Raloxifene Prevents Early Periprosthetic Bone Loss for Postmenopausal Women after Uncemented Total Hip Arthroplasty: A Randomized Placebo‐Controlled Clinical Trial
Objective To examine the results of raloxifene for prevention of periprosthetic bone loss around the femoral stem in patients undergoing total hip arthroplasty (THA). Methods Between January 2015 and May 2017, 240 female patients between 55 and 80 years underwent primary THA and were randomly alloca...
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doaj-4000a4e1ab394d99abaf83c4a2f338ef2020-11-25T02:45:45ZengWileyOrthopaedic Surgery1757-78531757-78612020-08-011241074108310.1111/os.12696Raloxifene Prevents Early Periprosthetic Bone Loss for Postmenopausal Women after Uncemented Total Hip Arthroplasty: A Randomized Placebo‐Controlled Clinical TrialLong Gong0Yao‐yao Zhang1Na Yang2Huan‐juan Qian3Ling‐kun Zhang4Ming‐sheng Tan5Department of Orthopaedic Surgery China–Japan Friendship Hospital, Peking Union Medical College, Chinese Academy of Medical College Beijing ChinaDepartment of Obstetrics and Gynecology West China Second University Hospital of Sichuan University Chengdu ChinaBao Ding Maternal and Children Hospital Baoding ChinaDepartment of Orthopedics Surgery 81 Group Military Hospital of Chinese PLA Baoding ChinaDepartment of Orthopedics Surgery 81 Group Military Hospital of Chinese PLA Baoding ChinaDepartment of Orthopaedic Surgery China–Japan Friendship Hospital, Peking Union Medical College, Chinese Academy of Medical College Beijing ChinaObjective To examine the results of raloxifene for prevention of periprosthetic bone loss around the femoral stem in patients undergoing total hip arthroplasty (THA). Methods Between January 2015 and May 2017, 240 female patients between 55 and 80 years underwent primary THA and were randomly allocated to receive 60 mg raloxifene hydrochloride per day (treatment group, TG, n = 120) or placebo (control group, CG, n = 120) orally at bedtime using computer‐generated randomization sequence generation. Baseline data, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), women's quality of life (QoL) score, bone mineral density (BMD) around the prosthesis, and adverse events were compared between the two groups. The measuring range of BMD around the prosthesis was divided into seven regions of interest (ROI). The sample size was calculated to detect a mean difference in BMD of 0.15 g/cm2 with a standard deviation (SD) of 0.3. The error was set at 0.05 and the power level at 90% with additional compensation for a possible dropout rate of 20%. Results A total of 240 participants in the study up to 24 months after THA. There were no significant differences in the mean BMD of all the zones between groups before surgery (all P > 0.05). However, there were significant differences in the BMD of Gruen zones 4 and 7 between groups at 6 months postoperatively (both P < 0.05); there were significant differences in Gruen zones 1, 4, 6, and 7 at 12 months postoperatively (all P < 0.01); there were significant differences in Gruen zones 1, 2, 4, 6, and 7 at 24 months postoperatively (all P < 0.001). Patients taking raloxifene reported higher QoL scores, with better improvement in BMD in all areas except in zones 3 and 5 compared with the control group. There were no significant differences in WOMAC pain (P = 0.4045), WOMAC function (P = 0.4456) and women's QoL scores (P = 0.5983) between groups before surgery. However, WOMAC pain, WOMAC function and women's QoL score in the treatment group were significantly better at all time points (all P < 0.05). Patients in the treatment group showed no increased adverse events, including cardiac events, stroke, venous thromboembolism, and gynecological cancer (all P > 0.05), but did show decreased odds of breast cancer in comparison with those using a placebo (P = 0.0437). Conclusion Raloxifene can help inhibit bone loss around the prosthesis and improve the QoL of postmenopausal women after THA with no increased adverse events, and can even decrease the odds of breast cancer.https://doi.org/10.1111/os.12696Bone lossPostmenopausal osteoporosisRaloxifeneTotal hip arthroplasty (THA) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Long Gong Yao‐yao Zhang Na Yang Huan‐juan Qian Ling‐kun Zhang Ming‐sheng Tan |
spellingShingle |
Long Gong Yao‐yao Zhang Na Yang Huan‐juan Qian Ling‐kun Zhang Ming‐sheng Tan Raloxifene Prevents Early Periprosthetic Bone Loss for Postmenopausal Women after Uncemented Total Hip Arthroplasty: A Randomized Placebo‐Controlled Clinical Trial Orthopaedic Surgery Bone loss Postmenopausal osteoporosis Raloxifene Total hip arthroplasty (THA) |
author_facet |
Long Gong Yao‐yao Zhang Na Yang Huan‐juan Qian Ling‐kun Zhang Ming‐sheng Tan |
author_sort |
Long Gong |
title |
Raloxifene Prevents Early Periprosthetic Bone Loss for Postmenopausal Women after Uncemented Total Hip Arthroplasty: A Randomized Placebo‐Controlled Clinical Trial |
title_short |
Raloxifene Prevents Early Periprosthetic Bone Loss for Postmenopausal Women after Uncemented Total Hip Arthroplasty: A Randomized Placebo‐Controlled Clinical Trial |
title_full |
Raloxifene Prevents Early Periprosthetic Bone Loss for Postmenopausal Women after Uncemented Total Hip Arthroplasty: A Randomized Placebo‐Controlled Clinical Trial |
title_fullStr |
Raloxifene Prevents Early Periprosthetic Bone Loss for Postmenopausal Women after Uncemented Total Hip Arthroplasty: A Randomized Placebo‐Controlled Clinical Trial |
title_full_unstemmed |
Raloxifene Prevents Early Periprosthetic Bone Loss for Postmenopausal Women after Uncemented Total Hip Arthroplasty: A Randomized Placebo‐Controlled Clinical Trial |
title_sort |
raloxifene prevents early periprosthetic bone loss for postmenopausal women after uncemented total hip arthroplasty: a randomized placebo‐controlled clinical trial |
publisher |
Wiley |
series |
Orthopaedic Surgery |
issn |
1757-7853 1757-7861 |
publishDate |
2020-08-01 |
description |
Objective To examine the results of raloxifene for prevention of periprosthetic bone loss around the femoral stem in patients undergoing total hip arthroplasty (THA). Methods Between January 2015 and May 2017, 240 female patients between 55 and 80 years underwent primary THA and were randomly allocated to receive 60 mg raloxifene hydrochloride per day (treatment group, TG, n = 120) or placebo (control group, CG, n = 120) orally at bedtime using computer‐generated randomization sequence generation. Baseline data, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), women's quality of life (QoL) score, bone mineral density (BMD) around the prosthesis, and adverse events were compared between the two groups. The measuring range of BMD around the prosthesis was divided into seven regions of interest (ROI). The sample size was calculated to detect a mean difference in BMD of 0.15 g/cm2 with a standard deviation (SD) of 0.3. The error was set at 0.05 and the power level at 90% with additional compensation for a possible dropout rate of 20%. Results A total of 240 participants in the study up to 24 months after THA. There were no significant differences in the mean BMD of all the zones between groups before surgery (all P > 0.05). However, there were significant differences in the BMD of Gruen zones 4 and 7 between groups at 6 months postoperatively (both P < 0.05); there were significant differences in Gruen zones 1, 4, 6, and 7 at 12 months postoperatively (all P < 0.01); there were significant differences in Gruen zones 1, 2, 4, 6, and 7 at 24 months postoperatively (all P < 0.001). Patients taking raloxifene reported higher QoL scores, with better improvement in BMD in all areas except in zones 3 and 5 compared with the control group. There were no significant differences in WOMAC pain (P = 0.4045), WOMAC function (P = 0.4456) and women's QoL scores (P = 0.5983) between groups before surgery. However, WOMAC pain, WOMAC function and women's QoL score in the treatment group were significantly better at all time points (all P < 0.05). Patients in the treatment group showed no increased adverse events, including cardiac events, stroke, venous thromboembolism, and gynecological cancer (all P > 0.05), but did show decreased odds of breast cancer in comparison with those using a placebo (P = 0.0437). Conclusion Raloxifene can help inhibit bone loss around the prosthesis and improve the QoL of postmenopausal women after THA with no increased adverse events, and can even decrease the odds of breast cancer. |
topic |
Bone loss Postmenopausal osteoporosis Raloxifene Total hip arthroplasty (THA) |
url |
https://doi.org/10.1111/os.12696 |
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