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股骨头假体置换术后假体周围骨量变化的观察

Quantitative Evaluation of Periprosthetic Bone-Remodeling After Hip Arthroplasty

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【作者】 林剑浩吕厚山寇伯龙袁燕林冯传汉

【Author】 /Lin Jianhao;LuHoushan;Kou Bolong;et al.(Arthritis Clinic and Re-search Center,People’s Hospital Beijing Medical Uni-versity,Beijing,100044)

【机构】 北京医科大学人民医院关节病诊疗研究中心

【摘要】 临床放射学研究发现,股骨头假体置换术后股骨周围常有骨质吸收现象。从1991年8月~1992年12月,采用双能X线骨密度测定及常规X线检查对照方法,对12例股骨头置换患者术前、后假体周围骨量进行连续测定。短期随访资料表明所有患者术后近端股骨骨量均有不同程度的丢失,其中尤以大转子最为严重,其次是股骨距,我们认为:(1)应力遮挡是造成术后假体周围骨质疏松的一个重要因素。(2)双能X线骨密度仪测定可作为人工股骨头或全髋置换术后股骨假体松动的早期辅助诊断工具。

【Abstract】 AbstractTotal hip arthroplasty is a useful procedure forpatients with severe hip diseases.Clinical radiographsshow resorptive remodeling changes around thefemoral prosthesis,which is mainly attributed tostress shielding. This can bring about many clinicalptoblems suchas osteoporosis , prosthetic looseningand difficulties for revision surgery, etc. It is very im-portant to define the natural history of bone lossaround a femoral prosthesis early for the clinical treat-ment,prognosis and prosthetic design. The bone re-modeling changes around 12 femoral prostheses offemoral neck fracture patients with femoral head re-placement were evaluated with Dual-energy X-ray ab-sorptiometry ( DEXA ) systems versus radiography.The contralateral hip served as the control. Analysisof the data revealed that :(1)Generally it was ob-served that decrease in the bone mineral density( BMD)values was relatively more in the proximalsites whereas the tip of the implant showed a slightlyincrease in the BMD value. This pattern is reflectiveof the stress shielding effect of the implant;(2)Thebone loss rate is related to the activity of patients, andit is the highest during the first 3 to 12 months afteroperation;(3)DEXA is superior to regular radiogra-phy with lower radiation dose,greater precision, earli-er diagnosis of loosening and more convenient datahandling.

【关键词】 骨量人工股骨头应力遮挡
  • 【文献出处】 中华骨科杂志 ,CHINESE JOURNAL OF ORTHOPAEDICS , 编辑部邮箱 ,1995年08期
  • 【分类号】R687.3
  • 【被引频次】35
  • 【下载频次】163
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