Publication:

Effectiveness of teriparatide in enhancing bone formation and reducing aseptic loosening risks post-hip arthroplasty in patients with avascular necrosis

Background The hip joint's critical role in weight-bearing and mobility is often compromised by avascular necrosis (AVN), leading to osteoarthritis (OA). This study evaluates the impact of teriparatide, a synthetic parathyroid hormone analog, on bone formation and the risk of aseptic loosening in post-hip arthroplasty patients affected by AVN.

Methods In this retrospective, single-centre study, 26 patients who underwent hip replacement surgery due to AVN between November 2021 and November 2023 were included. Participants were selected based on specific inclusion and exclusion criteria and received daily subcutaneous injections of teriparatide (20 μg) for six months. The study focused on assessing the efficacy of Teriparatide in mitigating prosthetic loosening and enhancing bone formation post-hip arthroplasty, alongside monitoring for adverse events.

Results The cohort had a mean age of 37.63 years, predominantly male (77%). The median time for post-surgical pain onset was 31 days. After 3 months of teriparatide therapy, all patients showed a significant reduction in joint pain and swelling, with improved mobility. Radiographic evaluations demonstrated a decrease in previously observed radiolucent lines, indicating successful prosthesis integration. At the 6-month mark, tomosynthesis revealed no space between either the femoral head or hip components and the osteotomy load surfaces. No adverse events were reported during the therapy period.

Conclusions Teriparatide-is a promising therapeutic agent for enhancing surgical outcomes in post-hip arthroplasty in patients with AVN. Its role in promoting bone formation and reducing aseptic loosening risks is significant, suggesting its potential in improving patient recovery and pre-empting postoperative complications.