药物预防全髋关节置换后继发假体周围骨溶解的5年随机对照评价

Drug prevention aganist periprosthetic osteolysis 5 years after total hip arthroplasty:A controlled randomized evaluation

背景:全髋关节置换后出现轻微的骨溶解,如果能找到理想的药物治疗,不但可减轻痛苦,还可节省医疗费用。目的:观察阿仑膦酸钠和阿法骨化醇联合应用预防全髋关节置换后假体周围骨溶解的效果。方法:75例股骨颈骨折患者行骨水泥型人工髋关节置换后随机分为3组,治疗组给予阿仑膦酸钠和阿法骨化醇口服联合治疗、对照组给予复方氨基酸螯合钙胶囊口服治疗,空白组正常饮食。随访1,3,5年,检测假体周围骨密度值变化、髋关节功能评分,5年后进行影像学评价。结果与结论:髋关节置换后3,5年治疗组骨密度值高于对照组和空白组(P<0.05),置换后5年治疗组骨溶解率低于对照组和空白组(P<0.05)。结果显示阿仑膦酸钠和阿法骨化醇联合应用,在预防髋关节假体置换后继发骨溶解发生的过程中起到了一定的积极作用。

BACKGROUND：The ideal drugs therapy for osteolysis may not only relieve the pain,but also save medical costs.OBJECTIVE：To investigate the 5-year effect of alendronate and alfacalcidol combination on preventing periprosthetic osteolysis after total hip arthroplasty.METHODS：Seventy-five patients undergoing cemented total hip replacement after femoral neck fracture were randomly divided into 3 groups：the treatment group was given alendronate and alfacalcidol oral combination therapy,the control group was treated with compound amino acid chelate joint capsule of oral calcium therapy,and the blank control group with normal diet.Periprosthetic bone mineral density and average Harris score were examined at the 1st,3rd,5th years after the operation,and imaging evaluation after 5 years.RESULTS AND CONCLUSION：Three and five years after hip replacement,bone density in treatment group was significantly higher than that in the control group（P 0.05）;5 years after surgery,bone dissolution rate of the treatment group was lower than that of the control group and the blank control group（P 0.05）.The results showed that the combination of alendronate and alfacalcidol played a positive role in preventing the occurrence of osteolysis after hip prosthesis replacement.