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Zoledronic Acid Does Not Retard Bone Union: A Randomized Controlled Trial in Fragility Intertrochanteric Femur
Ankit Gulia1, Shakti Prasad Das2, Suhas Sondur1
1Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus
|February 23, 2023
Summary
Postoperative zoledronic acid (ZOL) for hip fractures improves functional outcomes without delaying healing. This opportunistic treatment enhances osteoporosis management and fracture prevention compliance.
Area of Science:
- Orthopedics
- Geriatrics
- Pharmacology
Background:
- Hip fractures are a major cause of mortality in the elderly, particularly postmenopausal women.
- Bisphosphonates (BPs), like zoledronic acid (ZOL), are first-line osteoporosis treatments.
- The impact of BPs on fracture healing remains controversial.
Purpose of the Study:
- To investigate the effect of zoledronic acid on intertrochanteric fragility fracture healing.
- To assess if postoperative ZOL administration impacts fracture healing time and outcomes.
Main Methods:
- A randomized controlled trial involving 136 patients (age >50) with intertrochanteric femur fractures.
- Group T (n=68) received ZOL postoperatively; Group C (n=68) received interventions after healing.
- Radiological (RUSH, Singh Index) and functional (Harris Hip Score) outcomes were assessed over six months.
Main Results:
- No significant difference in radiological healing (RUSH, Singh Index) between groups.
- Functional outcomes (Harris Hip Score) were significantly better in the ZOL group (p < 0.005).
- Average healing time was comparable: 12.2 weeks (ZOL) vs. 13.0 weeks (control).
Conclusions:
- Postoperative intravenous zoledronic acid does not impede fracture healing in intertrochanteric fractures.
- Opportunistic ZOL administration can improve osteoporosis management compliance.
- This approach aids fracture prevention and enhances patient outcomes.
