Effect of zoledronic acid on bone mineral density and bone metabolism markers in elderly patients with osteoporotic intertrochanteric fracture after hip arthroplasty: 2-year follow-up

doi:10.12307/2021.312

Abstract

Abstract: BACKGROUND: In recent years, artificial joint arthroplasty has achieved good results in the surgical treatment of intertrochanteric fractures. Due to the presence of osteoporosis, postoperative loosening and subsidence of implant, periprosthetic fracture and other conditions have become one of serious postoperative complications. In addition to surgical treatment, senile osteoporotic fracture should be combined with anti-osteoporosis drugs to reduce the risk of recurrent fracture or implant loosening.
OBJECTIVE: To study the clinical significance of anti-osteoporosis treatment in elderly patients with intertrochanteric fracture after artificial hip arthroplasty.
METHODS: Forty-six elderly female patients with osteoporotic intertrochanteric fractures who underwent artificial femoral head replacement were included and were divided into two groups according to the treatment plan. Twenty-two patients in the treatment group were treated with zoledronic acid (once a year, a total of three infusions), and regularly orally taken calcitriol and caltrate D for anti-osteoporosis treatment. Twenty-four patients in the control group were regularly orally taken calcitriol and caltrate D for anti-osteoporosis treatment, with the absence of zoledronic acid. Bone mineral density and bone metabolism markers were measured before treatment and 6, 12 and 24 months after treatment. Serum osteocalcin was selected as bone formation marker, and tartrate resistant acid-base phosphatase-5b was selected as bone absorption marker. Dual-energy X-ray absorptiometry was used to detect bone mineral density, and ELISA was used to detect bone metabolism.
RESULTS AND CONCLUSION: (1) After treatment, the bone mineral density of the two groups increased in different degrees, and bone mineral density was better in the treatment group than that in the control group 1 year after treatment (P < 0.05). (2) Bone formation markers (osteocalcin) increased temporarily after injury, and gradually increased in the treatment group after 6 months; the difference was statistically significant (P < 0.05). The control group maintained at a certain level after 6 months. The difference between the two groups was statistically significant after 6 months (P < 0.05). (3) Bone resorption markers (tartrate resistant acid-base phosphatase-5b) increased after injury, and gradually decreased in the treatment group; the difference was statistically significant (P < 0.05). The decrease was not significant in the control group after treatment, and the difference was not significant (P > 0.05). The difference between the two groups was statistically significant 12 and 24 months after treatment (P < 0.05). (4) It is concluded that zoledronic acid can further assist in the anti-osteoporosis treatment of elderly patients with intertrochanteric fracture after hip arthroplasty, which plays an important role in improving bone mineral density, promoting bone formation and inhibiting bone resorption.

Key words: osteoporosis, intertrochanteric fractures in the elderly, zoledronic acid, bone mineral density, bone metabolism markers

CLC Number:

Qiu Wei, Lian Xingye. Effect of zoledronic acid on bone mineral density and bone metabolism markers in elderly patients with osteoporotic intertrochanteric fracture after hip arthroplasty: 2-year follow-up[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(33): 5265-5272.

Figures/Tables 12

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