人工髋关节翻修病人假体周围骨密度的变化

Changes of bone mineral density of the proximal femur in patients with revision total hip arthroplasty

[目的]使用双能X线骨密度仪（DEXA）测量9例人工髋关节翻修病人股骨近端假体周围骨密度,了解人工髋关节翻修病人假体周围骨丢失情况。[方法]因假体松动而接受初次人工全髋关节翻修手术病人9例,用双能X线骨密度仪（DEXA）对比测量双侧股骨近端骨密度,测量区域的划分采用Gruen七区法。术前临床评估以Harris髋关节评分（HHS）为标准。[结果]9例病人HHS评分61分,DEXA测量结果发现所有病人手术侧骨密度较非手术侧均出现明显下降,范围在8.9%～27.6%,平均15.4%,下降有统计学意义（P〈0.05）。[结论]人工髋关节置换术后早中期失败的病人,股骨近端假体周围骨丢失明显。

[ Objective ] To understand the changes of periprosthetic bone mineral density （BMD） of the proximal femur in patients with failed hip arthroplasty by measuring with dual energy X - ray absorptiometry （DEXA） . [ Method ] Periprosthetic BMD was determined in 9 patients with revision total hip arthroplasty by dual energy X- ray absorptiometry （DEXA）, defining regions of interest according to Gruen （ 1 - 7）, and comparing the operation side with the nonoperation side. Clinic results of the cases were evaluated according to Harris Hip Score （HHS） . [ Result] The mean HHS was 61 points in 9 patients at this follow - up examination. There was a significant decrease （ 8.9% - 27. 6 % ） in BMD in every Gruen zone as compared with the nonoperation side. [ Conclusion] The bone loss in the proximal femur in patients with failed hip arthroplasty is significant, and the pattern of bone loss around failed hip arthroplasty may be different from the typical remodeling seen after successful hip arthroplasty.