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Table 1 The studies included

From: Denosumab might prevent periprosthetic bone loss after total hip and knee arthroplasties: a review

Serial no.

Author

Denosumab

Control

Comments

n

Age (y)

Methods

n

Age (y)

Methods

1

Nagoya et al. [18]

10

78.4 ± 4.3

0.5 μg vitamin D3 daily and 60 mg denosumab every 6 months (1 to 2 weeks and 6 months postoperatively)

10

80.8 ± 2.2

0.75 μg active vitamin D3 daily by oral administration

Denosumab had a definitive effect on the restoration of proximal periprosthetic bone loss, especially in zone 7, after cementless THA. Denosumab contributed to the restoration of decreased periprosthetic BMD to normal levels.

2

Aro et al. [19]

33

69.1 ± 5.2

A 60 mg denosumab every 6 months; the first subcutaneous dose of denosumab 1 month before surgery and the second injection at 6 months, the efficacy lasted for 1 year.

32

69.1 ± 5.9

Vitamin D and calcium supplementation was started during the screening visit at a minimum of 2 weeks before administration. The first subcutaneous dose of placebo was given 1 month before surgery and the second injection at 6 months for an effective treatment period of 1 year.

Denosumab increased periprosthetic BMD in the clinically relevant regions of the proximal femur, but the treatment response was not associated with any reduction of initial stem migration.

3

MUrahashi et al. [20]

13

76.9 ± 7.3

0.5 μg vitamin D3 daily and 60 mg denosumab every 6 months (the day after surgery, 6 months and 12 months postoperatively)

15

75.3 ± 8.7

0.5 μg active vitamin D3 daily by oral administration

Denosumab treatment significantly reduced periprosthetic BMD loss, even at the early stages after TKA. This therapeutic strategy might facilitate early stable fixation of the prosthesis, which, in turn, might help to prevent early implant migration and reduce the need for revision surgery.

4

Håkan et al. [21]

25

66 ± 6.3

1 mL (60 mg) denosumab was given on the first postoperative day after knee replacement surgery and again after 6 months.

25

64 ± 5.5

1 mL saline was given on the first postoperative day after knee replacement surgery and again after 6 months.

Denosumab reduced early migration in total knee replacement and might be beneficial for long-term results.

5

Andreas et al. [22]

32

58 ± 5

The first subcutaneous injection containing 1 mL (60 mg) of denosumab was given after baseline periprosthetic BMD assessment with dual-energy X-ray absorptiometry scans had been performed and fasting morning blood samples drawn 1 to 3 day(s) postoperatively. The second and final injections were administered 6 months postoperatively.

32

59 ± 5

The first subcutaneous injection containing 1 mL of saline was given after baseline periprosthetic BMD assessment with dual-energy X-ray absorptiometry scans had been performed and fasting morning blood samples drawn 1 to 3 day(s) postoperatively. The second and final injections were administered 6 months postoperatively.

Denosumab potently prevented early periprosthetic bone loss after uncemented THA.