Abstract

Background: Senile osteoporosis is seen in people of age more than 70 years. Senescent bone formation and senile osteoporosis are caused by the differentiation of bone marrow cells into adipocytes, which occurs more frequently than osteoblasts. To identify osteoporosis, a Dual Energy X-ray Absorptiometry (DEXA) scan is employed. T-score and Z-score are used to describe the outcomes. Osteoporosis is defined as a T-score of -2.5 or lower. The bisphosphonate zoledronic acid has demonstrated efficacy in the management of hypercalcemia in multiple myeloma and prostate cancer patients. In the current study, we assess the efficacy of an annual injection of zoledronic acid in treatment of senile osteoporotic patients.

Methodology: The current prospective study was carried out on patients with senile osteoporosis from April 2021 to September 2022 at the Department of Orthopedics, Sri Aurobindo Medical College & Postgraduate Institute, Indore (M.P.). 50 patients with senile osteoporosis 65 years of age and older were enrolled in the study. These individuals were all T-score -2.5 on DEXA scans. After being hydrated with 500ml of intravenous saline solution, these patients received an injection of Zoledronic acid (5mg in 10ml ready to infuse solution). Patients were monitored and assessed for a full year. At each follow-up, the T-score and Z-score were recorded. To determine if the T and Z-scores have improved, the paired "t" test was used. Statistical significance was set at a P value of less than 0.05.

Result: 50 senile osteoporotic patients were included. 52% of them were women and 48% were men. The mean age of the patients was 70.12 ± 5.99 years, ranging from the youngest at 61 to the oldest at 83. In our investigation, we observed diabetes mellitus (36%), hypertension (32%), and asthma (2%). All of the patients had osteoporosis before to receiving the injection, and after 12 months, all of the patients exhibited T-scores indicative of osteopenia. Over the course of a year, there was a noticeable improvement in both the T and Z-scores.

Conclusion: The bone density of patients with senile osteoporosis greatly improved by the once-yearly injection of zoledronic acid. Given that the medication was administered only once a year, patient compliance was likewise very high. For senile osteoporotic patients, we advise using zoledronic acid.

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