Oettmeier R, Babisch J
Orthopaedic Clinic, Friedrich Schiller University of Jena, FRG.
Pathol Res Pract. 1992 Jun;188(4-5):620-4. doi: 10.1016/S0344-0338(11)80068-3.
Using bone histomorphometry, in this study the osteologic status of 107 patients with coxarthrosis and femoral neck fracture [FNF] was assessed and compared with bone parameters from patients revised for aseptic loosening. Bone biopsies of the acetabulum and the proximal femur from patients with primary coxarthrosis [pCoxA] (69), dysplastic coxarthrosis [CDH] (19), rheumatoid arthritis [RA] (9), femoral head necrosis [FHN] (8), femoral neck fracture [FNF] (4) and aseptic loosening (12) were taken during hip alloarthroplastic surgery, prepared undecalcified and analysed using histomorphometry (according to MERZ). In pCoxA the following average figures of bone parameters of the acetabular biopsy were determined: trabecular bone volume (TBV) 39.6%, osteoid volume (OV) 3.9%, active osteoblastic surface (AOS) 6.5%, osteoclastic resorption surface (ORS) 2.4%, osteoid surface (OS) 17.4% and resorption surface (RS) 7.0%. As average figures of the femoral biopsy in pCoxA were assessed: TBV = 17.2%, OV = 1.3%, AOS = 0.9%, ORS = 0.4%, OS = 6.5% and RS = 2.5%. These data were compared with bone parameters of secondary coxarthrosis, osteoporosis (FNF) and aseptic loosening. Based on the study of Oettmeier et al. on femoral heads (Skel Radiol 18: 165-174, 1989), the investigated groups were subdivided into three osteologic types of the hip. The osteopenic type was found in 10% of pCoxA, 43% of RA and 28% of CDH. The hyperostotic type, predominantly occurring in males, was mostly demarcated in FHN (38%) and pCoxA (12%). The results demonstrate the individual osteologic status of patients before hip alloarthroplasty. This could influence planning of the operation and the bone-implant interface as well as long-term prognosis of artificial joints.
在本研究中，使用骨组织形态计量学评估了107例髋关节病和股骨颈骨折（FNF）患者的骨学状况，并与因无菌性松动而接受翻修手术患者的骨参数进行了比较。在髋关节置换手术期间，从原发性髋关节病（pCoxA，69例）、发育性髋关节病（CDH，19例）、类风湿性关节炎（RA，9例）、股骨头坏死（FHN，8例）、股骨颈骨折（FNF，4例）和无菌性松动（12例）患者的髋臼和股骨近端获取骨活检样本，进行不脱钙处理并使用组织形态计量学（根据MERZ法）进行分析。在pCoxA患者中，髋臼活检的骨参数平均数据如下：小梁骨体积（TBV）39.6%，类骨质体积（OV）3.9%，活跃成骨细胞表面（AOS）6.5%，破骨细胞吸收表面（ORS）2.4%，类骨质表面（OS）17.4%，吸收表面（RS）7.0%。pCoxA患者股骨活检的平均数据评估如下：TBV = 17.2%，OV = 1.3%，AOS = 0.9%，ORS = 0.4%，OS = 6.5%，RS = 2.5%。将这些数据与继发性髋关节病、骨质疏松症（FNF）和无菌性松动的骨参数进行了比较。基于Oettmeier等人对股骨头的研究（《骨骼放射学》18: 165 - 174, 1989），将研究组细分为三种髋关节骨学类型。骨质减少型在10%的pCoxA患者、43%的RA患者和28%的CDH患者中发现。骨质增生型主要发生在男性，在FHN患者（38%）和pCoxA患者（12%）中最为明显。结果显示了髋关节置换术前患者的个体骨学状况。这可能会影响手术规划、骨 - 植入物界面以及人工关节的长期预后。
