Preventive effect of zoledronic acid on bone loss around the prosthesis stem after hip replacement. doi: /j.issn

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Theodore Boone
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1 Chinese Journal of Tissue Engineering Research August 27, 2015 Vol.19, No ( ) d 1 1 (P < 0.05) 1 (P < 0.05) 3 d (P < 0.05) 1 (P > 0.05) 1 (P < 0.05) 1 (P > 0.05) :R318 :A : (2015) [J] (35): doi: /j.issn Preventive effect of zoledronic acid on bone loss around the prosthesis stem after hip replacement Liu Guo-qing 1, Yuan Zhen-feng 2, Liu Peng 1, Pang Tong-tao 1, Zhang Xian-wei 1 ( 1 Department of Orthopedics, People s Hospital of Shenxian, Shenxian , Shandong Province, China; 2 Department of Joint Surgery, Liaocheng Clinical School Affiliated to Taishan Medical University, Liaocheng , Shandong Province, China) Abstract BACKGROUND: Bone loss to different degrees may appear within 1 year after hip replacement in the femoral or acetabular sides, and severely affect long-term stability of the prosthesis and bone strength. Thus, to reduce bone loss around the prosthesis stem after total hip replacement is significant to prolong the use time of the prosthesis and to prevent fractures surrounding the prosthesis. OBJECTIVE: To observe the preventive effect of zoledronic acid on bone loss surrounding the prosthesis stem after hip replacement. METHODS: A total of 80 patients after total hip replacement in the People s Hospital of Shenxian from February 2011 to September 2014 were enrolled in this study. They were divided into two groups (n=40). At 4 days after replacement, patients in the observation group received treatment with zoledronic acid, but those in the control Liu Guo-qing, Associate chief physician, Department of Orthopedics, People s Hospital of Shenxian, Shenxian , Shandong Province, China Accepted: ISSN CN /R CODEN: ZLKHAH 5593

2 . group did not give zoledronic acid. The rest medication was identical between the two groups. Bone mineral density in the hip was measured before replacement and at 1 year after replacement in both groups. Serum calcium and phosphorus levels and alkaline phosphatase activities were observed before replacement, 3 days and 1 year after medication in the two groups. Adverse reaction during medication was recorded in the observation group. RESULTS AND CONCLUSION: The average bone mineral density was significantly decreased in both groups at 1 year after replacement, and significant differences were found as compared with before replacement (P < 0.05). The average bone mineral density was significantly higher in the observation group than in the control group at 1 year after replacement (P < 0.05). Calcium and phosphorus levels were significantly diminished at 3 days after medication as compared with that before replacement (P < 0.05). Calcium and phosphorus levels maintained at the level before replacement at 1 year after medication. Alkaline phosphatase activities were slightly reduced within a short time after replacement in both groups, but no significant difference was found as compared with before replacement (P > 0.05). Alkaline phosphatase activities were low in the observation group at 1 year after medication, and significant difference was detected as compared with the control group and that before replacement (P < 0.05). No significant difference in alkaline phosphatase activities was detectable in the control group between 1-year post medication and pre-replacement (P > 0.05). Within two or three days after medication, nine patients suffered from varying degrees of muscle aches and fever in the observation group, and above symptoms were lessened after taking acetaminophen. These results verify that after total hip replacement, zoledronic acid injection can effectively prevent bone loss around the prosthesis in early stage after replacement, but fever symptoms may occur within a week after replacement. Thus, it is recommended that zoledronic acid injection can be given at 1 week after replacement. If fever and other symptoms appear, acetaminophen can be given. Subject headings: Arthroplasty, Replacement, Hip; Bone Density; Alkaline Phosphatase Liu GQ, Yuan ZF, Liu P, Pang TT, Zhang XW. Preventive effect of zoledronic acid on bone loss around the prosthesis stem after hip replacement. Zhongguo Zuzhi Gongcheng Yanjiu. 2015;19(35): Introduction [1] 1 [2] [3] Subjects and methods (61.3±2.1) (22.4±2.4) kg/m > (61.2±1.2) (21.4±2.7) kg/m (62.3±1.3) (21.1±3.4) kg/m VerSys LD/FX Zimaloy ISO ASTM F75 Morse 12/14 1/3 X CT P.O. Box 10002, Shenyang

3 . 12 cm cm Crowe Crowe Crowe Zweymuller 1 2 ( H ) 72 h D ml 50 mg/l ( 100 ml 5 mg) 1 1 > 15 min 500 ml 3 d X 1 15 Gruen 7 (region of interest ROI) 3 2 cm4 (Zone 4) 1 (Zone 1) 2 (Zone 2) 3 (Zone 3) 5 (Zone 5) 6 (Zone 6) 7 (Zone 7) 1 3 d1 SPSS x _ ±s t P < Results Figure 1 Flowchart of patients in both groups 2.2 (P > 0.05) 1 1 (n=40) Table 1 Comparison of baseline data of patients in both groups 2 /t P / (n) 15/25 17/ (x _ ±s ) 61.2± ± (x _ ±s kg/m 2 ) 21.4± ± (n) (n) (n) (n) (n) (n) (P < 0.05) 1 (P < 0.05) (P > 0.05) 3 d (P < 0.05) 1 (P > 0.05) ISSN CN /R CODEN: ZLKHAH 5595

4 . 2 (x _ ±s n=40 g/cm 2 ) Table 2 Comparison of average bone density surrounding the prosthesis in patients of both groups t 1 P ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± t P t 1 P 1 1 t 2 P (x _ ±s n=40) Table 3 Comparison of calcium and phosphorus metabolism in patients of both groups (mmol/l) (mmol/l) (U/L) 2.21± ± ± d 2.15±2.25 b 1.47±0.31 b 84.56± ± ± ±10.23 ab 2.32± ± ± d 2.25±0.23 b 1.45±0.24 b 85.34± ± ± ± a P < 0.05 b P < (P < 0.05) 1 (P > 0.05) Discussion [4-5] 20 65% 49% [6-7] [8-9] [10] (1.523±0.325) g/cm 2 (1.463±0.376) g/cm 2 (1.579±0.286) g/cm 2 (1.295±0.357) g/cm 2 1 (P < 0.05) (P > 0.05) 1 (P < 0.05) 1 [11-12] (2.21±0.22) mmol/l (1.53±0.23) mmol/l (2.32±0.12) mmol/l (1.47±0.15) mmol/l(p > 0.05) 3 d (2.15± 2.25) mmol/l (1.47±0.31) mmol/l (2.25±0.23) mmol/l (1.45± 0.24) mmol/l 3 d (P < 0.05)1 (P > 0.05)1 (P < 0.05)1 (P > 0.05) [9] 5596 P.O. Box 10002, Shenyang

5 . 80% [13-15] References [1] Klingenstein GG, Yeager AM, Lipman JD, et al. Computerized range of motion analysis following dual mobility total hip arthroplasty, traditional total hip arthroplasty, and hip resurfacing. J Arthroplasty. 2013;28(7): [2],,,. [J].,2014,18(35): [3],. [J].,2014,34(1): [4] Schiffern AN, Stevenson DA, Carroll KL, et al. Total hip arthroplasty, hip osteoarthritis, total knee arthroplasty, and knee osteoarthritis in patients with developmental dysplasia of the hip and their family members: A kinship analysis report. J Pediatr Orthop. 2012;32(6): [5],,,. [J].,2012,31(3): [6],,,. [J].,2014,20(7): [7],,,. [J].,2015, 14(5): [8],,,. [J].,2013,40(16): [9],.[J].,2012,38(16): [10],,,. [J]. ( ),2014, 8(15): [11],,,. [J].,2014,20(7): [12],,,. [J].,2013,53(15): [13],,,. [J].,2014,18(44): [14],,,. [J].,2014,18(13): [15],,,. [J].,2014,12(16): ISSN CN /R CODEN: ZLKHAH 5597

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