摘要
目的探讨生物固定C2型股骨柄人工全髋关节对股骨近端假体周围骨丢失方面的影响。方法31例C2型股骨柄全髋关节置换术(THA)后患者得到完整随访,包括X线片、Harris评分以及双能X线骨密度仪(DEXA)测量股骨近端假体周围骨密度,采用Gruen七区法,非手术侧作为对照。结果31例患者HHS评分优秀22例,良好8例,一般1例。X线显示所有柄都是稳定的,X线上未见明显假体周围骨密度改变。DEXA测量结果表明手术侧骨密度较非手术侧均出现下降,范围在2.42%～27.4%,平均6.67%,其中Gruen4区和7区的骨密度下降有统计学意义(t值分别是-5.52和-7.08,P<0.01)。结论C2型股骨柄术后2年临床疗效较好,DEXA在评估THA的术后假体周围骨密度方面比普通平片更敏感,THA术后股骨近端假体周围的骨丢失是存在的,尤其在股骨距区下降明显。假体周围骨丢失与假体设计存在关系。
Objective In order to understand the relationship between bone absorption and the design of metal implants, we evaluated the influence of biological fixation C2 femoral stem on stress-shiel- ding in proximal femur. Methods BMD of 31 cases in the regions of proximal femur adjacent to metal cementless femoral implants 2 years after the cementless THA using C2 femoral stem were determined and compared by means of DEXA. These cases also were examined by radiography and HHS. Results According HHS, excellent outcomes were in 22 patients, good in 8 patients and fair in one patient. All stems were judged stable by X-ray 2 years after THA. Radiographically, no significant bone mineral density changes were note in perioprosthetic regions. There was a mean reduction by 6. 67% （ range of 2.42% -27.4% ） in the value of the BMD for the ROIs （ Gruen zones） on the operated compared with the non-operated side. The BMD decrease in Gruen 4 and 7 was significant in statistics by t test （ t was - 5.52 and - 7.08 respectively, P 〈 0. 01 ）. Conclusions Stems of all cases were stable and no bone absorption was observed by X-ray 2 years after THA, but the bone loss was observed by DEXA, especially in femoral calcar, so X-ray is not as sensitive as DEXA to evaluate the bone loss after THA. No significant stress shielding was observed in all cases, and it maybe relate with the design of C2 femoral stem.
出处
《中华关节外科杂志（电子版）》
CAS
2008年第5期23-25,共3页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
关节成形术
置换
髋
骨密度
Arthroplasty, replacement, hip
Bone density
