Gerhardt Davey M J M, Smolders José M H, Rijnders Ton A J M, Hol Annemiek, van Susante Job L C
Department of Orthopedics, Rijnstate Hospital, Arnhem, The Netherlands.
J Arthroplasty. 2015 Feb;30(2):308-14. doi: 10.1016/j.arth.2014.09.007. Epub 2014 Sep 16.
We studied whether bone mineral density (BMD) is preserved without significant femoral neck narrowing (FNN) after hip resurfacing (RHA) (n=42) versus small diameter metal-on-metal total hip arthroplasty (MoM THA) (n=40). In this three to five year randomized trial BMD was measured in the calcar with dual energy absorptiometry (DXA) preoperatively, at three and six months, one, two, three and five years postoperatively. Four additional BMD regions of interest (ROIs) and femoral neck narrowing (FNN) were measured after RHA. BMD in the calcar increased to 107% (P<0.001) at one year and remained stable. Additional ROIs in the femoral neck and trochanter-area BMD changes fluctuated between 99.9% and 104.1%. FNN was minimal with a mean of 1.3% at three years. After THA BMD decreased in the calcar to 80% at one year (P<0.001) and stabilized. This bone stock preserving nature of RHA must be weighed against potential disadvantages caused by specific metal-on-metal bearing problems.
我们研究了髋关节表面置换术（RHA，n = 42）与小直径金属对金属全髋关节置换术（MoM THA，n = 40）后，骨密度（BMD）是否得以保留且无明显股骨颈缩窄（FNN）。在这项三到五年的随机试验中，术前、术后三个月、六个月、一年、两年、三年和五年时，使用双能吸收法（DXA）测量转子区的骨密度。RHA术后还测量了另外四个骨密度感兴趣区域（ROI）以及股骨颈缩窄（FNN）。转子区的骨密度在术后一年增加至107%（P < 0.001）并保持稳定。股骨颈和转子区的其他ROI骨密度变化在99.9%至104.1%之间波动。三年时FNN最小，平均为1.3%。全髋关节置换术后，转子区的骨密度在术后一年降至80%（P < 0.001）并稳定下来。RHA这种保留骨量的特性必须与特定金属对金属轴承问题导致的潜在缺点相权衡。
