Hughes S S, Furia J P, Smith P, Pellegrini V D
Department of Orthopaedics, University of Rochester, New York.
J Bone Joint Surg Am. 1995 Feb;77(2):231-9. doi: 10.2106/00004623-199502000-00009.
The purpose of this study was to compare the density of periprosthetic bone about titanium and cobalt-chromium stems that had been inserted without cement. The analysis was done, three to four years after a total hip arthroplasty, in a retrospectively matched cohort of thirty patients. Fifteen patients had a stem that was collarless, proximally coated, and made of titanium; the other fifteen had a stem of similar design that was made of cobalt-chromium. The criteria for selection in the study included an excellent clinical and radiographic result and separately calculated modified Harris and Mayo hip scores of more than 94 points. All stems had radiographic evidence of osseous ingrowth. A comparison of the bone-mineral density about the two different types of stem with dual-energy x-ray absorptiometry revealed a significant difference only along the calcar of the femur. There was no significant difference about the remaining, preponderant portion of the proximal part of the femur. Our data suggest that the difference in the modulus of elasticity between the two types of stem had little effect on the loss of bone-mineral density in most of the proximal part of the femur after arthroplasty without cement.
本研究的目的是比较无骨水泥植入的钛合金和钴铬合金股骨柄周围假体周围骨的密度。在全髋关节置换术后三到四年，对30例患者的回顾性匹配队列进行了分析。15例患者使用的股骨柄无领、近端涂层且由钛合金制成；另外15例患者使用的股骨柄设计相似，由钴铬合金制成。研究的入选标准包括临床和影像学结果优秀，以及分别计算的改良Harris和Mayo髋关节评分超过94分。所有股骨柄均有骨长入的影像学证据。用双能X线吸收法比较两种不同类型股骨柄周围的骨密度，结果显示仅在股骨距处有显著差异。在股骨近端其余占优势的部分没有显著差异。我们的数据表明，在无骨水泥置换术后，两种类型股骨柄之间的弹性模量差异对股骨近端大部分区域的骨密度丢失影响很小。
