Moroni A, Hoang-Kim A, Lio V, Giannini S
Rizzoli Orthopaedic Institute, University of Bologna, Bologna, Italy.
Scand J Surg. 2006;95(2):103-9. doi: 10.1177/145749690609500205.
Osteoporosis is defined as the deterioration of microarchitecture and overall poor bone quality, which represents a risk of implant fixation failure when patients with osteoporosis are surgically treated. Fragility fractures in elderly patients, typically at the hip, spine and wrist, should be assessed by the orthopaedic surgeon prior to surgery in order to select the most appropriate technique necessary to overcome failures and other complications associated with reduced osteofixation. In this review, advanced methods of augmenting implant fixation in osteoporotic bone are described including polymethylmethacrylate (PMMA), bone grafts, calcium phosphate implants, calcium phosphate cements, calcium phosphate coatings, modified implants and pharmaceutical augmentation concepts. The indication for these techniques should be based on the quantitative assessment of the osteoporotic quality of bone evaluated by dual energy X-ray absorptiometry (DXA).
骨质疏松症被定义为微结构的恶化和整体较差的骨质量，这意味着骨质疏松症患者接受手术治疗时存在植入物固定失败的风险。老年患者的脆性骨折，通常发生在髋部、脊柱和腕部，骨科医生在手术前应进行评估，以便选择最适当的技术，以克服与骨固定减少相关的失败和其他并发症。在本综述中，描述了增强骨质疏松性骨植入物固定的先进方法，包括聚甲基丙烯酸甲酯（PMMA）、骨移植、磷酸钙植入物、磷酸钙骨水泥、磷酸钙涂层、改良植入物和药物增强概念。这些技术的适应症应基于通过双能X线吸收法（DXA）评估的骨质疏松性骨质量的定量评估。
