İBANDRONİK ASİT VE KALSİYUM-D VİTAMİNİ TEDAVİSİNİN OSTEOİNTEGRASYON ÜZERİNDEKİ ETKİLERİNİN KARŞILAŞTIRILMASI Comparison Of The Effects Of Ibandronic Acid and Calcium-D Vitamin Treatment On Osteointegration

Year 2019, Volume: 9 Issue: 2, 102 - 111, 28.06.2019

Serhat Durusoy , Meriç Çırpar Mehmet Yalçınozan Arif Aslan Mahi Balcı Teyfik Demir

Abstract

ÖZET

Amaç: Bu çalışmada ibandronik asit ve kalsiyum- D vitamini kompleksinin osteointegrasyon üzerine olan

etkilerini histomorfometrik ve mekanik olarak değerlendirmeyi amaçlamaktadır.

Gereç ve Yöntem: Çalışma 45 adet dişi Sprague-Dawley cinsi ratın sol femurları üzerinde yapılmıştır. Cerrahi

olarak ratların sol femurlarına intramedüller K teli yerleştirilmiştir. Ratlar rasgele eşit sayıda olacak şekilde

kontrol grubu, ibandronat alan grup ve Ca+D vitamini alan grup olacak şekilde gruplandırılmıştır. Altı hafta

sonra sakrifiye edilen ratların femurları mekanik teste ve histomorfometrik inceleme tabi tutulmuştur. Elde

edilen veriler istatistiksel olarak kıyaslanmıştır.

Bulgular: Grup A (kontrol) ve Grup B (Ca+D vitamini) arasında ortalama maksimum çekme gücü ve osteointegrasyon

endeksi açısından istatistiksel olarak anlamlı bir farklılık yoktu (maksimum çekme için p=0,828,

OintE için p=0,172). İbandronik asit verilen Grup C için ortalama maksimum çekme gücü ve osteointegrasyon

endeksi Grup A ve Grup B ile kıyaslandığında elde edilen değerin istatistiksel olarak anlamlı derecede

yüksek olduğu saptandı (Maksimum çekme gücü için grup A’da p=0,001, grup B’de p=0,001, OintE için grup

A’ da p=0,009, grup B’de p=0,016)

Sonuç: Bu çalışma ibandronatın metal implant-kemik tutunumu üzerinde belirgin bir olumlu etkiye sahip

olduğunu göstermektedir. Ancak, bu deneysel çalışmanın sonuçlarını destekleyecek ileri klinik çalışmalara

ihtiyaç vardır.

Anahtar Kelimeler: Osteointegrasyon; İbandronat; Kalsiyum; D vitamini

ABSTRACT

Objective: The aim of this study is to evaluate the effects of ibandronate and calcium-vitamin D complex on

osteointegration of metal implants histomorphometrically and mechanically.

Material and Method: The study was performed on 45 female Sprague-Dawley rats. Rats were divided into

three groups. Intramedullary nailing was performed in all rat’s left femurs with a stainless steel K-wire in 1

mm diameter. The rats in Group A, the control group, didn’t receive any medication after the intramedullary

nailing of left femur. The rats in Group B received calcium and 25IU vitamin D daily; in Group C received

single dosage ibandronate subcutaneously after intramedullary nailing of left femurs. At the end of six

weeks all the rats were sacrificed. Maximum pull out strenghts were measured for all K wires and the mean

maximum pull out strenghts were calculated for each group. Hystomorphometrically the thickness of the

new bone around the K wire was measured and proportioned to the thickness of the K wire to get the novel

osteointegration index(Oint-E) for each group.

Results: There were no statistically significantly difference between Group A and Group B with regard to

Oint-E (p=0,172) and mean pull out strength(p=0,828). The mean pull out strength and Oint-E for Group

C, ibandronate medication group, were higher when compared with Group A and B with a statistically

significant difference (for mean pull out strengths p=0,001 for Group A, p=0,001 for Group B; for Oint-E

p=0,009 for Group A, p=0,016 for Group B).

Conclusion: The results of this study demonstrated that ibandronate has a significant positive effect on

bone metal implant integration. We believe that ibandronate can be used postoperatively to augment

osteointegration of metal implants. However further clinical studies are needed to support results of this

experimental study.

Key Words: Osteointegration; Ibandronate; Calcium; Vitamin D; Implant survival

Keywords

İBANDRONİK ASİT VE KALSİYUM-D VİTAMİNİ TEDAVİSİNİN OSTEOİNTEGRASYON ÜZERİNDEKİ ETKİLERİNİN KARŞILAŞTIRILMASI Comparison Of The Effects Of Ibandronic Acid and Calcium-D Vitamin Treatment On Osteointegration

References

• 1. Brånemark PI. Osseointegration and its experimental background. J Prosthet Dent. 1983;50:399–410. 2. Mavrogenis a F, Dimitriou R, Parvizi J, Babis GC. Biology of implant osseointegration. J Musculoskelet Neuronal Interact [Internet]. 2009;9:61–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19516081 3. Reid DM. Osteoporosis, Handbook. 4. Clinics RO. Hastalarda Osteoporoz ‹ nsidans ›. 2010;10–3. 5. Fini M, Giavaresi G, Torricelli P, Borsari V, Giardino R, Nicolini a, et al. Osteoporosis and biomaterial osteointegration. Biomed Pharmacother [Internet]. 2004 Dec [cited 2013 Dec 31];58:487–93. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15511604 6. Raisz LG. Physiology and pathophysiology of bone remodeling. Clin Chem [Internet]. 1999 Aug;45(8 Pt 2):1353–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10430818 7. Ochsner PE. Osteointegration of orthopaedic devices. Semin Immunopathol [Internet]. 2011 May [cited 2013 Dec 31];33(3):245–56. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21253729 8. Macinnes SJ, Gordon A, Wilkinson JM. Risk Factors for Aseptic Loosening Following Total Hip Arthroplasty. 1960; 9. Austin MS, Sharkey PF, Hozack WJ, Rothman RH. Knee failure Mechanisms after Total Knee Arthroplasty. 2004;3(1):55–9. 10. Ulrich SD, Seyler TM, Bennett D, Delanois RE, Saleh KJ, Thongtrangan I, et al. Total hip arthroplasties: what are the reasons for revision? Int Orthop [Internet]. 2008 Oct [cited 2014 Jan 28];32(5):597–604. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2551710&tool=pmcentrez&rendertype=abstract