Dorr L D, Arnala I, Faugere M C, Malluche H H
Kerlan-Jobe Orthopaedic Clinic, Inglewood, California.
Clin Orthop Relat Res. 1990 Oct(259):114-21.
To determine whether bone cellular abnormality affects the results of cemented femoral arthroplasty, 21 patients had biopsies of the iliac crest and femoral cortex at the time of surgery. Roentgenographic and histomorphometric studies were used to characterize fibrous membrane formation, cancellous bone, calcar resorption, and bone turnover. Patients with high bone turnover and decreased femoral thickness and density before surgery were at risk of developing calcar resorption and cancellous diaphyses, conditions that weaken proximal stem support and lead to early failure. These findings suggest that noncemented stems may be indicated in this group. Another group, osteoporotic patients, suffered from osteoblastic insufficiency, which may be the indication for the use of cemented stems rather than noncemented stems, which require bony ingrowth.
为确定骨细胞异常是否会影响骨水泥型股骨置换术的结果，21例患者在手术时进行了髂嵴和股骨皮质活检。采用X线和组织形态计量学研究来描述纤维膜形成、松质骨、股骨距吸收和骨转换的特征。术前骨转换率高且股骨厚度和密度降低的患者有发生股骨距吸收和骨干松质化的风险，这些情况会削弱近端柄的支撑并导致早期失败。这些发现表明该组患者可能适合使用非骨水泥型柄。另一组患者，即骨质疏松患者，存在成骨细胞功能不全，这可能是使用骨水泥型柄而非需要骨长入的非骨水泥型柄的指征。
