Effect of denosumab on bone mineral density and joint function in patients with osteoporotic fractures undergoing total hip arthroplasty
Li Yunlong
Zhang Hao
Wang Yongjun
Sun Yufeng
Abstract：Objective To explore the effect of denosumab on bone mineral density(BMD)and joint function in patients with osteoporotic fractures undergoing total hip arthroplasty(THA).Methods A retrospective study was conducted.A total of 80 pa-tients with osteoporotic fractures who underwent THA for the first time at Anyang People's Hospital from January 2020 to January 2023 were enrolled and divided into the control group and the observation group according to different treatment methods.The con-trol group(n=42)received oral calcium carbonate D tablets after surgery,while the observation group(n=38)received oral calcium carbonate D tablets and subcutaneous injection of denosumab after surgery.The BMD,joint function,serum bone metabolism indica-tors,prosthesis loosening rates and adverse reactions in the control group and the observation group were analyzed.Results After 6 months and 12 months of treatment,the BMD in Gruen 1 and 7 zones in the observation group(Gruen 1 zone:(0.65±0.10)g·(cm2)-1,(0.63±0.11)g·(cm2)-1;Gruen 7 zone:(0.63±0.09)g·(cm2)-1,(0.64±0.10)g·(cm2)-1)were higher than those in the control group(Gruen 1 zone:(0.60±0.09)g·(cm2)-1,(0.58±0.10)g·(cm2)-1;Gruen 7 zone:(0.54±0.12)g·(cm2)-1,(0.51±0.14)g·(cm2)-1),with statistically significant differences(t=2.354,2.130,3.763,4.734,all P<0.05).After 12 months of treatment,the Harris hip joint scores for each dimension in the observation group((37.11±2.96)points,(37.66±3.38)points,(3.40±0.43)points,(3.16±0.34)points,respectively)were higher than those in the control group((32.84±2.62)points,(32.20±3.20)points,(2.59±0.31)points,(2.51±0.27)points,re-spectively),with statistically significant differences(t=6.854,7.420,9.731,9.512,all P<0.05).After 12 months of treatment,the levels of serum type Ⅰ procollagen N-terminal propeptide and precalcitonin in the observation group((40.35±3.63)ng·mL-1,(7.20±1.04)µg·L-1,respectively)were higher than those in the control group((32.17±2.58)ng·mL-1,(5.23±1.05)µg·L-1,respectively);the level of beta-collagen degradation products in the observation group((0.42±0.06)ng·mL-1)was lower than that in the control group((0.56±0.08)ng·mL-1),with statistically significant differences(t=11.701,8.780,8.418,all P<0.05).The total incidence of prosthesis loosening was 7.14%(3/42)in the control group and 2.63%(1/38)in the observation group,with no statistically significant differ-ence(χ2=0.169,P=0.681).The incidence of adverse reactions was 14.29%(6/42)in the control group and 10.53%(4/38)in the obser-vation group,with no statistically significant difference(χ2=0.029,P=0.866).Conclusion For patients with osteoporotic fractures undergoing THA,the addition of denosumab to conventional calcium supplementation after surgery can effectively increase the bone density in critical areas around the prosthesis and improve the recovery process of hip joint function after surgery.
Keywords：Osteoporotic fracturesTotal hip arthroplastyBone mineral densityJoint functionDenosumab
Publication Date：2025-09-25
Online Publishing Date：2025-10-10(First online date of this platform, not the publication date of the document)
Pages：5( 1084-1088 )