人工髋关节置换术后股骨段的骨反应（附80例X线片分析）

Bony changes at the femur side after hip Joint replace- ment:radiologic analysis of 80 hip joints

作者根据Ａｍｓｔｕｔｚ的分区方法对２年以上的８０个骨水泥固定人工髋关节置换病例进行Ｘ线观察研究，在所观察的８０个关节中有６４个关节发生不同程度的骨反应，发生率为８０％。其中骨硬化３２个关节，占４０％，骨萎缩２５个关节，占３１．４％，骨吸收２４个关节，占３０％，骨皮质增厚１８个关节，占２２．６％，骨髓腔扩大１２个关节，占１５％。骨膜反应８个关节，占１０％，骨皮质变薄１个关节，占１．３％。发生时间以术后６个月～２年为多。发生部位以１、４、５、７区为主。这些骨反应的出现除与假体的弹性、硬度、骨水泥、摩擦力等诸因素有关外，主要与生物力学应力分布不均有关。

Abstract The authors,according to Amstutz,studied theroentgenographs of 80 postoperation cases of cementedhip joint replacement performed more than two years ago There were bone changes in 64 cases(80%),ofthem,sclerosis of bone in 32 cases(40%),atrophy of bone in 25 cases(31%),absorption of bone in 24 cases(30%),thickness of bone cortex in 18 cases(22%),enlargement of medullary cavity in 12 cases(15%),periosteum reaction in 8 cases(10%),and thinness of bone cortex in 1 case (1.3%). Most of them usually occurred in the sixth month to the second year post-op-eration and located mainly at the 1、4、 5 and 7 regions. The authors think that the most important cause is the unbalance of biologic stress, and other factors are elas- ticity and hardness of prosthesis, frictional force,ce- mented of the stem, etc.