Department of Surgery, North-Carelia Central Hospital, Joensuu, Finland.
Scand J Surg. 2012;101(3):211-5. doi: 10.1177/145749691210100312.
Resurfacing hip arthroplasty (RHA) has been suggested to provide an alternative to conventional total hip arthroplasty in younger, active patients. It seems to have an ability to conserve the bone mass on the femoral side. Some controversy exists regarding to the possible disadvantages of RHA and some of them are connected to poor femoral bone quality after surgery. Hence we wanted to study the bone mineral density changes 3 and 12 months after RHA.
A total of 26 patients (22 men and 4 women, 28 hips) underwent a hip resurfacing arthroplasty. The mean age of the patients was 55,2 (range 38-69) years. Bone mineral density (BMD) of the proximal femur was measured by using the dual-energy X-ray absorptiometry (DXA) postoperatively and within 3 and 12 months from surgery. For analysis, we divided the femoral neck area into four equal-sized regions of interest ranging from the prosthesis to the trochanter level.
At three months follow-up the BMD changes varied between -5.1% (ROI C) and + 1.9% (ROI A), as compared with the immediate postoperative values. After one year follow-up the BMD changes were + 1.1% in the ROI A, + 5.4% in the ROI B, -3.9% in the ROI C and + 1.3% in the ROI D. The changes in BMD were not statistically significant.
While there is still much debate and room for additional research in this topic, the results suggest that BMD is conserved in the femoral neck one year after hip resurfacing arthroplasty.
表面置换髋关节成形术(RHA)已被建议为年轻、活跃患者提供一种替代传统全髋关节成形术的方法。它似乎有能力保留股骨侧的骨量。关于 RHA 的可能缺点存在一些争议,其中一些与手术后股骨骨质量差有关。因此,我们想研究 RHA 后 3 个月和 12 个月的骨密度变化。
共有 26 名患者(22 名男性和 4 名女性,28 髋)接受了髋关节表面置换术。患者的平均年龄为 55.2 岁(范围 38-69 岁)。术后和手术 3 个月和 12 个月,使用双能 X 线吸收法(DXA)测量股骨近端骨密度(BMD)。为了分析,我们将股骨颈区域分为四个大小相等的感兴趣区域,从假体到转子水平。
在 3 个月的随访中,BMD 变化范围从 -5.1%(ROI C)到+1.9%(ROI A),与术后即刻值相比。随访 1 年后,ROI A 的 BMD 变化为+1.1%,ROI B 的 BMD 变化为+5.4%,ROI C 的 BMD 变化为-3.9%,ROI D 的 BMD 变化为+1.3%。BMD 的变化无统计学意义。
虽然在这个话题上仍有很多争论和进一步研究的空间,但结果表明,髋关节表面置换术后一年股骨颈的 BMD 得到了保留。