Analysis of the clinical effect of zoledronic acid combined with hip replacement in the treatment of postmenopausal osteoporotic femoral neck fractures / 中华内分泌外科杂志

ABSTRACT

Objective:To analyze the clinical effect of zoledronic acid combined with hip replacement in treatment of postmenopausal osteoporotic femoral neck fractures.Methods:152 patients with postmenopausal osteoporotic femoral neck fractures treated in our hospital from Dec. 2016 to Dec. 2018 were selected as the research subjects. According to the random number table method, they were divided into experimental group (zoledronic acid combined with hip replacement treatment) and control group (hip replacement treatment) , with 76 cases in each group. Lumbar and hip bone mineral density, Harris score, SF-36 score, bone formation markers (osteocalcin (OC) , total bone type I procollagen amino-terminal elongation peptide (PINP) , bone specific alkaline phosphate) Enzyme (BALP) ) , bone resorption markers (type I collagen carboxyterminal peptide β special sequence (β-CTX) , tartrate-resistant acid phosphatase 5b (TRACP-5b) ) , risk of periprosthetic fractures, and adverse reactions were compared.Results:There was no significant difference in lumbar bone mineral density ( t=-0.083, P=0.934) , hip bone mineral density ( t=0.081, P=0.935) , Harris score ( t=-0.051, P=0.960) , SF-36 score ( t=-0.027, P=0.978) , OC ( t=0.043, P=0.996) , PINP ( t=-0.411, P=0.682) , BALP ( t=-0.224, P=0.823) , β-CTX ( t=-1.3, P=0.196) , and TRACP-5b ( t=-3.263, P=0.001) between the two groups of patients before surgery. At 1 month, 6 months, and 12 months after surgery, the lumbar and hip bone mineral density, Harris score, and SF-36 scores were higher in the two groups than before surgery, and the experimental group of patients with lumbar bone mineral density ( t=2.113, P=0.036; t=2.049, P=0.042; t=3.824, P=0.000) , hip bone mineral density ( t=2.204, P=0.029; t=2.068, P=0.040; t=4.762, P=0.000) , Harris score ( t=2.578, P=0.011; t=2.616, P=0.010; t=2.868, P=0.005) , SF-36 score ( t=4.873, P=0.000; t=7.621, P=0.010; t=8.747, P=0.000) was significantly higher than the control group. OC, PINP, BALP, β-CTX, and TRACP-5b were lower in the two groups at 6 months after the operation than before, and the experimental group of patients with OC ( t=-3.263, P=0.001) , PINP ( t=-3.263, P=0.001) , BALP ( t=-3.263, P=0.001) , β-CTX ( t=-3.263, P=0.001) , and TRACP-5b ( t=-3.263, P=0.001) was significantly lower than the control group. The risk of periprosthetic fractures in the experimental group was significantly lower than that in the control group ( χ2=4.788, P=0.028) . However, there was no significant difference in adverse reac-tion rates between the two groups ( χ2=0.336, P=0.562) . Conclusion:Zoledronic acid combined with hip replacement for postmenopausal osteoporotic femoral neck fractures can increase bone density, improve bone metabolism, reduce the risk of fractures around the prosthesis, and is safe and effective.