50 patients that underwent total hip replacements in 56 hips and were randomized to receive either a single intravenous infusion of pamidronate or a placebo to determine their effects of peri-prosthetic bone mineral density. After 5 years 37 patients (42 hips) returned for assessment. Throughout the course of the study the pamidronate group and placebo group achieved similar Harris hip scores and 2 patients from each group developed osteolytic lesions visible on plain radiography. The femoral and acetabular post-surgical bone mineral densities were similar in both the pamidronate and placebo groups indicating that a single intravenous infusion of pamidronate does not improve clinical outcomes of prevent the development of osteolytic lesions in patients 5 years after total hip replacements.