Kjaersgaard-Andersen P, Pedersen P, Kristensen S S, Schmidt S A, Pedersen N W
Department of Orthopaedic Surgery, Kolding Hospital, Denmark.
Clin Orthop Relat Res. 1988 Sep(234):102-9.
Serum alkaline phosphatase (SAP) was analyzed in 193 patients treated with total hip arthroplasty (THA) and correlated with the degree of heterotopic bone formation (HBF) one year after surgery. The influence of indomethacin on changes in SAP related to the development of heterotopic bone was studied. Ninety-eight patients received 25 mg of indomethacin three times daily for the first six postoperative weeks; the remaining 95 patients received a placebo treatment. No further anti-inflammatory drugs were allowed during the six weeks. SAP was measured preoperatively and six weeks and 12 weeks after surgery. No patients at risk for developing heterotopic bone after THA could be identified from the preoperative level of SAP. The level of SAP six weeks after THA gradually increased with the amount of HBF. A rise in SAP above 250 IU/liter 12 weeks after surgery was associated with the development of severe heterotopic bone in 13 of 17 patients. Indomethacin inhibited the development of heterotopic bone associated with a rise in SAP following THA. Future studies on HBF and SAP following THA should include information on patient use of anti-inflammatory drugs in the early postoperative period.
对193例行全髋关节置换术（THA）的患者进行血清碱性磷酸酶（SAP）分析，并将其与术后一年的异位骨形成（HBF）程度相关联。研究了吲哚美辛对与异位骨发育相关的SAP变化的影响。98例患者在术后前六周每天三次服用25 mg吲哚美辛；其余95例患者接受安慰剂治疗。六周内不允许使用其他抗炎药物。在术前、术后六周和十二周测量SAP。从术前SAP水平无法识别出THA术后有发生异位骨风险的患者。THA术后六周SAP水平随HBF量逐渐升高。术后12周SAP升高至250 IU/升以上与17例患者中的13例严重异位骨形成有关。吲哚美辛抑制了THA后与SAP升高相关的异位骨形成。未来关于THA后HBF和SAP的研究应包括患者术后早期使用抗炎药物的信息。
