Digas Georgios, Kärrholm Johan, Thanner Jonas
Department of Orthopaedics, Institute of Surgical Science, Sahlgrenska University Hospital, Göteborg University, Sweden.
Clin Orthop Relat Res. 2006 Jul;448:58-66. doi: 10.1097/01.blo.0000224014.35045.7b.
Improved fixation to bone is vital for improving the long term success of cemented implants. Addition of fluoride to acrylic bone cement may be one way to improve the quality of the bone cement interface and thereby reduce the risk of loosening. Ninety patients (97 hips) with a median age of 70 years (range, 31-81 years) scheduled for total hip arthroplasty were randomized to receive a stem fixed with fluoride-containing acrylic bone cement or conventional acrylic bone cement. Fixation and bone remodeling around the femoral component was studied with radiostereometry and dual-energy xray absorptiometry up to 5 years after the operation in 73 patients (77 hips). Radiostereometric evaluation at 5 years revealed no differences in stem migration (subsidence/lift-off) or rotations. The stem subsidence inside the mantle was similar in the two groups. At 5 years the study group had lost more bone mineral in Gruen regions 5 and 7 than the controls. The Harris hip and pain score did not differ. Use of fluoride containing bone cement did not improve the stem fixation compared with a conventional cement used up to 5 years, but resulted in more pronounced loss of bone mineral density in the medial cortex.
Therapeutic Level I. See Guidelines for Authors for a complete description of levels of evidence.
改善与骨的固定对于提高骨水泥型植入物的长期成功率至关重要。向丙烯酸骨水泥中添加氟化物可能是改善骨水泥界面质量从而降低松动风险的一种方法。将90例（97髋）计划行全髋关节置换术的患者随机分组，这些患者中位年龄为70岁（范围31 - 81岁），分别接受用含氟丙烯酸骨水泥或传统丙烯酸骨水泥固定的假体柄。对73例患者（77髋）术后长达5年采用放射立体测量法和双能X线吸收法研究股骨假体周围的固定和骨重塑情况。5年时的放射立体测量评估显示假体柄的移位（下沉/翘起）或旋转无差异。两组假体柄在骨水泥壳内的下沉情况相似。5年时，研究组在Gruen 5区和7区的骨矿物质流失比对照组更多。Harris髋关节评分和疼痛评分无差异。与使用传统骨水泥长达5年相比，使用含氟骨水泥并未改善假体柄的固定，但导致内侧皮质骨矿物质密度更明显的流失。
治疗性I级。有关证据水平的完整描述，请参见作者指南。
