Efficacy and Safety of Single Dose Therapy of Zoledronic Acid for the Treatment of Transient Osteoporosis of Hip

25 Aug, 21

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Introduction

Transient osteoporosis of the hip (TOH), also known as transient bone marrow edema (BME) syndrome is characterized by painful limp and osteopenia of the affected joint. Treatment with bisphosphonates have shown the promising result in shortening the clinical course of the disease.

Aim

To evaluate the clinic radiological outcome of management of TOH with zoledronic acid administration

Patient Profile

N=19 (17 Males, 2 Females)
Patients with TOH
Mean age was 42.1 years
15 had acute onset of symptoms and rest had insidious onset of symptoms

Methods

Reterospective analysis

Any adverse effects of the oral alendronate administration were also evaluated.

Results

The mean time of onset of symptom was 4 weeks.
At 12-week
- MRI analysis revealed complete resolution of baseline edema of the hip joint in 16 out of 19 patients (84.21%) (Figure 1)
- None of the patients had either limp or pain during hip joint movement
- VAS pain scores reduced consistently with each follow-up visit as compared to baseline and was statistically significant (p<0.0001)
Patients treated with single injection of intravenous zoledronic acid were pain-free and had no limp within an average of 2.8 weeks and remained asymptomatic at a mean follow-up of 35 months

Figure 1: Radiological and clinical assessment

No major adverse events were reported
None of the patients progressed to avascular necrosis at their last follow-up

Conclusion

Treatment with Intravenous single dose of zoledronic acid reveals shortening of the natural course of the disease, reflected in terms of pain relief as early as 2 weeks and normalization of MRI changes at 3 months
Intravenous single dose administration of zoledronic acid was associated with early pain relief and complete reversal of TOH
Zoledronic acid is proposed as a new paradigm in the management of TOH

References

Ann Rehabil Med 2019;43;3:314-320

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