全髋关节置换术中髋臼的血流情况。
Acetabular blood flow during total hip arthroplasty.
作者信息
elMaraghy A W, Schemitsch E H, Waddell J P
机构信息
Musculoskeletal Research Laboratory, Department of Surgery, St. Michael's Hospital, Toronto, Ont.
出版信息
Can J Surg. 2000 Jun;43(3):197-201.
OBJECTIVE
To determine the immediate effect of reaming and insertion of the acetabular component with and without cement on peri-acetabular blood flow during primary total hip arthroplasty (THA).
DESIGN
A clinical experimental study.
SETTING
A tertiary referral and teaching hospital in Toronto.
PATIENTS
Sixteen patients (9 men, 7 women) ranging in age from 30 to 78 years and suffering from arthritis.
INTERVENTION
Elective primary THA with a cemented (8 patients) and non-cemented (8 patients) acetabular component. All procedures were done by a single surgeon who used a posterior approach.
MAIN OUTCOME MEASURE
Acetabular bone blood-flow measurements made with a laser Doppler flowmeter before reaming, after reaming and after insertion of the acetabular prosthesis.
RESULTS
Acetabular blood flow after prosthesis insertion was decreased by 52% in the non-cemented group (p < 0.001) and 59% in the cemented group (p < 0.001) compared with baseline (pre-reaming) values.
CONCLUSION
The significance of these changes in peri-acetabular bone blood flow during THA may relate to the extent of bony ingrowth, peri-prosthetic remodelling and ultimately the incidence of implant failure because of aseptic loosening.
目的
确定在初次全髋关节置换术（THA）中，使用或不使用骨水泥进行髋臼部件扩孔和植入对髋臼周围血流的即时影响。
设计
一项临床实验研究。
地点
多伦多的一家三级转诊和教学医院。
患者
16例患者（9例男性，7例女性），年龄在30至78岁之间，患有关节炎。
干预措施
对8例患者使用骨水泥型髋臼部件、8例患者使用非骨水泥型髋臼部件进行择期初次THA。所有手术均由一名外科医生采用后入路完成。
主要观察指标
在扩孔前、扩孔后以及髋臼假体植入后，使用激光多普勒血流仪测量髋臼骨血流。
结果
与基线（扩孔前）值相比，非骨水泥组假体植入后的髋臼血流减少了52%（p < 0.001），骨水泥组减少了59%（p < 0.001）。
结论
THA期间髋臼周围骨血流的这些变化的意义可能与骨长入程度、假体周围重塑以及最终因无菌性松动导致的植入物失败发生率有关。
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