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Treatment with Weekly Parathyroid Hormone Improves Bone Ingrowth after Cementless Total Knee Arthroplasty Takao KANEKO 1 , Takahiro OTANI 1 , Norihiko KOHNO 1 , Yuta MOCHIZUKI 1 , Nobuhito NANGO 2 , Hiroyasu IKEGAMI 1 , Yoshiro MUSHA 1 1Department of Orthopaedics Surgery (Ohashi), School of Medicine, Toho University 2Ratoc System Engineering Co., Ltd. Keyword: 副甲状腺ホルモン製剤 , treatment with parathyroid hormone , PTH.1-34 , 骨内形成 , bone ingrowth , セメントレス人工膝関節置換術 , cementless total knee arthroplasty pp.583-590
Published Date 2014/7/25
DOI https://doi.org/10.11477/mf.1408103090
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 Background:In this study we investigated whether weekly postoperative subcutaneous injections of teriparatide (56.5 μg) would promote bone ingrowth between the joint prosthesis and cancellous bone after cementless total knee arthroplasty.

 Methods:Cementless total knee arthroplasty with a trabecular metal modular tibia was performed to treat medial gonarthrosis in 20 knees. Multi-detector-row computed tomography (MDCT) of the knee was performed immediately postoperatively and again at 3, 6, and 9 months postoperatively. The cancellous trabecular structure of the knee was visualized three-dimensionally by using osteomorphometric software, and ossification density was calculated from the computed structural parameters. Some patients received a subcutaneous injection of teriparatide once a week (teriparatide group, n=10), and the other patients did not (control group, n=10). The bone mineral content/total volume (BMC/TV) and bone volume/total volume (BV/TV) values of the two groups were compared between over time.

 Results:The mean BMC/TV value and mean BV/TV value of the medial zone under the tibia at 3, 6, and 9 months postoperatively were significantly higher in the teriparatide group.

 Conclusions:Teriparatide treatment increases bone mass by promoting ossification to a rate that exceeds the rate of bone resorption, and our hypothesis that teriparatide promotes bone ingrowth between the joint prosthesis after cementless total knee arthroplasty and medial cancellous bone was verified by the results of this study.


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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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