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骨水泥型假体与生物型假体初次人工全髋关节置换术后周围骨量丢失的分析

Analysis of Bone Loss around Cemented and Biologic Prostheses after Hemiarthroplasty.

机构信息

The Department of Orthopedic Surgery, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215028 Jiangsu, China.

The Department of Orthopedic Surgery, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, 215000 Jiangsu, China.

出版信息

Dis Markers. 2022 Aug 5;2022:7366576. doi: 10.1155/2022/7366576. eCollection 2022.

Abstract

OBJECTIVE

To perform hemiarthroplasty (HA) on elderly patients with femoral neck fractures using cemented and biologic prostheses and then compare the bone loss around the two types of prostheses after surgery.

METHODS

A total of 60 patients aged over 75 years (with a mean age of 83.5 years) and suffering from femoral neck fracture (Garden types III and IV) from January 2018 to December 2020 were selected; they were randomly divided into group A ( = 30, cemented prostheses) and group B ( = 30, biologic prostheses) and received HA. At 1 month, 6 months, and 12 months after surgery, Harris Hip Scale (HHS) was adopted for patient evaluation, and patients' bone mineral density (BMD) of the 7 Gruen zones around the prostheses was measured by dual-energy X-ray absorptiometry (DEXA scan).

RESULTS

Both groups achieved satisfactory results postoperatively, and the Harris scores of the hips increased gradually over time, which were better in group A than in group B. Gruen zones in group A showed a slower trend of decreasing BMD than group B, and the differences were significant at zones 2, 3, and 4 ( < 0.05).

CONCLUSION

For elderly patients with femoral neck fractures, selecting cemented prosthesis for HA better recovers the hip function and has a low rate of bone loss around the prosthesis.

摘要

目的

对老年股骨颈骨折患者行人工股骨头置换术,分别采用骨水泥型假体和生物型假体,并比较两种假体术后周围骨量丢失情况。

方法

选取 2018 年 1 月至 2020 年 12 月收治的 60 例年龄>75 岁(平均年龄 83.5 岁)的股骨颈骨折(Garden 分型为Ⅲ、Ⅳ型)患者,随机分为 A 组(n=30,骨水泥型假体)和 B 组(n=30,生物型假体),行人工股骨头置换术。术后 1 个月、6 个月、12 个月,采用 Harris 髋关节评分评估患者髋关节功能,双能 X 线吸收仪(DEXA 扫描)测量假体周围 7 个 Gruen 区的骨密度(BMD)。

结果

两组术后均取得满意效果,髋关节 Harris 评分逐渐增高,A 组优于 B 组;A 组假体周围各区域 BMD 呈缓慢下降趋势,其中 2、3、4 区较 B 组下降明显,差异有统计学意义(<0.05)。

结论

对于老年股骨颈骨折患者,人工股骨头置换术采用骨水泥型假体髋关节功能恢复更好,假体周围骨量丢失率较低。

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