• Yutaka Ohkawa, Kunihiko Tokunaga, and Naoto Endo.
• Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan.
• J Orthop Sci. 2008 Nov 1; 13 (6): 533-42.

BackgroundAs hydroxyapatite (HA) has good osteoconductive properties, HA is used as coating material for the implants in cementless arthroplasty. However, its effect is not sufficient for osteoporotic bone. Parathyroid hormone (PTH) is known to have anabolic effects on bone formation. Intermittent administration of PTH increases both cancellous and cortical bone mass. The aim of this study was to confirm the effect of the fixation strength of HA-coated implants in the osteoporotic condition with a mechanical test and a bone histomorphometric method.MethodsFemale Sprague-Dawley rats were used for this study. Four weeks after ovariectomy (OVX) or sham surgery, HA-coated titanium rods were inserted into the distal femoral canal (Sham+HA group and OVX+HA group). PTH was administered immediately after the implantation of the HAcoated rods (OVX+HA+P group). We measured the shear strength at the bone-implant interface by a push-out test and the newly formed bone volume on the implant (BV.Im) by bone histomorphometry at 2 and 4 weeks after implantation.ResultsThe bone-implant shear strength in the OVX+HA group was significantly lower than that in the Sham+HA group at 2 weeks after implantation of the rods. In the OVX+HA+P group, the strength was significantly higher than that in the other groups. Similarly, at 4 weeks, statistically significant differences were confirmed in the bone-implant shear strength among the Sham+HA group, the OVX+HA group, and the OVX+HA+P group. BV.Im in the OVX+HA group was significantly lower than that in the Sham+HA group at 2 weeks after implantation. BV.Im was significantly higher in the OVX+HA+P group than that in the OVX+HA group. However, there was no difference in BV.Im between the Sham+HA group and the OVX+HA+P group. At 4 weeks after implantation, BV.Im was significantly lower in the OVX+HA group than that in the other groups, but no difference was found between the Sham+HA group and the OVX+HA+P group.ConclusionsIntermittent administration of PTH has an effect to increase new bone formation on the surface of HA-coated implants in the osteoporotic condition. This finding suggests that PTH administration is useful to improve the initial fixation of HA-coated implants even in osteoporotic patients.

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