Department of Orthopedics, Sorlandet Hospital Kristiansand, Norway.
University of Oslo, Olso, Norway.
J Int Med Res. 2024 Sep;52(9):3000605241276491. doi: 10.1177/03000605241276491.
The relationship between the surgical approach used for hemiarthroplasty and periprosthetic bone mineral density (BMD) is not well understood. We have previously described a decrease in BMD 1 year postoperatively. Here, we assessed the medium-term changes in periprosthetic BMD.
We performed a follow-up study of patients with femoral neck fracture (FNF) who underwent uncemented hemiarthoplasty using a direct lateral or anterolateral approach. Dual-energy X-ray absorptiometry (DXA) was used to evaluate the changes in BMD in 23 patients over 5 years.
A mean 6% loss of total BMD occurred over 1 year, but between 1 and 5 years, BMD was restored to the baseline value. The mean total BMD in the anterolateral group had decreased by 2% after 3 months and 3% after 12 months, and increased by 2% after 5 years, . decreases of 7%, 8%, and 3% for the direct lateral group. Between 1 and 5 years, BMD increased in Gruen zones 2, 3, 4, 5, and 6 in both groups. There was a significantly larger increase in zone 4 in the lateral group (4%) than the anterolateral group.
The surgical approach affects periprosthetic BMD in patients with FNF. Furthermore, BMD is restored to the baseline value 5 years postoperatively. NCT03753100.
髋关节置换术中使用的手术入路与假体周围骨密度（BMD）之间的关系尚未完全明确。我们之前描述过术后 1 年 BMD 下降。在此，我们评估了假体周围 BMD 的中期变化。
我们对接受非骨水泥半髋关节置换术的股骨颈骨折（FNF）患者进行了随访研究，这些患者采用直接外侧或前外侧入路。双能 X 线吸收法（DXA）用于评估 23 例患者 5 年内 BMD 的变化。
1 年内总 BMD 平均丢失 6%，但在 1 至 5 年内，BMD 恢复到基线值。前外侧组的平均总 BMD 在 3 个月后下降了 2%，在 12 个月后下降了 3%，在 5 年后增加了 2%。直接外侧组分别下降了 7%、8%和 3%。在 1 至 5 年内，两组的Gruen 区 2、3、4、5 和 6 的 BMD 均增加。外侧组（4%）的区 4 增加明显大于前外侧组。
手术入路会影响 FNF 患者假体周围的 BMD。此外，术后 5 年 BMD 恢复到基线值。NCT03753100。
