 to 8).

Our results show an improvement in the clinical function, a reduction in the rate of collapse and a decrease in the requirement for total hip replacement, compared with the findings of other studies in which no treatment was given. This improvement is particularly marked if the treatment is begun in the pre-collapse stages of the disease. Even in Ficat stage-III hips some benefit was obtained from treatment with alendronate by at least a delay in the need for total hip replacement.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General