Roth A, Richartz G, Sander K, Sachse A, Fuhrmann R, Wagner A, Venbrocks R-A
Orthopädische Klinik am Waldkrankenhaus "Rudolf-Elle" gGmbH, Lehrstuhl für Orthopädie, Friedrich-Schiller-Universität Jena, Eisenberg.
Orthopade. 2005 Apr;34(4):334-44. doi: 10.1007/s00132-005-0773-1.
The changes of the periprosthetic bone density were examined with DEXA in 81 patients over a period of 1 year after implantation of cementless total hip endoprosthesis. Four types of endoprostheses (Vision 2000/Duraloc, ALPHA-Fit/ALPHA-Lock Plus, CLS/Allofit, Mayo/Trilogy) were implanted. Information on the changes of the periprosthetic bone density depending on the type of the prosthesis and the bony situation at the femur before operation was expected from these measurements. In all types of stems the strongest reduction of the bone density was found in the region of the calcar femoris, and the smallest changes were found distally and medially of the tip of the prostheses. In the prosthesis with shorter stem the change of the bone density was altogether clearly lower than in prostheses with longer stem. With increasing size of the prosthesis with proximally porous coating made from cobalt-chrome alloy, proximal atrophy was observed more frequently, whilst in the prosthesis made from titanium alloy with completely rough-blasted surface the distal hypertrophy increased. A low preoperative corticalis-bone marrow index strengthened the proximal atrophy in proximally porously coated prosthesis made from cobalt-chrome alloy and led in the prosthesis with completely rough-blasted surface more often to distal hypertrophy of the bone.
在81例患者植入非骨水泥型全髋关节假体后1年期间，采用双能X线吸收法（DEXA）检查假体周围骨密度的变化。植入了四种类型的假体（Vision 2000/Duraloc、ALPHA-Fit/ALPHA-Lock Plus、CLS/Allofit、Mayo/Trilogy）。期望通过这些测量获得关于假体周围骨密度变化与假体类型以及术前股骨骨质情况之间关系的信息。在所有类型的柄部中，股骨距区域的骨密度降低最为明显，而在假体尖端的远侧和内侧骨密度变化最小。柄部较短的假体其骨密度变化总体上明显低于柄部较长的假体。随着近端采用钴铬合金多孔涂层的假体尺寸增大，近端萎缩更为常见，而在表面完全经过粗喷砂处理的钛合金假体中，远端肥大增加。术前皮质骨-骨髓指数较低会加重近端采用钴铬合金多孔涂层假体的近端萎缩，并更常导致表面完全经过粗喷砂处理的假体出现骨远端肥大。
