Oral risedronate increases Gruen zone bone mineral density after primary total hip arthroplasty: a meta-analysis
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Oral risedronate increases Gruen zone bone mineral density after primary total hip arthroplasty: a meta-analysis Qifeng Li1,2 and Baoshan Xu2*
Abstract Background: This meta-analysis was performed to assess the efficacy of risedronate in increasing bone mineral density (BMD) in patients undergoing primary total hip arthroplasty (THA). Methods: We systematically searched the following databases: PubMed, Embase, Web of Science, Cochrane Library, and Chinese Wanfang database from inception up to October 2017. Included patients were prepared for THA and were separated into two groups: intervention group (risedronate treatment) and control group (placebo treatment). BMD change in Gruen zone 1 and 7 were primary outcomes. Meta-analysis was performed using Stata 12.0 software. Results: Five randomized controlled trials (RCTs) involving 259 patients (risedronate group = 127, control group = 132) were finally included in this meta-analysis. Meta-analysis indicated that oral risedronate significantly increased the BMD change in Gruen zone 1. However, there was little clinical significance between the risedronate and control group in terms of the Gruen zones 2, 3, and 7. Oral risedronate significantly increased the Harris hip scores compared with the control group (P < 0.05). Conclusion: Oral risedronate could significantly reduce peri-prosthetic bone resorption around an uncemented femoral stem (Gruen zone 1) after THA. Due to the limited included studies, more high-quality randomized controlled trials (RCTs) were still needed to identify the efficacy of risedronate for bone loss in THA. Keywords: Risedronate, Total hip arthroplasty, Meta-analysis
Background Total hip arthroplasty (THA) has become a popular and successful surgical option for patients with hip osteoarthritis or hip fracture [1]. Some studies revealed that more than 75% of the revision arthroplasties were performed due to prosthesis loosening and peri-prosthetic fracture, which were accompanied by severe periprosthetic bone loss [2]. If an ideal drug suppressing the bone resorption after THA was found, the service life of prosthesis would be much prolonged [3, 4]. Numerous studies have focused on peri-prosthetic bone metabolism after THA [5, 6]. Bone resorption is considered to be the main reason for prosthesis loosening [7]. Currently, bisphosphonates are anti-resorptive * Correspondence: [email protected] 2 Department of orthopaedics, Tianjin Hospital, 406. No, Jiefangnan Road, Hexi district, Tianjin 300000, China Full list of author information is available at the end of the article
agents which promote bone mineralization and inhibit the biological effect of osteoclasts [8]. Many RCTs have demonstrated its beneficial effect on preserving periprosthetic bone in cementless THA [9, 10]. The risedronate has been used successfully to prevent osteoporotic fractures, mainly in the hip and vertebrae, by inhibiting osteoclast activity [11]. Risedronate can also reduce the risk of vertebral and hip fractures in patients with osteoporo
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