Chinese Journal of Tissue Engineering Research ›› 2022, Vol. 26 ›› Issue (12): 1812-1815.doi: 10.12307/2022.500

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Effect of zoledronic acid on femoral implant subsidence after hip arthroplasty

Chen Yong, Sun Yang   

  1. Department of Orthopedics, Central Hospital Affiliated to Shenyang Medical College, Shenyang 110024, Liaoning Province, China
  • Received:2021-07-21 Revised:2021-07-22 Accepted:2021-09-04 Online:2022-04-28 Published:2021-12-14
  • Contact: Sun Yang, Associate chief physician, Department of Orthopedics, Central Hospital Affiliated to Shenyang Medical College, Shenyang 110024, Liaoning Province, China
  • About author:Chen Yong, MD, Associate chief physician, Department of Orthopedics, Central Hospital Affiliated to Shenyang Medical College, Shenyang 110024, Liaoning Province, China
  • Supported by:
    the Natural Science Foundation of Liaoning Province, No. 2019-ZD-0329 (to SY)

Abstract: BACKGROUND: Implant subsidence after hip arthroplasty is the main cause of surgical failure. Zoledronic acid has a good effect on improving bone mass and bone density around cementless femoral prosthesis after hip arthroplasty, and it is speculated that zoledronic acid can reduce implant subsidence.  
OBJECTIVE: To analyze the effect of zoledronic acid on femoral implant subsidence after hip arthroplasty.
METHODS:  Totally 50 female patients with postmenopausal osteoporotic hip fracture who underwent hip arthroplasty in Central Hospital Affiliated to Shenyang Medical College from April 2019 to April 2020 were selected and randomly assigned to two groups. The 25 patients in the trial group received intravenous infusion of zoledronic acid 1 week after total hip arthroplasty, and 25 patients in the control group did not receive zoledronic acid treatment after total hip arthroplasty. At 1 year after arthroplasty, X-ray was used to record the femoral implant subsidence distance. The bone mineral density around the femoral prosthesis was measured using dual energy X-ray bone densitometer. Harris scoring system was used to assess hip joint function.  
RESULTS AND CONCLUSION: (1) The femoral implant subsidence distance was less in the trial group than that in the control group at 1 year after arthroplasty (P < 0.05). The average bone mineral density around the femoral prosthesis was higher in the trial group than that in the control group at 1 year after arthroplasty (P < 0.05). (2) Harris hip function score in the two groups was higher at 1 year after arthroplasty than that before arthroplasty (P < 0.05), and there was no significant difference between the two groups (P > 0.05). (3) Eight patients in the trial group developed fever within 3 days, and the symptoms were relieved after oral administration of ibuprofen suspension and drinking plenty of water. (4) It is indicated that zoledronic acid can effectively reduce the loss of bone mineral density around cementless femoral prosthesis and improve the stability of prosthesis after hip arthroplasty.

Key words: osteoporosis, total hip arthroplasty, zoledronic acid, hip fracture, femoral implant, bone mineral density, implant subsidence

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