Table 10.

Effect of Bisphosphonate Treatment on Progression of Osteoarthritis

Risk‐benefit balance

The effects of bisphosphonates on progression of osteoarthritis have not been adequately studied.

Quality of evidence

Very low

Patient values and preferences

Prevention of osteoarthritis is likely to be valued by patients with PDB. If treatment strategies could be identified that were effective in preventing progression of osteoarthritis, it is likely that they would be favored by patients.

Costs and use of resources

Bisphosphonates are inexpensive, but intravenous therapy involves additional support costs and costs in terms of patient time attending for the infusion that may need to be considered.

Recommendation

There is insufficient evidence that bisphosphonate therapy prevents progression of osteoarthritis in PDB, and they are not recommended for this indication.