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To withhold or to implement bisphosphonate after cementless hip arthroplasty: a dilemma in elderly hip fracture patients

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Authors
Lee, Young-Kyun; Kim, Tae-Young; Ha, Yong-Chan; Koo, Kyung-Hoi
Issue Date
2019-02-26
Citation
Journal of Orthopaedic Surgery and Research. 2019 Feb 26;14(1):66
Abstract
Background
Prior studies reported ambivalent effects of bisphosphonates on the fixation of cementless stem in hip arthroplasty patients. To set up the postoperative guide of bisphosphonate use after cementless hip arthroplasty, we investigated whether zoledronate has beneficial or negative effects in the stem migration and walking ability after cementless hemi-arthroplasty in elderly patients, who were operated due to femoral neck fracture.

Methods
We compared 59 patients (zoledronate group), who received zoledronate after cementless hemi-arthroplasty, and 66 patients (control group), who did not receive that agent. We evaluated stem subsidence, cortical porosis around the stem, and walking ability with the use of Koval’s categories at 2-year follow-up.

Results
No patient had more than 2 mm of stem subsidence in both groups. One patient in the control group had cortical porosis around the stem, but none in the zoledronate group. There were no significant differences in the postoperative Koval scores (p = 0.769) and in the proportion of walking recovery to pre-fracture status (p = 0.695) between the two groups.

Conclusion
We did not find neither beneficial nor negative effect of this agent in terms of stem fixation and walking ability. Zoledronate can be used after cementless hemi-arthroplasty to manage the osteoporosis in elderly patients.
ISSN
1749-799X
URI
http://hdl.handle.net/10371/147196
DOI
doi.org/10.1186/s13018-019-1104-2
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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