To withhold or to implement bisphosphonate after cementless hip arthroplasty: a dilemma in elderly hip fracture patients

Journal of Orthopaedic Surgery and Research

卷:14

Yong-Chan Ha¹  Kyung-Hoi Koo²  Young-Kyun Lee²  Tae-Young Kim³ 

[1] Department of Orthopaedic Surgery, College of Medicine, Chung-Ang University;

[2] Department of Orthopaedic Surgery, Seoul National University Bundang Hospital;

[3] Konkuk University Medical Center, Department of Orthopaedic Surgery, School of Medicine, Konkuk University;

关键词: Bisphosphonate;    Cementless hip arthroplasty;    Subsidence;    Stem migration;    Femur neck fracture;   

DOI  :  10.1186/s13018-019-1104-2

来源: DOAJ

【 摘 要 】

Abstract Background Prior studies reported ambivalent effects of bisphosphonates on the fixation of cementless stem in hip arthroplasty patients. To set up the postoperative guide of bisphosphonate use after cementless hip arthroplasty, we investigated whether zoledronate has beneficial or negative effects in the stem migration and walking ability after cementless hemi-arthroplasty in elderly patients, who were operated due to femoral neck fracture. Methods We compared 59 patients (zoledronate group), who received zoledronate after cementless hemi-arthroplasty, and 66 patients (control group), who did not receive that agent. We evaluated stem subsidence, cortical porosis around the stem, and walking ability with the use of Koval’s categories at 2-year follow-up. Results No patient had more than 2 mm of stem subsidence in both groups. One patient in the control group had cortical porosis around the stem, but none in the zoledronate group. There were no significant differences in the postoperative Koval scores (p = 0.769) and in the proportion of walking recovery to pre-fracture status (p = 0.695) between the two groups. Conclusion We did not find neither beneficial nor negative effect of this agent in terms of stem fixation and walking ability. Zoledronate can be used after cementless hemi-arthroplasty to manage the osteoporosis in elderly patients.

【 授权许可】

Unknown