Effects of zoledronic acid on bone mineral density around prostheses and bone metabolism markers after primary total hip arthroplasty in females with postmenopausal osteoporosis

• Published in: Osteoporosis international 2019-08, Vol.30 (8), p.1581-1589
• Main Authors: Zhou, W., Liu, Y., Guo, X., Yang, H., Xu, Y., Geng, D.
• Format: Article
• Language: English
• Subjects: 25-Hydroxyvitamin D; Absorptiometry, Photon - methods; Acids; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Biomarkers - blood; Bone density; Bone Density - drug effects; Bone Density Conservation Agents - pharmacology; Bone Density Conservation Agents - therapeutic use; Bone growth; Bone mass; Bone mineral density; Bone remodeling; Bone Remodeling - drug effects; Bone resorption; Bone Resorption - etiology; Bone Resorption - physiopathology; Bone Resorption - prevention & control; Bone turnover; Calcitriol; Calcitriol - therapeutic use; Calcium; Calcium Carbonate - therapeutic use; Collagen; Drug Therapy, Combination; Dual energy X-ray absorptiometry; Endocrinology; Female; Females; Follow-Up Studies; Hip; Hip Prosthesis; Humans; Intravenous administration; Joint surgery; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Original Article; Orthopedics; Osteoporosis; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - physiopathology; Post-menopause; Postoperative Care - methods; Prosthetics; Rheumatology; Single-Blind Method; Total hip arthroplasty; Zoledronic acid; Zoledronic Acid - pharmacology; Zoledronic Acid - therapeutic use
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-019-05005-7

Introduction To investigate the effect of zoledronic acid on periprosthetic bone mineral density (BMD) and bone metabolism markers after primary total hip arthroplasty in females with postmenopausal osteoporosis. Methods From November 2015 to April 2016, 40 female patients who met the inclusion criteria were randomized into two groups: a control group (calcium + calcitriol) and a zoledronic acid group (calcium + calcitriol + zoledronic acid). At 1 week and 3, 6, and 12 months after operation, BMD was obtained through dual-energy X-ray absorptiometry (DEXA). At pre-operation and at 3, 6, and 12 months after the operation, levels of bone metabolism markers were obtained by serum examination. Results Loss of BMD was significantly more pronounced in the control group than in the ZOL group in zones 1, 4, 6, and 7 at 6 months and in zones 1, 2, 4, 6, and 7 at 12 months after the operation. The levels of bone-resorption marker (β-CTX) were significantly lower in the ZOL group than in the control group at 3, 6, and 12 months after operation. The levels of bone-formation marker (TP1NP) performed statistically differences only at 12 months after the operation in these two groups. Conclusions Receiving an intravenous infusion of 5 mg zoledronic acid after THA can effectively reduce periprosthetic BMD loss and improve bone remodeling in females with postmenopausal osteoporosis. Summary Zoledronic acid significantly inhibited bone mass loss in zones 1, 2, 4, 6, and 7 after THA and inhibited bone-resorption marker (β-CTX) to improve bone remodeling. Zoledronic acid treatment is potentially important for patients with osteoporosis after THA.