Iwana Daiki, Nishii Takashi, Miki Hidenobu, Sugano Nobuhiko, Sakai Takashi, Ohzono Kenji, Yoshikawa Hideki
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Kyowakai Hospital, Osaka, Japan.
Int Orthop. 2008 Aug;32(4):431-6. doi: 10.1007/s00264-007-0357-2. Epub 2007 Apr 27.
In revision surgery with proximal femoral bone loss, progressive bone atrophy due to stress shielding remains a concern. We compared 2-year radiological results between two types of cementless long titanium stems with different configurations and surface coatings. Of 17 hips implanted with a wholly hydroxyapatite-coated stem, 12 (71%) exhibited stress shielding of the second degree or higher according to Engh's criteria, and the mean relative bone mass index decreased from 22.1% pre-operatively to 14.6% at 2 years post-operatively. In 23 hips implanted with a sand-blasted, conically shaped stem, no hip showed stress shielding of the second degree or higher. The mean relative bone mass index increased from 21.6% to 31.4%. These results indicate that the configuration and surface coating of the stem have a significant influence on proximal bone remodelling after revision surgery.
在伴有股骨近端骨质流失的翻修手术中，应力遮挡导致的渐进性骨质萎缩仍是一个令人担忧的问题。我们比较了两种不同构型和表面涂层的非骨水泥长钛柄在2年时的放射学结果。在17例植入全羟基磷灰石涂层柄的髋关节中，根据恩格标准，12例（71%）表现出二级或更高程度的应力遮挡，平均相对骨量指数从术前的22.1%降至术后2年的14.6%。在23例植入喷砂锥形柄的髋关节中，没有髋关节表现出二级或更高程度的应力遮挡。平均相对骨量指数从21.6%增加到31.4%。这些结果表明，柄的构型和表面涂层对翻修手术后近端骨重塑有显著影响。
