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[地诺单抗对绝经后骨质疏松症患者全髋关节置换术后股骨近端假体周围骨密度的影响]

[Effects of denosumab on bone mineral density around proximal femoral prosthesis after total hip replacement in postmenopausal osteoporotic patients].

作者信息

Ning Wei-Hong, Xu Guo-Zhu, Wang Jian-Wei

机构信息

Department of Orthopaedics, Traditional Chinese Medical Hospital of Changxing, Huzhou 313100, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2023 Nov 25;36(11):1041-5. doi: 10.12200/j.issn.1003-0034.2023.11.007.

Abstract

OBJECTIVE

To evaluate the effect of denosumab on bone mineral density around proximal femoral prosthesis after total hip arthroplasty(THA) in the postmenopausal osteoporotic patients.

METHODS

Fifty-four consecutive patients underwent unilateral primary THA were included in this retrospective study. Twenty-five patients received denosumab for osteoporosis as the treatment group, and the twenty-nine without denosumab were the control group. At 1 week, 3month, 6 months, and 12 months after THA, bone turnover markers and proximal femoral periprosthetic bone mineral density (BMD) were measured.

RESULTS

At 3, 6 and 12 months after operation, the level of TRACP-5b in the control group was significantly higher than that in the treatment group (<0.05);the level of bone-specific alkaline phosphatase (BALP) between two groups showed significant difference in 12 months after operation (control group was higher than treatment group, <0.05). The BMD of Gruen 1 and Gruen 7 decreased at 3, 6 and 12 months after operation compared with 1 week after operation. Comparing the treatment group and the control group, the differences of the the decrease of BMD in Gruen 1 and Gruen 7 were no significant at 3 months after surgery. In Gruen 1, Gruen 7 at 6 months after operation and Gruen 1, Gruen 7 at 12 months after operation, the decrease of BMD in the control group was significantly higher than that in the treatment group(<0.05). It is suggested that desudumab could inhibit the loss of BMD after 6 months, and continuously show a protective effect on bone mass at 12 months after operation.

CONCLUSION

After THA in postmenopausal patients with osteoporotic femoral neck fracture, Desuzumab can reduce the loss of BMD around the proximal femoral prosthesis and effectively inhibit bone resorption.

摘要

目的

评估地诺单抗对绝经后骨质疏松患者全髋关节置换术(THA)后股骨近端假体周围骨密度的影响。

方法

本回顾性研究纳入了54例连续接受单侧初次THA的患者。25例接受地诺单抗治疗骨质疏松的患者作为治疗组,29例未接受地诺单抗的患者为对照组。在THA术后1周、3个月、6个月和12个月,测量骨转换标志物和股骨近端假体周围骨密度(BMD)。

结果

术后3、6和12个月,对照组血清抗酒石酸酸性磷酸酶5b(TRACP-5b)水平显著高于治疗组(P<0.05);术后12个月两组骨特异性碱性磷酸酶(BALP)水平差异有统计学意义(对照组高于治疗组,P<0.05)。与术后1周相比,Gruen 1区和Gruen 7区的骨密度在术后3、6和12个月均降低。术后3个月时,治疗组和对照组Gruen 1区和Gruen 7区骨密度降低幅度差异无统计学意义。术后6个月时Gruen 1区、Gruen 7区以及术后12个月时Gruen 1区、Gruen 7区,对照组骨密度降低幅度均显著高于治疗组(P<0.05)。提示地诺单抗在术后6个月可抑制骨密度丢失,并在术后12个月持续对骨量显示保护作用。

结论

绝经后骨质疏松性股骨颈骨折患者THA术后,地诺单抗可减少股骨近端假体周围骨密度丢失,有效抑制骨吸收。

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