Effect of zoledronic acid combined with simvastatin on postoperative recovery of elderly patients with osteoporotic intertrochanteric fractures.

PURPOSE: To evaluate the effects of zoledronic acid combined with simvastatin on postoperative functional recovery in elderly patients with osteoporotic intertrochanteric femoral fractures.

METHODS

This retrospective study included 150 elderly patients with osteoporotic intertrochanteric femoral fractures who underwent proximal femoral nail antirotation (PFNA) fixation between May 2022 and May 2024. According to postoperative pharmacological regimens, patients were assigned to a conventional group (n = 79), receiving zoledronic acid alone, or a combination group (n = 71), receiving zoledronic acid plus oral simvastatin.Harris Hip Score (HHS), visual analogue scale(VAS)for pain, and serum bone metabolism markers, includingβ-C-terminal telopeptide of type I collagen (β-CTX), procollagen type I N-terminal propeptide (PINP), 25-hydroxyvitamin D[25(OH)D], and osteocalcin, were assessed preoperatively and at 3 and 6 months after surgery. The occurrence of internal fixation failure and refracture was also recorded. Statistical analyses were performed using R software.

RESULTS

HHS scores increased progressively at postoperative assessment time points in both groups, whereas VAS scores showed a gradual decline. At 3 and 6 months after surgery, the combination group exhibited higher HHS scores than the conventional group (P < 0.05). 3 months after surgery, the VAS score in the combined group was lower than that in the conventional group (P < 0.05). With respect to bone metabolism, postoperative levels ofβ-CTX, PINP, and osteocalcin decreased over time in both groups, while 25 (OH) D levels increased.Differences in several bone metabolism indicators were observed between groups at postoperative time points. The proportions of internal fixation failure and refracture were lower in the combination group; however, the between-group differences were not statistically significant (P > 0.05).

CONCLUSION

In elderly patients with osteoporotic intertrochanteric femoral fractures treated with PFNA, postoperative administration of zoledronic acid combined with simvastatin was associated with better hip function, favorable changes in bone metabolism and greater short-term improvement in postoperative pain compared with zoledronic acid alonebone metabolism.