Scott D F, Jaffe W L
Department of Orthopaedics, Hospital For Joint Diseases Orthopaedic Institute, New York, NY 10003, USA.
J Arthroplasty. 1996 Jun;11(4):429-37. doi: 10.1016/s0883-5403(96)80033-7.
Uncemented porous-coated cobalt-chrome femoral stems have produced satisfactory short-term clinical results, although slightly inferior to the results of cemented total hip arthroplasty. Proximal femoral bone resorption, osteolysis and fibrous ingrowth have been reported with porous-coated stems. Hydroxyapatite-coated stems and titanium stems have been introduced to avoid these findings through improved fixation. Dual-energy x-ray absorptiometry allows quantitative examination of bone density changes after uncemented total hip arthroplasty. This study examines the host-bone response to hydroxyapatite-coated titanium and porous-coated cobalt-chrome stems of identical geometry in three paired bilateral cases at 5 to 7 years. Distinctly different patterns of femoral bone mineral density changes were observed with the two stem designs. The authors conclude that dual-energy x-ray absorptiometry is a promising technique allowing noninvasive analysis of uncemented stem fixation, and that the data from this study suggest improved fixation and stress transfer with hydroxyapatite-coated titanium stems.
非骨水泥型多孔涂层钴铬合金股骨柄假体已取得了令人满意的短期临床效果，尽管略逊于骨水泥型全髋关节置换术的效果。有报道称，使用多孔涂层柄假体后出现了股骨近端骨吸收、骨溶解和纤维长入的情况。为避免出现这些问题，人们引入了羟基磷灰石涂层柄假体和钛柄假体，以期通过改善固定效果来解决。双能X线吸收法可对非骨水泥型全髋关节置换术后的骨密度变化进行定量检测。本研究在5至7年的时间里，对3例双侧配对病例中，相同几何形状的羟基磷灰石涂层钛柄假体和多孔涂层钴铬合金柄假体的宿主骨反应进行了研究。观察到两种柄假体设计的股骨骨矿物质密度变化模式明显不同。作者得出结论，双能X线吸收法是一种很有前景的技术，可对非骨水泥型柄假体的固定情况进行无创分析，并且本研究的数据表明，羟基磷灰石涂层钛柄假体的固定效果和应力传递得到了改善。
