Kilgus D J, Shimaoka E E, Tipton J S, Eberle R W
Division of Orthopaedic Surgery, UCLA School of Medicine 90024.
J Bone Joint Surg Br. 1993 Mar;75(2):279-87. doi: 10.1302/0301-620X.75B2.8444950.
The measurement of bone mineral density in defined areas around metal implants has improved with the development of dual-energy X-ray absorptiometry. We used this technique to compare the bone mineral density adjacent to metal cementless femoral implants with that of identical regions of bone in normal proximal femora. We studied the anteroposterior views only of 72 femora which contained total hip implants and 34 non-operated femora. We compared the regional bone mineral density of bone adjacent to proximally porous-coated and distally porous-coated implants of one design, to measure the relative differences in the remodelling changes induced by different amounts of porous coating. We also measured differences in bone density with time and with variations in implant size (and therefore stiffness). The greatest decrease in bone mineral density (34.8%) occurred in the most proximal 1 cm of the medial femoral cortex around relatively stiff, extensively porous-coated implants. The next most severe decrease (20% to 25%) was in the next most proximal 6 cm of the medial femoral cortex. Small, progressive decreases in bone mineral density continued for five to seven years after implantation.
随着双能X线吸收法的发展，金属植入物周围特定区域骨密度的测量得到了改善。我们使用该技术比较了非骨水泥型股骨金属植入物附近的骨密度与正常股骨近端相同区域的骨密度。我们仅研究了72例包含全髋关节植入物的股骨前后位片以及34例未手术的股骨。我们比较了一种设计的近端多孔涂层和远端多孔涂层植入物附近区域的骨密度，以测量不同量多孔涂层引起的重塑变化的相对差异。我们还测量了骨密度随时间以及植入物尺寸（进而刚度）变化的差异。在相对较硬、广泛多孔涂层的植入物周围，股骨内侧皮质最近端1厘米处的骨密度下降最为明显（34.8%）。其次最严重的下降（20%至25%）出现在股骨内侧皮质近端接下来的6厘米处。植入后五到七年，骨密度持续出现小幅度的逐渐下降。
