The use of bone turnover markers for monitoring the treatment of osteoporosis in postmenopausal females undergoing total knee arthroplasty : a prospective randomized study

BACKGROUND: Osteoporosis (OP) and osteoarthritis (OA) commonly coexist in postmenopausal females. The decrease in bone density and increase in bone resorption in postmenopausal females with OP may consequently affect the surgical outcome of total knee arthroplasty (TKA). However, clinicians often ignore monitoring the treatment of OP in the perioperative management of TKA. Bone turnover marker (BTM) can timely and accurately reflect bone metabolism to monitor the treatment of OP. The purpose of this study was to investigate the effect of BTM monitoring to guide the treatment of OP in postmenopausal females undergoing TKA.

METHODS: Postmenopausal females with OP who underwent primary unilateral TKA were randomly divided into two groups (monitoring group and control group), given oral medication (alendronate, calcitriol, and calcium), and followed for 1 year. In the monitoring group, serum BTMs (C-telopeptide of type I collagen (CTX-I), N-terminal propeptide of type I procollagen (PINP), and 25(OH)D) were assessed preoperatively and repeated postoperatively; alendronate was withdrawn when CTX-I and PINP reached the reference interval; and calcitriol and calcium were withdrawn when 25(OH)D reached the reference interval. In the control group, oral medication was implemented for a uniform duration of 3 months. During the 1-year follow-up, the mean maximum total point motion (MTPM) of the tibial component, bone mineral density (BMD), visual analog scale (VAS) score, range of motion, and Oxford Knee Score (OKS) score were obtained.

RESULTS: In the monitoring group, BTM monitoring prolonged the medication duration, but did not cause more adverse reactions than in the control group. The mean MTPM values at 6 m and 12 m in the monitoring group were lower than those in the control group, and the BMD at 12 m in the monitoring group was significantly higher than that in the control group. Patients in the monitoring group had lower VAS scores at 6 m and higher OKS scores at 6 m and 12 m than those in the control group.

CONCLUSION: In postmenopausal females with osteoporosis undergoing primary TKA, the application of BTM monitoring to guide the treatment of osteoporosis can enhance bone density, maintain prosthesis stability, and improve surgical outcome.

TRIAL REGISTRATION: ChiCTR ChiCTR-INR-17010495 . Registered on 22 January 2017.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:16

Enthalten in:

Journal of orthopaedic surgery and research - 16(2021), 1 vom: 17. März, Seite 195

Sprache:

Englisch

Beteiligte Personen:

Ma, Rui [VerfasserIn]
Wu, Mengjun [VerfasserIn]
Li, Yongwei [VerfasserIn]
Wang, Jialin [VerfasserIn]
Yang, Pei [VerfasserIn]
Chen, Yuanyuan [VerfasserIn]
Wang, Wei [VerfasserIn]
Song, Jinhui [VerfasserIn]
Wang, Kunzheng [VerfasserIn]

Links:

Volltext

Themen:

1406-16-2
25-hydroxyvitamin D
A288AR3C9H
Alendronate
Biomarkers
Bone Density Conservation Agents
Bone turnover markers
Calcitriol
Calcium
Collagen Type I
Collagen type I trimeric cross-linked peptide
FXC9231JVH
Journal Article
Monitoring treatment
Osteoarthritis
Peptide Fragments
Peptides
Postmenopausal osteoporosis
Procollagen
Procollagen Type I N-terminal peptide
Randomized Controlled Trial
SY7Q814VUP
Total knee arthroplasty
Vitamin D
X1J18R4W8P

Anmerkungen:

Date Completed 03.09.2021

Date Revised 03.09.2021

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s13018-021-02343-3

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM322877695