| Abstrakt: |
Objective To observe the short-term clinical efficacy of zoledronic acid injection (Aclasta) on preventing periprosthetic bone loss around the femoral stem after the total hip arthroplasty. Methods Twenty patients, who underwentthe unilateral total hip arthroplasty from May 2012 to June 2012, were included and randomly divided into zoledronic acid group (observation group) and control group. One week after the operation, patients in the observation group received one intravenous injection of 5 mg zoledronic acid (Aclasta), while patients in the control group did not receive the injection. The bone mineral density (BMD) around the femoral stem was detected using dual-energy X-ray absorptiometry preoperatively and 1-year after the operation. The results were used to analyze the bone mass change. Results A total of 20 patients were included, and each group contained 10 patients. The followed-up lasted for 1 year. The mean BMD around the femoral stem in both groups decreased 1-year after the operation, especially at Zone i and VII. But in the observation group, BMD at Zone IV showed a trend of increase. The mean BMD in the observation group decreased from preoperative 1.523 ±0.325 to postoperative 1.463 ± 0.376, while the decrease was from preoperative 1.579 ± 0.286 to postoperativel. 295 ±0.357 in the control group. Compared to the preoperative level, the serum levels of calcium and phosphorus decreased slightly 3-day after the operation. But it maintained at the preoperative level 1-year after the operation. The serum ALP level in both groups declined slightly at early stage after the operation. One year later, the serum ALP in the control group returned to preoperative level, while the serum level in the observation group was lower than the preoperative level, and the difference between two groups was significant. Within 2-3 days after the injection, S patients in the observation group had varying degree of fever or muscle ache, which relieved after taking acetaminophen (Tylenol). Conclusion Zoledronic acid injection (Aclasta) is effective in preventing early postoperative periprosthetic bone loss after total hip arthroplasty. It is with good compliance, but there is flu-like side effect. And it is difficult to differentiate the side effect from the fever associated with surgery in 1 week after the operation. So, it is recommended that zoledronic acid injection (Aclasta) should be used 1 week after the operation, when the body is in stable condition. If fever or other symptoms occur, acetaminophen or other anti - inflammatory drugs can be used. And no any other adverse reactions are observed. [ABSTRACT FROM AUTHOR] |
