Kutsuna T, Kasahara T, Tsutsumi Y, Masukawa S
Department of Surgery, Saga Medical School, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1992 Oct;66(10):985-95.
We investigated radiological and functional changes of the femurs with cementless total hip arthroplasty. Our particular attention was paid to the relationship between the thigh pain and the rate, period of its incidence and the progression of radiological changes. The cases studied consisted of 57 female patients with severe coxarthrosis who were implanted with a SUS316-L macroanchoring type of THP (JIAT). Clinical evaluations, radiographic findings in the femoral side, and osteometric observations were carried out periodically in the period before surgery until five years after surgery. The JOA criterion at the time of the final examination was average 91 points. However, we observed a high degree of bone change in the femur on the radiogram. Of 63 hips, there was 71% cortical bone atrophy, a 43% reduction of cortex thickness, 25% cortical bone hypertrophy, 94% endosteal bone bridging in the stem tip, a 64% linear sclerosis of the neighboring stem, and a 37% enlargement of the medullary cavity. Bone atrophy was manifested soon after surgery, and there was 34% recovery. Further, there was no connection between thigh pain and bone changes. We, therefore, concluded that such bone changes as atrophy would not immediately bring about adverse consequences.
我们研究了非骨水泥型全髋关节置换术中股骨的放射学和功能变化。我们特别关注大腿疼痛与其发生率、发病时间以及放射学变化进展之间的关系。研究病例包括57例患有严重髋关节病的女性患者，她们接受了SUS316 - L型宏锚定THP（JIAT）植入手术。在手术前至手术后五年期间定期进行临床评估、股骨侧的影像学检查以及骨测量观察。最后一次检查时的JOA标准平均为91分。然而，我们在X线片上观察到股骨有高度的骨质变化。在63个髋关节中，有71%的皮质骨萎缩，皮质厚度减少43%，25%的皮质骨肥大，94%的骨内膜在柄尖处桥接，相邻柄部有64%的线性硬化，以及37%的髓腔扩大。骨质萎缩在手术后很快出现，有34%的恢复。此外，大腿疼痛与骨质变化之间没有关联。因此，我们得出结论，诸如萎缩等骨质变化不会立即带来不良后果。
