The Effect on Implant Fixation of Soaking Tricalcium Phosphate Granules in Bisphosphonate

Thomas Jakobsen* , 1, Jørgen Baas1, Joan E Bechtold2, Brian Elmengaard1, Kjeld Søballe1
1 Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, Denmark
2 Orthopaedic Biomechanics Laboratory, Midwest Research Foundation, Minneapolis, MN, U

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© Jakobsen et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Orthopaedic Research Laboratory, Aarhus University Hospital, Norrebrogade 44, Building 1A, DK-8000 Aarhus C, Denmark; Tel: +45 8949-4134; Fax: 45-8949-4150; E-mail:


The use of bone grafting is a well-established way to enhance initial implant fixation in situations with reduced bone stock. Ceramic bone substitutes are inferior alternatives to autogenous or allogeneic bone graft. Improvement of bone graft substitutes is needed. We investigated whether biomechanical implant fixation and osseointegration of experimental implant grafted with β-TCP granules (Conduit) could be improved by soaking the β-TCP granules in bisphosphonate (zoledronate).

In 10 dogs, a pair of titanium coated implants surrounded by a 2.5 mm gap was inserted into the proximal part of each tibia. The gap was grafted with β-TCP granules either soaked with zoledronate or saline. At 12 weeks, the implants were evaluated with biomechanical push-out test and histomorphometrical analysis.

We found that bisphosphonate increased one of the three biomechanical parameters, but found no difference in the amount of new bone or β-TCP granules between the two treatment groups.

This study indicates that local treatment of β-TCP granules with zoledronate not only has the potential to increase implant fixation but also calls for further experimental research in order to optimize the dose of zoledronate.

Keywords:: Implant fixation, bisphosphonate, biomechanical fixation, histomorphometry, bone graft substitute.