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Model to optimise the amount of drug on an implant used as drug delivery system

The fixation of an orthopaedic implant depends strongly upon its initial stability. Peri-implant bone may resorb shortly after the surgery. This resorption is directly followed by new bone formation and implants fixation strengthening, the so-called secondary fixation. If the initial stability is not reached, the resorption continues and the implant fixation weakens, which leads to implant loosening. Previous studies with rats and dogs have shown that a solution to prevent early peri-implant resorption is to deliver bisphosphonate from the implant surface. The aims of the present study were, first, to develop a theoretical model of bone remodelling around an implant delivering bisphosphonate based on available data. Second, to use the model to predict the dose of zoledronate that would induce the maximal periprosthetic bone density. Third, to verify in vivo that the periprosthetic bone density is maximal with the calculated dose compared to previously tested doses.