唑来磷酸钠联合胫骨延长杆在重度骨质疏松症的高龄TKA患者中的疗效分析  

Exploring the Curative Effect of Zoledronic Acid Sodium Combined with Tibial Lengthening Rod in Elderly TKA Patients with Severe Osteoporosis

作　　者：陶晶[1] 李明洋 刘博 唐永冬 闫朋朋 曾乐乐 何斌[1] TAO Jing;LI Ming-yang;LIU Bo;TANG Yong-dong;YAN Peng-peng;ZENG Le-le;HE Bin(Department of Orthopedics(Joint Surgery),People's Hospital of Shihezi,XinJiang Shihezi,832000)

机构地区：[1]石河子市人民医院骨二科(关节外科),新疆石河子832000

出　　处：《农垦医学》2023年第6期516-520,共5页Journal of Nongken Medicine

基　　金：新疆生产建设兵团科技创新人才项目(2022CB010-04)。

摘　　要：目的:探究患有重度骨质疏松症的高龄(>75岁)膝关节骨性关节炎患者,膝关节置换使用唑来磷酸钠联合胫骨延长杆对患者术后骨密度变化、假体松动及再骨折发生率等的影响。方法:选取单侧膝关节置换的高龄重度骨质疏松患者58例,术前均进行骨密度筛查,随机分为实验组及对照组。实验组术中加用胫骨延长杆、术后一周予以唑来磷酸钠注射,对照组术中使用标准膝关节假体,所有患者均予以口服骨化三醇及维生素D3抗骨质疏松治疗。通过骨密度检测比较两组术前及术后1年骨密度值变化,HSS评分及VAS评分比较膝关节功能,比较术后1年两组再骨折及假体周围骨折发生率情况。结果:实验组与对照组术后1年HSS评分及VAS评分比较差异无统计学意义(P>0.05);术后1年骨密度实验组高于对照组,再骨折发生率实验组低于对照组,两组比较差异具有统计学意义(P<0.05)。结论:重度骨质疏松的高龄TKA患者使用唑来磷酸钠联合胫骨延长杆可以提高骨密度,减少再骨折及假体周围骨折发生率。Objective:To explore the effect of Zoledronic acid sodium combined with tibial lengthening rod on bone mineral density,prosthesis loosening and refracture rate of elderly(>75 years old)knee osteoarthritis patients with severe osteoporosis after knee Joint replacement.Methods:58 elderly patients with severe osteoporosis who underwent unilateral knee Joint replacement were randomly divided into experimental group and control group.In the experimental group,the tibia extension rod was added during the operation,and Zoledronic acid sodium was injected one week after the operation.In the control group,the standard knee prosthesis was used during the operation.All patients were given oral Calcitriol and vitamin D3 anti osteoporosis treatment.Compare the changes in bone density values between the two groups before and 1 year after surgery through bone density testing,compare knee joint function with HSS and VAS scores,and compare the incidence of re fractures and periprosthetic fractures between the two groups 1 year after surgery.Results:There was no statistically significant difference in HSS score and VAS score between the experimental group and the control group at 1 year after surgery(P>0.05),but there was a statistically significant difference in bone density and the incidence of recurrent fractures at 1 year after surgery(P<0.05).Conclusion:In elderly TKA patients with severe osteoporosis,sodium Zoledronic acid combined with tibial lengthening rod can improve bone density and reduce the incidence of refracture and periprosthetic fracture.

关 键 词：全膝关节置换术 唑来磷酸 胫骨延长杆 抗骨质疏松 

分 类 号：R681.55[医药卫生—骨科学]