| Objective: The effect of Qianggubao No.1 prescription on the bone volume around the femoral stem prosthesis was investigated by applying Gemstone Spectral Imaging imaging to assess the changes in the mean HAP values around the femoral stem prosthesis in patients after total hip arthroplasty to provide an evidence-based basis for clinical application.Methods:Sixty patients were admitted to our department from October 2020 to August 2021 who met the inclusion criteria as well as the exclusion criteria for primary unilateral THA for femoral head necrosis were selected.The patients were randomly divided into experimental group and control group,with 30 cases in each group.Patients in both groups underwent initial unilateral THA with the same type of prosthesis and were given conventional treatment after surgery.In the control group since 1 week after surgery,600 mg of calcium carbonate D3 tablets once daily and0.25 μg of calcitriol capsules once daily were administered for 3 months.Test group: on the basis of the control group,Qianggubao No.1 granule mixed with warm boiled water was added,taken once at 30 min after meals in the morning and evening for 3 months.The mean HAP values around the prosthesis were measured by GSI at 1 week,3 months and 6 months after surgery in both groups.SPSS 23.0 statistical software was applied to analyze the data and compare the bone loss around the prosthesis after pharmacological prevention and treatment of THA in the 2 groups.Results:A total of 57 patients were followed up,including 29 cases in the test group and 28 cases in the control group.During the follow-up period,the prostheses of the included patients were intact without infection,loosening,dislocation,periprosthetic fracture,etc.No obvious abnormality was found in the postoperative blood examination.1.General information: there was no significant difference between the test group and the control group in gender,BMI,age,surgical site and preoperative imaging stage(P > 0.05),which was comparable.2.Postoperative periprosthetic bone volume changes: there was an overall decreasing trend in the periprosthetic bone volume of the femoral stem prosthesis in both groups during the 6 month follow-up time.Mean HAP values in ROI 1-7areas were lower in both groups at 3 and 6 months postoperatively than that at 1 week postoperatively(P<0.05).At 3 months after surgery,the mean HAP values in the ROI1 and ROI2 areas of the test group were higher than the control group(P<0.05);At 6 months after surgery,the mean HAP values in the ROI1,ROI2,ROI3,ROI5,ROI6 and ROI7 areas of the test group were higher than in the control group(P<0.05).3.Mean postoperative HAP loss rate: During the 6-month postoperative follow-up period,there was a progressive increase in the mean HAP loss rate for each ROI areas in both groups at different periods,with the fastest rate at 3 months postoperatively and a slower rate at 6 months postoperatively,which was more pronounced in the proximal femur.At 3 months postoperatively:The mean HAP value loss rate in ROI2 and ROI4 areas of the test group was lower than the control group(P<0.05).At 6 months postoperatively: The mean HAP value loss rate in ROI1,ROI2,ROI5,ROI6 and ROI7 areas of the test group was lower than the control group(P<0.05).Conclusions : Bone volume around the prosthesis generally tends to decrease after THA,especially in the proximal femur.The change of bone volume can be effectively observed with Gemstone Spectral Imaging.Bone loss around the prosthesis after THA could be effectively prevented by the use of Qianggubao No.1 prescription,and the effect of preventing and treating bone loss becomes more pronounced as the follow-up period increases. |
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