唑来膦酸注射液对膝关节置换术后假体周围骨密度变化的影响  

Effect of zoledronic acid injection on the change of bone mineral density around the prosthesis after knee arthroplasty

作　　者：杨广杰 殷保仓 周炳康 窦继元 郑浩 陈有 YANG Guangjie;YIN Baocang;ZHOU Bingkang;DOU Jiyuan;ZHENG Hao;CHEN You(Department of Orthopedics,The First Affiliated Hospital of Henan University,Kaifeng 475000,Henan,China)

机构地区：[1]河南大学第一附属医院骨科,河南开封475000

出　　处：《右江医学》2022年第1期24-28,共5页Chinese Youjiang Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200541)。

摘　　要：目的研究唑来膦酸注射液在膝关节置换术后的应用效果,探讨其对假体周围骨密度变化的影响。方法收集2019年1月~2020年1月在河南大学第一附属医院骨科住院并给予单侧膝关节置换的患者68例,采用随机数字表均分为观察组和对照组,观察组于术后第5天给予静脉滴注唑来膦酸注射液,遵循单盲原则,对照组给予等量的安慰剂,于术后1周、3个月、6个月、12个月测量两组膝关节置换术后假体周围的骨密度值并进行比较。结果观察组及对照组假体周围骨密度均有一定程度的降低,在术后3个月内下降最为明显,但对照组较观察组降低更明显,差异有统计学意义(P<0.05)。术后6个月及12个月,观察组假体周围的骨密度趋于平稳或有所回升,对照组则持续下降,差异有统计学意义(P<0.05)。结论唑来膦酸注射液在膝关节置换术后的应用,可明显改善膝关节假体周围骨质,增加假体周围生物力学稳定性,降低假体无菌性松动的发生率,延长假体使用寿命,值得临床推广应用。Objective To study the effect of zoledronic acid injection after knee arthroplasty,so as to explore its effect on the changes of bone mineral density around the prosthesis.Methods From January 2019 to January 2020,68 patients who hospitalized in the Department of Orthopedics of the First Affiliated Hospital of Henan University and received unilateral knee arthroplasty were collected.The patients were divided into observation group and control group by random number table.The observation group were given intravenous zoledronic acid injection on the fifth day after operation,and the the control group were given the same amount of placebo according to single-blind principle.The bone mineral density around the prosthesis was measured and compared between the two groups at 1 week,3 months,6 months and 12 months after knee arthroplasty.Results The bone mineral density around the prosthesis in the two groups decreased to a certain extent,and the decrease was most obvious within 3 months after operation,but the decrease in the control group was more significant than that in the observation group,and difference was statistically significant (P<0.05).At 6 months and 12 months after operation,the bone mineral density around the prosthesis in the observation group tended to be stable or increased,while that in the control group continued to decline,and the difference was statistically significant (P<0.05).Conclusion Zoledronic acid injection after knee arthroplasty can significantly improve the bone around the knee prosthesis,increase the biomechanical stability around the prosthesis,reduce the incidence of aseptic loosening of the prosthesis,and prolong the service life of prosthesis.Thus,it is worthy of clinical promotion and application.

关 键 词：唑来膦酸注射液 膝关节置换术 骨密度 

分 类 号：R687.42[医药卫生—骨科学]