Objective To analyse the curative effect and security of zoledronic acid on total hip arthroplasty with os -teoporosis .Methods A total of 148 osteoporotic patients with THA were enrolled from 2009 to 2010 .Patients were as-signed into the treatment group (n=95, meanage=68.8 years) receiving Caltrate D and Calcitriol plus zoledronic acid for 36 month and the control group (n=97, meanage=68.1 years) receiving Caltrate D and Calcitriol only .Bone min-eral density ( BMD) was measured by dual-X-ray absorptiometry ( DXA) at lumbar spine and the healthy hip before pre-intervention and after 36 months intervention respectively .The rate of prosthesis loosening and prosthesis adjacent fracture were observed and compared .Results The BMD was improved in treatment group compared with pre-intervention , which was significantly better than control group ( P<0.05 ) .The prosthesis loosening and prosthesis adjacent fracture in treat-ment group was obviously less than control group .The adverse reactions were significantly higher in the treatment group than the control group ( P<0.05 ) .Conclusion Zoledronic acid could significantly improve BMD , reduce the prosthe-sis loosening and prosthesis adjacent fracture .%目的：研究老年女性骨质疏松症合并髋关节病患者行全髋关节置换术后急性期内应用唑来膦酸的疗效及安全性。方法选择2009年1月至2010年1月因髋部骨折或股骨头无菌性坏死住院接受全髋关节（非骨水泥型假体）置换术的老年女性患者，根据骨密度（ BMD）检测结果选取骨质疏松症患者148例，随机分为治疗组和对照组，2组患者手术后均接受钙剂和骨化三醇治疗，治疗组于术后1～2周给予唑来膦酸5 mg静脉滴注，以后每年给药1次，连续3年，对照组在治疗组用药同期给予相同体积0.9％氯化钠注射液。每年复查并记录腰椎及健侧髋部骨密度变化，观察术后3年内假体周围骨折及假体无菌性松动的发生情况。结果治疗组连续治疗3年后骨密度较用药前提高，差异有统计学意义（ P＜0.05）；对照组用药前后骨密度差异有统计学意义（ P＜0.05）；术后3年内治疗组发生假体周围骨折及假体无菌性松动的例数均低于对照组。2组用药后不良反应发生率差异有统计学意义（ P＜0.05）。结论骨质疏松患者行关节置换术后急性期内使用唑来膦酸安全有效，可提高骨密度，且可能减少假体周围骨折和假体松动的发生。
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