Schai P, Brunner R, Morscher E, Schubert K H
Department of Orthopaedic Surgery, University of Basel, Switzerland.
Arch Orthop Trauma Surg. 1995;114(3):153-8. doi: 10.1007/BF00443389.
Radiotherapy has proven to be efficient in the prevention of heterotopic bone formation. Its importance is increasing in the treatment of uncemented implants in prosthetic hip surgery, where a localized irradiation field is applied to cover the bone-implant interface. In a prospective study the efficiency of two radiation concepts using two different doses to prevent heterotopic ossifications after total hip arthroplasties or revision arthroplasties was compared. In 7 patients after fractioned irradiation (5 x 2 Gy), two recurrences of periarticular ossification occurred, whilst in 17 patients after a single-shot irradiation of 6 Gy on the first postoperative day, no recurrences were seen. There were no side-effects from the radiation. Radiological signs of lucent cement-free implants or delayed wound-healing were absent. Thus, a single shot of 6 Gy applied within 24 h postoperatively reliably prevents heterotopic bone formation. It is safer than 5 x 2 Gy and facilitates the management of the patient.
放射治疗已被证明在预防异位骨形成方面是有效的。在人工髋关节置换术中非骨水泥型植入物的治疗中，其重要性日益增加，此时会应用局部照射野来覆盖骨-植入物界面。在一项前瞻性研究中，比较了两种使用不同剂量的放射方案预防全髋关节置换术或翻修置换术后异位骨化的效果。在7例接受分次照射（5×2 Gy）的患者中，发生了2例关节周围骨化复发，而在17例术后第一天接受单次6 Gy照射的患者中，未见复发。放射治疗没有副作用。没有出现无骨水泥植入物透亮或伤口愈合延迟的放射学征象。因此，术后24小时内单次给予6 Gy能可靠地预防异位骨形成。它比5×2 Gy更安全，且便于患者管理。
