Ten-year follow-up of avascular necrosis of femoral head treated with alendronate for 3 years.

Although all the recent reports of the use of bisphosphonates in avascular necrosis of femoral head (AVNFH) have been encouraging, none has studied long-term effects of this novel therapy. We therefore performed a 10-year follow-up study of 40 patients (53 hips) of AVNFH treated with 3-year-long oral alendronate therapy. Rates of clinical failure defined as need for further surgical intervention, of radiologic progression for the Ficat-Arlet scale, and of collapse of femoral head showed marked reduction even at 10 years as compared to the historical data available for natural history of hips with untreated AVNFH. Alendronate given for 3 years maintains its beneficial effects for as long as 10 years and hence is a worthwhile option to postpone the need for arthroplasty in these young and active patients.