Yang Lei, Yang Maowei
1 Department of Orthopedics, the First Hospital of China Medical University, Liaoning, China.
2 Department of Orthopedics, Shenjing Hospital of China Medical University, Shenyang, China.
J Int Med Res. 2018 Aug;46(8):3251-3261. doi: 10.1177/0300060518760128. Epub 2018 Apr 16.
Objective This prospective randomized controlled study was performed to determine whether early drug use for osteoporosis impacts bone healing after orthomorphic surgery for hallux valgus (HV) in menopausal patients with osteoporosis. Methods This study included 113 consecutive patients with osteoporosis who underwent a combination of Lapidus arthrodesis and Akin osteotomy for treatment of HV. The patients were randomly divided into a zoledronic acid (ZOL) group (5-mg intravenous injection of ZOL, n = 56) and a placebo group (n = 57); both ZOL and placebo were administered 1 week postoperatively. Radiographs were taken preoperatively and at 1, 6, 8, 10, and 12 weeks postoperatively to record the time of the first tarsometatarsal joint (FTJ) fusion and Akin osteotomy site healing. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) scoring system 24 weeks after surgery. Results There were no statistically significant differences in the FTJ fusion time after Lapidus arthrodesis, healing time after Akin osteotomy, or postoperative AOFAS scores between the two groups. Conclusion Early initiation of ZOL does not impact the bone healing or clinical outcomes of orthomorphic surgery for HV in postmenopausal women diagnosed with osteoporosis after a combination of Lapidus arthrodesis and Akin osteotomy.
目的 本前瞻性随机对照研究旨在确定骨质疏松症的早期药物治疗是否会影响绝经后骨质疏松症患者拇外翻(HV)矫形手术后的骨愈合。方法 本研究纳入了113例连续接受Lapidus关节融合术和Akin截骨术联合治疗HV的骨质疏松症患者。患者被随机分为唑来膦酸(ZOL)组(静脉注射5 mg ZOL,n = 56)和安慰剂组(n = 57);ZOL和安慰剂均在术后1周给药。术前及术后1、6、8、10和12周拍摄X线片,记录第一跖跗关节(FTJ)融合时间和Akin截骨部位愈合情况。术后24周使用美国矫形足踝协会(AOFAS)评分系统评估临床疗效。结果 两组在Lapidus关节融合术后的FTJ融合时间、Akin截骨术后的愈合时间或术后AOFAS评分方面均无统计学显著差异。结论 对于接受Lapidus关节融合术和Akin截骨术联合治疗的绝经后骨质疏松症患者,早期使用ZOL不会影响HV矫形手术的骨愈合或临床疗效。