使用两种不同股骨柄涂层的髋关节置换术中磨损与骨溶解的比较。
Comparison of wear and osteolysis in hip replacement using two different coatings of the femoral stem.
作者信息
Sanchez-Sotelo Joaquin, Lewallen David G, Harmsen William Scott, Harrington Jeffrey, Cabanela Miguel E
机构信息
Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
出版信息
Int Orthop. 2004 Aug;28(4):206-10. doi: 10.1007/s00264-004-0558-x. Epub 2004 Apr 29.
We compared the clinical and radiographic results of two matched series of total hip arthroplasties, one with hydroxyapatite-coated femoral stems, the other with a similar but porous-coated femoral stem. The prevalence of radiographic osteolysis was 16% in hips with hydroxyapatite-coated stems and 43% in hips with porous-coated femoral stems. In hips with hydroxyapatite-coated stems, osteolysis was always limited to Gruen zones 1 and 7. In contrast, distal osteolysis was present around 26% of the porous-coated stems. At 7 years, the survival-free rate of distal osteolysis was 100% in hips with hydroxyapatite-coated stems but 90% in hips with porous-coated stems (p=0.04). Circumferential hydroxyapatite coating of the femoral component reduced the occurrence of osteolysis and eliminated distal osteolysis at 5-10 years of follow-up. In addition, hydroxyapatite coating did not alter the wear rate.
我们比较了两组匹配的全髋关节置换术的临床和影像学结果，一组使用羟基磷灰石涂层股骨柄，另一组使用类似但为多孔涂层的股骨柄。在使用羟基磷灰石涂层柄的髋关节中，影像学骨溶解的发生率为16%，而在使用多孔涂层股骨柄的髋关节中为43%。在使用羟基磷灰石涂层柄的髋关节中，骨溶解总是局限于Gruen 1区和7区。相比之下，约26%的多孔涂层柄周围存在远端骨溶解。7年后，使用羟基磷灰石涂层柄的髋关节远端骨溶解的无生存率为100%，而使用多孔涂层柄的髋关节为90%（p=0.04）。股骨部件的环形羟基磷灰石涂层减少了骨溶解的发生，并在随访5至10年时消除了远端骨溶解。此外，羟基磷灰石涂层并未改变磨损率。
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