Moon Kyoung Ho, Kang Jun Soon, Lee Tong Joo, Lee Sang Hyeop, Choi Sung Wook, Won Man Hee
Department of Orthopaedics, Inha University Hospital, Incheon, Korea.
Yonsei Med J. 2008 Oct 31;49(5):719-24. doi: 10.3349/ymj.2008.49.5.719.
This study examined the rate of degeneration of acetabular cartilage by the bipolar head according to time, and also which clinical factors are related to the degeneration of acetabular cartilage.
Among 192 patients (226 hip joints) who received bipolar hemiarthroplasty from August 1996 to August 2002, 61 patients (65 hip joints) were enrolled in this study, who were followed up for more than 2 years and showed no signs of dislocation, infection, or functional problems. A modified form of a computer assisted vector wear analysis program was used to measure the rate of degeneration of the acetabular cartilage. The factors that appeared to affect the rate of acetabular degeneration in the two groups was evaluated.
The average linear degenerative change in the acetabular cartilage and the volumetric degenerative change were 0.23 +/- 0.107mm/year and 114 +/- 47.2mm3/year, respectively. The result showed significant differences in activity and HHS between the 2 groups. The HHS showed a reverse relationship with the linear degeneration and volumetric degeneration, and the activity showed a correlation with the linear and volumetric degeneration.
The acetabular cartilage degenerates faster as the patient' activity increases, and slower with a higher HHS. When surgeons perform hip joint arthroplasty, it is strongly recommended that the life expectancy and the level of activity should be considered when deciding between a hemiarthroplasty and total hip arthroplasty.
本研究根据时间检测双极股骨头导致髋臼软骨的退变率,以及哪些临床因素与髋臼软骨退变相关。
在1996年8月至2002年8月接受双极半髋关节置换术的192例患者(226个髋关节)中,选取61例患者(65个髋关节)纳入本研究,这些患者随访超过2年,且未出现脱位、感染或功能问题。使用一种改良形式的计算机辅助矢量磨损分析程序来测量髋臼软骨的退变率。评估两组中似乎影响髋臼退变率的因素。
髋臼软骨的平均线性退变变化和体积退变变化分别为0.23±0.107mm/年和114±47.2mm³/年。结果显示两组在活动度和髋关节 Harris 评分(HHS)方面存在显著差异。HHS与线性退变和体积退变呈负相关,活动度与线性退变和体积退变呈正相关。
随着患者活动度增加,髋臼软骨退变更快,而HHS越高退变越慢。当外科医生进行髋关节置换术时,强烈建议在决定行半髋关节置换术还是全髋关节置换术时应考虑患者的预期寿命和活动水平。