高龄膝关节骨性关节炎患者术后抗骨质疏松治疗效果研究

Study on effects of postoperative anti-osteoporosis treatmentin elderly patients with knee osteoarthritis

目的:探讨高龄膝关节骨性关节炎患者术后抗骨质疏松治疗的效果。方法:将42例高龄(年龄>80)人工全膝关节置换术患者随机分为研究组(n=21)和对照组(n=21)。对照组行全膝关节置换术,手术治疗后行常规性指导;观察组在对照组的基础上应用抗骨质疏松药物进行治疗,肌肉注射唑来膦酸注射液5 mg/次,每天注射1次,7 d为1个疗程,连续治疗3个疗程。随访1年,以家庭随访或电话随访的方式进行。结果:两组术前骨密度比较,差异无统计学意义(P>0.05);术后6个月两组骨密度均高于术前(P<0.05),且研究组骨密度高于对照组(P>0.05)。两组患者术前VAS评分比较,差异无统计学意义(P>0.05);术后6个月两组VAS评分均低于术前(P<0.05),观察组VAS评分明显低于对照组(P<0.05)。两组患者术前HSS评分比较差异无统计学意义(P>0.05),术后6个月后观察组患者HISS评分明显高于对照组(P<0.05)。结论:术后抗骨质疏松治疗有利于促进高龄人工全膝关节置换术患者术后康复。

Objective: To explore effects of postoperative anti-osteoporosis treatment in elderly patients with knee osteoarthritis.Methods: 42 cases(age>80 yeas) underwent total knee arthroplasty(TKA) were randomly divided into study group(n = 21) and control group(n = 21).The control group was treated by routine operation,while the study group was applied with anti-osteoporosis drug treatment(intramuscularinjection of Zoledronic acid injection 5 mg/time,1 time/day,7 days and 3 courses).All the patients were given home follow-up or telephone follow-up for 1 year.Results: There were no statistical differences in the bone mineral density,VAS score and HSS score between the two groups before the operation(all P>0.05).The bone mineral densities of the two groups6 months after the operation were higher than those before the operation(P<0.05),while the VAS scores were lower than those before the operation(P<0.05).The bone mineral density of the study group 6 months after the operation was higher than that of the control group(P<0.05),while the VAS score and HSS score were significantly lower than those of the control group(P<0.05).Conclusions:Thepostoperative anti-osteoporosis treatment is beneficial to the recovery in the elderly patients after TKA.