Jasty M, Schutzer S, Tepper J, Willett C, Stracher M A, Harris W H
Department of Orthopaedic Surgery, Massachusetts General Hospital 02114.
Clin Orthop Relat Res. 1990 Aug(257):138-45.
Sixteen patients (18 hips) were treated with localized radiation therapy limited to periarticular regions surrounding the femoral neck by shielding the prosthesis and the adjacent regions to prevent heterotopic bone formation around the uncemented prosthesis. All hips received 1500 rads. Eight of these hips were irradiated after excising severe heterotopic bone, five because they developed extensive heterotopic ossification in the opposite hip, and five others because they were considered to be at high risk for developing heterotopic ossification. Only two of the 18 hips developed a small amount of heterotopic bone after localized periarticular radiation. All wounds healed primarily. No progressive radiolucencies developed at the bone-prosthesis interface. There was only one trochanteric nonunion of six trochanteric osteotomies. Localized periarticular radiation therapy with precision shielding of the prosthetic components and adjacent skeletal structures is an effective means to prevent heterotopic bone formation around cementless total hip arthroplasties. It also has the advantage of not adversely affecting the healing of the trochanteric osteotomy.
16名患者（18髋）接受了局部放射治疗，通过对假体及相邻区域进行屏蔽，将放射局限于股骨颈周围的关节周围区域，以防止非骨水泥型假体周围异位骨形成。所有髋关节均接受1500拉德的照射。其中8髋在切除严重异位骨后接受照射，5髋因对侧髋关节出现广泛异位骨化而接受照射，另外5髋因被认为发生异位骨化的风险较高而接受照射。18髋中仅有2髋在局部关节周围放射治疗后出现少量异位骨。所有伤口均一期愈合。骨-假体界面未出现进行性透亮区。6例转子截骨术中仅1例发生转子不愈合。对假体部件和相邻骨骼结构进行精确屏蔽的局部关节周围放射治疗是预防非骨水泥型全髋关节置换术后异位骨形成的有效方法。它还具有不负面影响转子截骨愈合的优点。
