Teriparatide in the treatment of a loose hip prosthesis.

To the Editor: The complexity of surgical and medical problems associated with reimplantation of a loose hip prosthesis does not always render this procedure acceptable. In addition, certain drugs may enhance the quality of bone around the prosthesis1,2. We treated a patient with teriparatide following loosening of his hip prosthesis, which was implanted for the second time; further surgery was no longer an option. The patient had osteoarthritis and had an uncemented prosthesis when he was 56 years of age; by the age of 61 years he required a reimplant, as a result of aseptic loosening. At the age of 74 years, he began to develop increasing pain and progressive loss of power. He had a history of dilated cardiomyopathy, and in view of this a surgical solution was ruled out. By the age of 77 years, he was treated with clodronate (100 mg intramuscularly weekly) and oral calcium (1.5 g daily) for 1 year. At age 78, radiographic imaging showed extensive loosening of the bone around the cup and a marked reduction in cortical thickness. Although he was already using a cane, he was advised to use 2 canes to allow partial weight-bearing. He was subsequently prescribed teriparatide (20 μg daily for … [↵][1]Address correspondence to Dr. D. Sarti, Via Mario Conti 53, San Lazzaro di Savena, Bologna, 40068, Italy. E-mail: danielesarti1978{at}gmail.com [1]: #xref-corresp-1-1