[髋关节表面置换术后股骨近端骨密度的变化]

[Changes of the bone mineral density of proximal femur after hip resurfacing arthroplasty].

作者信息

Lian Yong-yun, Yoo Myung-chul, Pei Fu-xing, Cheng Jing-qiu, Feng Wei, Cho Yoon-je, Kim Gung-il, Chun Sung-wook

机构信息

Department of Orthopedic Surgery, Kyung Hee University Hospital, Seoul 130702, Korea.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Aug 15;45(16):1091-4.

PMID:18005605

Abstract

OBJECTIVE

To evaluate the changes of periprosthetic bone mineral density in femur after hip resurfacing arthroplasty.

METHODS

From July 2002 to June 2005, a comparative study was carried out on 52 hips in 52 patients. Twenty-six patients (26 hips) who underwent Birmingham hip resurfacing arthroplasty (group BHR), and 26 patients (26 hips) who performed cementless total hip arthroplasty with Versys System stem (group THA). The periprosthetic bone mineral density of the femur was measured through dual energy X-ray absorptiometry of the Gruen zones at pre-operation, post-operation 3, 6, 12 and 24 months in patients from both group BHR and group THA. The bone mineral density of femoral neck in group BHR was measured too. Changes of bone mineral density ratio in proximal femur between pre-operation and post-operation were compared and analyzed.

RESULTS

The mean ratio of bone mineral density of the proximal femur in group BHR reduced by 5.8%, 4.9%, 2.6% and 0.4%, in group THA reduced by 7.0%, 10.6%, 1.0% and 4.1% at 3, 6, 12 and 24 months respectively. In group BHR, the mean ratio of bone mineral density in range of interest 1 decreased to 89.7% at 6 months and increased to 103.8% at 24 months, in range of interest 7 decreased to 95.1% at 6 months and increased to 103.7% at 24 months. In group THA, the mean ratio of bone mineral density in range of interest 1 decreased to 90.8% at 6 months, 94.4% at 24 months and in range of interest 7 decreased to 94.2% at 3 months, 96.7% at 24 months. In group BHR, the bone mineral density of femoral neck was restored to the pre-operation level at 6 months. The bone mineral density in superior-lateral zone of femoral neck decreased to 97.1% at 3 months and increased to 107.4% at 24 months respectively. The bone mineral density in inferior-medial zone of femoral neck increased to 117.9% at 24 months.

CONCLUSION

The bone stock of proximal femur can be well preserved and recovered quickly after hip resurfacing arthroplasty.

摘要

目的

评估髋关节表面置换术后股骨假体周围骨密度的变化。

方法

2002年7月至2005年6月，对52例患者的52髋进行了一项对比研究。26例患者（26髋）接受了伯明翰髋关节表面置换术（BHR组），26例患者（26髋）采用Versys系统柄进行非骨水泥型全髋关节置换术（THA组）。通过双能X线吸收法测量BHR组和THA组患者术前、术后3个月、6个月、12个月和24个月时Gruen分区的股骨假体周围骨密度。同时测量BHR组股骨颈的骨密度。比较并分析术前与术后股骨近端骨密度比值的变化。

结果

BHR组股骨近端骨密度平均比值在术后3个月、6个月、12个月和24个月分别降低了5.8%、4.9%、2.6%和0.4%，THA组分别降低了7.0%、10.6%、1.0%和4.1%。在BHR组，感兴趣区域1的骨密度平均比值在6个月时降至89.7%，在24个月时升至103.8%；感兴趣区域7的骨密度平均比值在6个月时降至95.1%，在24个月时升至103.7%。在THA组，感兴趣区域1的骨密度平均比值在6个月时降至90.8%，在24个月时为94.4%；感兴趣区域7的骨密度平均比值在3个月时降至94.2%，在24个月时为96.7%。在BHR组，股骨颈骨密度在6个月时恢复到术前水平。股骨颈上外侧区骨密度在3个月时降至97.1%，在24个月时升至107.4%。股骨颈下内侧区骨密度在24个月时升至117.9%。