Clinical Study On The Prevention Of Aseptic Loosening After Total Hip Arthroplasty With Zoledronic Acid

Objective: To investigate whether zoledronic acid can reduce the incidence of aseptic loosening after total hip arthroplasty,and to investigate the safety,efficacy and feasibility of this preventive method.Methods: A retrospective analysis was made of 145 patients who underwent total hip arthroplasty from August 2010 to December 2019 due to the end-stage hip diseases such as avascular necrosis of the femoral head or fracture of the femoral neck.Finally,143 patients were included in the statistics.Among them,70 patients were given zoledronic acid 5mg intravenously every year in the experimental group and 73 patients were not given zoledronic acid in the control group,cases in the two group need to take calcium and vitamin D.Regular follow-up was carried out after the operation,and X-ray films,bone mineral density and functional recovery of hip joint were examined.The main outcome measures were aseptic loosening or periprosthetic fractures,the change of bone mineral density,and the secondary outcome measures were hip joint function and alkaline phosphatase.Results:There were 4 cases of aseptic loosening in the control group,no cases of periprosthetic fracture,and no cases of aseptic loosening and periprosthetic fracture in the experimental group.At the last follow-up,the BMD of the two groups was lower than that of the former,but the BMD of the experimental group was higher than that of the control group after zoledronic acid application,which was statistically significant.In terms of hip joint function, from the beginning of 3 months to the last follow-up,the experimental group was higher than the control group,indicating that the improvement of hip joint in the experimental group was more satisfactory.At the last follow-up,compared with before operation,ALP in the experimental group decreased significantly,with statistical difference.Conclusion: Zoledronic acid can reduce the incidence of aseptic loosening in the short and medium term,improve the lumbar bone mineral density and hip joint function,decrease the alkaline phosphatase significantly,and have no serious adverse reactions.The prevention scheme shows safety,effectiveness and feasibility.