Akesson K, Onsten I, Obrant K J
Department of Orthopedics, Malmö General Hospital, Sweden.
Acta Orthop Scand. 1994 Apr;65(2):135-8. doi: 10.3109/17453679408995420.
Histomorphologic differences of the periarticular bone in rheumatoid arthritis (RA) and osteoarthrosis (OA) may be of importance for long-term prosthetic fixation. We have evaluated bone specimens, obtained during total hip replacement from an acetabular and a femoral biopsy site, in 42 RA-hips and 61 OA-hips. In both groups the bone turnover was increased in the acetabulum compared to that in the femur. In the acetabulums the total trabecular bone volume was equal, but osteoid volume, osteoid surface, resorptive surface, and the appositional rate were increased in RA. On the femoral side, only the osteoid volume was higher in RA. The increased bone turnover with a greater amount of unmineralized tissue, as well as resorptive activity in the acetabulum, may be of importance for the higher rate of acetabular component migration and loosening after total hip replacement in RA.
类风湿关节炎(RA)和骨关节炎(OA)关节周围骨的组织形态学差异可能对长期假体固定具有重要意义。我们评估了42例RA髋关节和61例OA髋关节全髋关节置换术中取自髋臼和股骨活检部位的骨标本。两组中,髋臼的骨转换均高于股骨。在髋臼中,总骨小梁体积相等,但RA组的类骨质体积、类骨质表面、吸收表面和沉积率增加。在股骨侧,仅RA组的类骨质体积较高。RA患者髋臼中骨转换增加,未矿化组织量增多以及存在吸收活性,这可能是RA患者全髋关节置换术后髋臼假体组件移位和松动率较高的重要原因。