Pandit Salil, Graydon Andrew, Bradley Lyndon, Walker Cameron, Pitto Rocco
Department of Orthopaedic Surgery, Middlemore Hospital, South Auckland Clinical School, University of Auckland, Auckland, New Zealand.
ANZ J Surg. 2006 Sep;76(9):778-81. doi: 10.1111/j.1445-2197.2006.03866.x.
Periprosthetic bone remodelling is an important issue in total hip arthroplasty, which can compromise long-term outcomes. The aim of this study was to evaluate bone remodelling of the proximal femur with an uncemented hydroxyapatite-coated taper stem.
Twenty-three patients (27 hips) were included in this study. The mean age of the patients at the index operation was 57.2 years. There were 15 men and 8 women. Bone remodelling was assessed with quantitative computed tomography and the clinical outcome determined using the Harris Hip Scores. The mean preoperative Harris Hip Score was 38 points and at the 1-year follow up, it was rated 96 points. All hips were radiologically stable.
At the 1-year follow up, we found a greater bone-density loss of the cancellous bone (ranging from 16.7 to 28.2%) compared with the cortical bone (ranging from 5.3 to 7.8%). A strong correlation was found between the low density of the cortical bone at the index operation and a higher loss of bone density at the follow up.
The newly designed tapered stem showed good clinical and radiological outcomes with a proximal femoral bone loss that compares favourably with other studies.
假体周围骨重塑是全髋关节置换术中的一个重要问题,它可能会影响长期疗效。本研究的目的是评估使用非骨水泥型羟基磷灰石涂层锥形柄时股骨近端的骨重塑情况。
本研究纳入了23例患者(27髋)。初次手术时患者的平均年龄为57.2岁。其中男性15例,女性8例。采用定量计算机断层扫描评估骨重塑情况,并使用Harris髋关节评分来确定临床疗效。术前Harris髋关节评分的平均值为38分,在1年随访时,评分为96分。所有髋关节在影像学上均稳定。
在1年随访时,我们发现与皮质骨(骨密度损失范围为5.3%至7.8%)相比,松质骨的骨密度损失更大(范围为16.7%至28.2%)。初次手术时皮质骨密度低与随访时更高的骨密度损失之间存在很强的相关性。
新设计的锥形柄显示出良好的临床和影像学结果,股骨近端骨丢失情况与其他研究相比具有优势。