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We conducted a single\u2010center, randomized, double\u2010blinded, placebo\u2010controlled trial of 65 postmenopausal women with primary hip osteoarthritis and Dorr type A or B proximal femur anatomy. The patients randomly received subcutaneous injections of denosumab 60\u2009mg or placebo once every 6 months for 12 months, starting 1 month before surgery. The primary endpoint was the change in bone mineral density (BMD) of the proximal femur (Gruen zone 7) at week 48, and the secondary endpoint was stem subsidence measured by radiostereometric analysis (RSA) at week 48. Exploratory endpoints included changes in BMDs of the contralateral hip, lumbar spine and distal radius, serum levels of bone turnover markers, walking speed, walking activity, patient\u2010reported outcome measures, and radiographic assessment of stem osseointegration. The participants underwent vertebral\u2010fracture assessment in an extension safety study at 3 years. Denosumab significantly decreased bone loss in the medial femoral neck (zone 7) and increased periprosthetic BMD in the greater trochanteric region (zone 1) and lesser trochanteric region (zone 6). Denosumab did not reduce temporary femoral stem migration. The migration occurred mainly during the settling period (0 to 12 weeks) after implantation of the prosthesis. All of the stems osseointegrated, as evaluated by RSA and radiographs. There were no intergroup differences in functional recovery. Discontinuation of denosumab did not lead to any adverse events. In conclusion, 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. \u00a9 2019 The Authors. <jats:italic>JBMR Plus<\/jats:italic> published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.<\/jats:p>","DOI":"10.1002\/jbm4.10217","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T19:03:53Z","timestamp":1562871833000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Effect of Denosumab on Femoral Periprosthetic BMD and Early Femoral Stem Subsidence in Postmenopausal Women Undergoing Cementless Total Hip Arthroplasty"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3118-9144","authenticated-orcid":false,"given":"Hannu T","family":"Aro","sequence":"first","affiliation":[{"name":"Departments of Orthopaedic Surgery and Traumatology Turku University Hospital and University of Turku Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9183-1667","authenticated-orcid":false,"given":"Sanaz","family":"Nazari\u2010Farsani","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and Traumatology Turku University Hospital and University of Turku Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0522-1588","authenticated-orcid":false,"given":"Mia","family":"Vuopio","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and Traumatology Turku University Hospital and University of Turku Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7278-6511","authenticated-orcid":false,"given":"Eliisa","family":"L\u00f6yttyniemi","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Department of Clinical Medicine University of Turku Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2969-4299","authenticated-orcid":false,"given":"Kimmo","family":"Mattila","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging Turku University Hospital Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,14]]},"reference":[{"key":"e_1_2_7_1_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01617"},{"key":"e_1_2_7_1_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00774"},{"key":"e_1_2_7_1_4_1","unstructured":"Australian Orthopaedic Association NJRR. 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