Evidence map›Paper›PMID 35308048›Full record

ArticleArthroplasty today2022

Bisphosphonates in Total Joint Arthroplasty: A Review of Their Use and Complications.

Christopher L McDonald, Nicholas J Lemme, Edward J Testa, Roy Aaron, Davis A Hartnett, Eric M Cohen

Abstract read
In one paragraph

Article in Arthroplasty today, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Perioperative denosumab exposure and risk of revision after total hip and knee arthroplasty in osteoarthritis: a registry-based data linkage study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  5. Article
  6. Improving Total Joint Outcomes: A Survey of Surgeon Implementation of Perioperative Optimization Protocols.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
    Article
  7. Article
  8. The growing burden of periprosthetic fractures after total hip arthroplasty: identifying overall trends and at-risk groups.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Article
  9. Article
  10. Article
  11. Review
  12. Periprosthetic fractures are osteoporotic fractures: missed opportunities for osteoporosis diagnosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024
    Article
  13. Review
  14. Review
  15. Article
  16. Article
  17. Periprosthetic fractures: an unrecognized osteoporosis crisis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023
    Article
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Christopher L McDonaldDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Nicholas J LemmeDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Edward J TestaDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Roy AaronDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Davis A HartnettDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Eric M CohenDepartment of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Considerable interest has been expressed in the use of bisphosphonates to treat periprosthetic osteoporosis with the clinical goals of reducing periprosthetic fractures and prolonging implant survival. Methods: A systematic review was performed with the goal of identifying both basic science and clinical studies related to the risks and benefits of bisphosphonate use in total joint arthroplasty. Results: Studies have shown that bisphosphonates may increase early bony ingrowth, decrease the postoperative loss of bone mineral density, and increase the longevity of implants by reducing the need for revisions secondary to aseptic loosening. Continuing bisphosphonates for 1 year postoperatively seems to provide the greatest benefit, with only marginal benefit being shown by continuing therapy for up to 2 years. Current data present some concerns for an increased risk of periprosthetic fractures especially in younger patients, and prolonged therapy is not recommended due to the potential risk of atypical femur fractures. Patients should be counseled regarding the risk of side effects of bisphosphonates, including the risk of osteonecrosis of the jaw, which is a rare but serious side effect. They should also be counseled on the risk of atypical femur fractures and gastrointestinal intolerance. Conclusions: Orthopedic surgeons could consider bisphosphonates for up to 1 year postoperatively regardless of the patient's prior bone mineral density, after discussion regarding the risks and benefits with the patient.

Indexed as

Arthroplasty revisionAtypical fracturesBisphosphonatesPeriprosthetic fracture

Identifiers

PMID35308048
PMCPMC8927797

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.