Herzwurm P J, Simpson S L, Duffin S, Oswald S G, Ebert F R
Department of Orthopaedic Surgery, The Eisenhower Army Medical Center, Augusta, GA, USA.
Clin Orthop Relat Res. 1997 Mar(336):156-61. doi: 10.1097/00003086-199703000-00022.
From January 1988 to May 1990, 60 patients underwent 68 total hip arthroplasties at the Eisenhower Army Medical Center. The authors excluded 11 patients (11 hips) in whom infection developed, who were lost to followup, or who had incomplete records, leaving 49 patients (57 hips) as the study population. The 35 uncemented and 22 cemented femoral stems were evaluated with technetium bone scans at 1 week, 6 months, 1 year, and 2.5 years after surgery. Patients with uncemented femoral stems had markedly more thigh pain and more radiopharmaceutical uptake around the stem tip at 2.5 years followup than did patients with cemented femoral stems. In addition, patients with thigh pain had more uptake around the stem tip and a higher incidence of bone hypertrophy around the stem tip than did those without thigh pain, suggesting stress transfer as a cause of thigh pain.
1988年1月至1990年5月,60例患者在艾森豪威尔陆军医疗中心接受了68次全髋关节置换术。作者排除了11例患者(11髋),这些患者出现了感染、失访或记录不完整,最终留下49例患者(57髋)作为研究对象。对35个非骨水泥型和22个骨水泥型股骨柄在术后1周、6个月、1年和2.5年时进行了锝骨扫描评估。在2.5年的随访中,非骨水泥型股骨柄的患者比骨水泥型股骨柄的患者出现明显更多的大腿疼痛,且股骨柄尖端周围有更多的放射性药物摄取。此外,有大腿疼痛的患者比没有大腿疼痛的患者在股骨柄尖端周围有更多的摄取以及更高的骨肥大发生率,提示应力转移是大腿疼痛的一个原因。