This article is more than 5 years old. Information may no longer be current.
Zoledronate does not prevent femoral head collapse in patients with osteonecrosis
According to results of this 2-year level 1 study, zoledronate does not prevent femoral head collapse in patients with medium to large areas of non-traumatic osteonecrosis of the femoral head and does not reduce the need for subsequent total hip arthroplasty.
Researchers from South Korea prospectively studied 110 patients with Steinberg stage I or II osteonecrosis a necrotic area of more than 30%. During the study, 55 patients with a mean age of 44 years were assigned to receive 5 mg of zoledronate intravenously per year along with oral supplements of calcium and vitamin D. A control group of 55 patients with a mean age of 45 years only received supplements. The patients were not restricted from daily activities and weight bearing, and the researchers were blinded to the patients’ allocation.
The patients were followed up at 3 months, 6 months, 9 months, 1 year and then every 6 months. At all follow-ups, researchers evaluated patients using radiographs, the WOMAC score and the Harris Hip score (HHS). CT and MRI scans were obtained at 2-year follow-up. The investigators used subsidence of at least 2 mm of the articular surface to determine femoral head collapse.
They discovered 29 femoral heads collapsed in the zoledronate group vs. 22 in the control group. Nineteen hips in the zoledronate group required total hip arthroplasty (THA) compared with 20 hips in the control group. There were no significant differences between the groups for the rates of femoral head collapse or THA.
During follow-up, mean WOMAC scores and HHS improved in 50 hips. No adverse events occurred during administration of zoledronate, according to the researchers. ‒by Monica Jaramillo
Disclosures: Lee reports no relevant financial disclosures. Please see the full study for a list of all other author’s relevant financial disclosures.
Collapse