Clinical significance of zoledronic acid in combination with calcium tablets and calcitriol for hip biomechanics and bone mineral density after total hip replacement: a prospective randomized controlled trial

Abstract

Purpose: To investigate the effects of zoledronic acid (ZA) combined with calcium tablets and calcitriol on bone mineral density (BMD), hip function after total hip arthroplasty (THA). Methods: 50 elderly patients with THA from January 2022 to December 2022 were included in this study. The ZA group was given ZA combined with calcium tablets and calcitriol, while the control group was only given calcium tablets and calcitriol. The preoperative and postoperative BMD, bone metabolism-related indexes, Harris score, incidence of prosthesis loosening and hip biomechanics between the two groups were compared. Results: There were no significant differences in age, sex, Body Mass Index. Postoperative systemic BMD and periprosthetic BMDin ZA group were higher than those in the control group. The BMD in Gruen zones 1, 6 and 7 at postoperative 6 months, Gruen zones 1, 2, 4, 6 and 7 at postoperative 1 year was significantly higher than that in the control group. Postoperative 1 year, the 25-hydroxyvitamin D, procollagen 1 intact N-terminal and Harris score in ZA group were higher than those in control group, the β-type Ⅰ collagen carboxy-terminal peptide was lower. Acetabular height and acetabular deviation in ZA group were significantly better than those in control group at postoperative 1 year. Only 2 cases of prosthesis loosening in control group. Conclusion: ZA can effectively restore the loss of BMD, maintain the biomechanical stability of the hip, and reduce the incidence of prosthesis loosening. It is an effective method to prevent osteoporosis after THA. Trial registration: This study has been registered in the Chinese Clinical Registry (registration No.: ChiCTR2200065144, date: January 2022)