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European Journal of Orthopaedic Surgery & Traumatology

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01-12-2018 | Original Article • HIP - ARTHROPLASTY

Restoration of proximal periprosthetic bone loss by denosumab in cementless total hip arthroplasty

Authors: Satoshi Nagoya, Kenji Tateda, Shunichiro Okazaki, Ima Kosukegawa, Junya Shimizu, Toshihiko Yamashita

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 8/2018

Abstract

Summary

Denosumab contributed to the restoration of proximal periprosthetic bone loss around the femoral stem that were measured using a DEXA, especially in zone 7, at 1 year after cementless THA in elderly osteoporotic patients.

Introduction

Although bone quality is an important issue in elderly osteoporotic patients who underwent total hip arthroplasty (THA) with a cementless stem, periprosthetic bone mineral density (BMD) in the proximal femur has been reported to be decreased by 15–40% postoperatively. Some authors have examined the use of several types of bisphosphonates to prevent decreases in BMD in the proximal femur after cementless THA; however, few reports have demonstrated success in restoring BMD in the proximal medial femoral bone, such as zone 7.

Methods

We conducted prospective study comparing patients who underwent cementless THA administered with denosumab (10 patients) and without denosumab (10 patients). BMD around the femoral stem were measured using a DEXA immediately after surgery, and at 6 months and at 1 year after surgery. No difference was found between the two groups referred to the patient’s demographic data.

Results

We found that denosumab displayed definitive effects in increasing the % change in periprosthetic BMD at zone 7 by an average of 7.3% in patients with cementless THA, compared to control group who were given only vitamin D.

Conclusion

Denosumab is one of a number of anti-osteoporotic agents to have a definitive effect on the restoration of proximal periprosthetic bone loss, especially in zone 7, after cementless THA. Denosumab contributed to the restoration of decreased periprosthetic BMD to normal levels. As the decrease in BMD in the proximal femur after THA is considered to be apparent at 6–12 months after surgery, it is believed that prevention of the deterioration of bone quality is important in the proximal femur immediately after cementless THA for elderly female patients with osteoporosis.

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Title: Restoration of proximal periprosthetic bone loss by denosumab in cementless total hip arthroplasty
Authors: Satoshi Nagoya
Kenji Tateda
Shunichiro Okazaki
Ima Kosukegawa
Junya Shimizu
Toshihiko Yamashita
Publication date: 01-12-2018
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 8/2018
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-018-2223-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Restoration of proximal periprosthetic bone loss by denosumab in cementless total hip arthroplasty

Abstract

Summary

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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