Effect of zoledronic acid on reducing femoral bone mineral density loss following total hip arthroplasty: A meta-analysis from randomized controlled trails

Jian Gao1, Chong Gao1, Hui Li, Guo-sheng Wang, Chang Xu, Jian Ran 1Jian Gao and Chong Gao equally contributed to this study.

DOI: http://dx.doi.org/10.1016/j.ijsu.2017.08.559

Highlights

•To assess the efficiency of intravenous administration of zoledronic acid on reducing femoral periprosthetic bone mineral density loss in THA.

•Four randomized controlled trials (RCTs) were included in the meta-analysis.

•Intravenous administration of zoledronic acid could significantly reduce periprosthetic bone mineral density loss.

Abstract

Objective

This meta-analysis aimed to assess the efficiency of intravenous administration of zoledronic acid on reducing femoral periprosthetic bone mineral density loss in patients undergoing primary total hip arthroplasty (THA).

Methods

A systematic search was performed in Medline (1966–2017.07.31), PubMed (1966–2017.07.31), Embase (1980–2017.07.31), ScienceDirect (1985–2017.07.31) and the Cochrane Library (1966–2017.07.31). Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Sensitivity analysis was conducted and publication bias was assessed. Meta-analysis was performed using Stata 11.0 software.

Results

Four studies including 185 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of periprosthetic bone mineral density in Gruen zone 1 (SMD = 0.752, 95% CI: 0.454 to 1.051, P = 0.000), 2 (SMD = 0.524, 95% CI: 0.230 to 0.819, P = 0.000), 4 (SMD = 0.400, 95% CI: 0.107 to 0.693, P = 0.008), 6 (SMD = 0.893, 95% CI: 0.588 to 1.198, P = 0.000) and 7 (SMD = 0.988, 95% CI: 0.677 to 1.300, P = 0.000).

Conclusion

Intravenous administration of zoledronic acid could significantly reduce periprosthetic bone mineral density loss (Gruen zone 1, 2, 4, 6 and 7) after THA. In addition, no severe adverse events were identified. High-quality RCTs with large sample size were still required.

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