The Effect Of Tonifying-kindney And Spleen Formula On Femoral Periprosthetic Bone Loss Of The Elderly After Total Hip Arthroplasty

Purpose:To observe the clinical effects of Tonifying-kindney and Spleen Formula on femoral periprosthetic bone loss after Total Hip Arthroplasty(THA)in elderly patients.Method:74 elderly patients who planned to operate THA and met the criteria in 2016.12?2017.03 were selected in this study.They were randomly divided into the study group and the control group each with 37 cases.In study group,patients were treated with Tonifying-kindney and Spleen Formula and Calcium D 5 days after THA and lasted for 3 months;while patients in control group were treated with Calcium D alone for 3 months.The femoral periprosthetic bone mineral density(BMD),The levels of serum tartrate resistant acid phosphatase 5b(TRAP-5b)and bone alkaline phosphatase(BALP)were evaluated at 5 days,1,3 and 6 months postoperatively in both groups;the harris hip score was evaluated at 1,3 and 6 months postoperatively.Results:29 and 31 cases were finally enrolled in the study group and control group,respectively.There were no significant difference in general data between the two groups(P>0.05),including age,gender,body mass index,preoperative harriship score,preoperative T-score,treatment side,etc.1.The femoral periprosthetic BMD:The femoral periprosthetic BMD in the 7 regions of interest(ROI)in both groups was significantly lower at 6 months than at 3 months postoperatively,and was significantly lower at 3 months than at 1 months postoperatively(P<0.05).There was no significant difference between 5 days and 1 month postoperatively(P>0.05).The change in BMD of the ROI 1 and 7 at 3 and 6 months postoperatively was significantly lower in study group than that in control group(P<0.05),while there was no significant difference in ROI 2 to 6 between the two groups(P>0.05).2.The level of serum TRAP-5b:The level of patients' serum TRAP-5b increased after THA,but the study group reversed the tendency 1 month later,and it got much lower when compared to the control group at 3 and 6 months postoperatively(P<0.05).3.The level of serum bone alkaline phosphatasev:There was no significant difference in the level of serum alkaline phosphatase between the two groups at 1,3 and 6 months postoperatively(P>0.05).4.Harris hip score:There was no significant difference in hip harris scores between the two groups at 1 month postoperatively(P>0.05).The harris hip scores was significantly higher in study group than in the control group both at 3 and 6 months postoperatively(P<0.05).5.Safety assessment:In safety assessment,there were 3 cases of dry mouth and 2 cases of constipation in the study group,which were improved after adjusting drug dose.There was no harmful on liver and kidney and no serious adverse events in the two groups during follow-up.Conclusion:Tonifying-kindney and Spleen Formula used in the elderly after THA might inhibit the osteoclast activity and bone resorption,thus reducing the loss of bone around the femoral prosthesis and improving the clinical efficacy of hip surgery.