Study On The Effect Of Qianggubao1 Prescription On Femoral Bone Density After Total Knee Replacement In Postmenopausal Patients

Objective: By observing the changes of bone mineral density around the femoral prosthesis,to explore the efficacy of Qianggubao No.1 prescription in the prevention and treatment of periprosthetic bone mass loss in postmenopausal patients after total knee arthroplasty,so as to provide evidence-based basis for clinical application.Methods: A total of 60 patients who met the inclusion criteria and exclusion criteria were selected from the joint surgery ward of Fuzhou second Hospital from December 2018 to June2019.Sixty patients were randomly divided into control group(n = 30)and experimental group(n = 30).The patients in both groups were treated with post-stable knee prosthesis made by Smith&Nephew Company for the first time of unilateral total knee arthroplasty.The prosthesis was fixed with bone cement and the same rehabilitation method was used after operation.One week after operation,the control group was given calcitriol D(0.6g/,once a day)and calcitriol capsule(0.25 ? g,once a day).One week after operation,the experimental group was treated with Qianggubao No.1 granule(1 dose / day,morning and evening)for 12 weeks.The bone mineral density around the femoral prosthesis was measured by dual energy X-ray absorptiometry at 1 week,12 weeks and 24 weeks after operation,and the changes of HSS score were recorded at the same time.The data were analyzed by SPSS20 statistical software to compare the clinical efficacy of two groups of drugs in the prevention and treatment of periprosthetic bone loss in postmenopausal patients after total knee arthroplasty.Results: A total of 55 cases were followed up in this study,including 27 cases in the experimental group and 28 cases in the control group.During the follow-up period,there were no obvious abnormalities in liver,renal function and blood calcium,and no problems such as poor incision healing,infection,prosthesis loosening,periprosthetic fracture and so on.1.General data: There was no significant difference in operative site,imaging grade,age,body mass index,preoperative HSS score and preoperative bone mineral density T value between the two groups.2.Average bone mineral density(BMD)after operation: The average bone mineral density in ROI1~4 area at 12 and 24 weeks after operation in both groups was lower than that at 1 week after operation,and there was no significant difference in the average bone mineral density in ROI3~4 area between the two groups.24 weeks after operation,the average bone mineral density in ROI1~2 area in the experimental group was higher than that in the control group,and there was no significant difference in other periods after operation.3.Postoperative bone mineral density loss rate: There was no significant difference in the bone mineral density loss rate in the ROI3~4 area between the two groups;the bone mineral density loss rate in the ROI1~2 area in the experimental group was lower than that in the control group at 24 weeks after operation,and there was no statistical difference in other periods after operation;the bone mineral density loss rate in each ROI area of the two groups increased progressively in different periods after operation,which was the fastest at 12 weeks after operation,and slowed down at 24 weeks after operation,and was the most obvious in the ROI1~2 area.4.HSS score: The HSS score of the two groups at 12 and 24 weeks after operation was better than that of 1 week after operation;the HSS score of the test group at 12 and 24 weeks after operation was better than that of the control group,and the difference between the twogroups was mainly in pain,function and range of activity;24 weeks after operation,the HSS score of the test group was better than that of the control group.Conclusion: 1.Qianggubao No.1 can reduce the bone loss around the femoral prosthesis in postmenopausal patients after total knee arthroplasty,especially in the ROI1~2 area.2.Qianggubao No.1 prescription can improve the HSS score of postmenopausal patients after total knee arthroplasty to a certain extent,promote the recovery of the affected limb,mainly in relieving pain,improving function and range of motion,and improving the HSS rating of patients after operation.The curative effect is significant and the safety is high,so it is worthy of clinical application.