髋关节置换术后假体周围骨密度的变化及对疗效影响的相关研究

Hip arthroplasty periprosthetic bone mineral density changes and the impact of research for clinical effect

目的:观察髋关节置换术(THA)后骨密度(BMD)动态变化情况,分析其与临床疗效的相关性。方法:2005年1月～2008年12月入本院行THA手术治疗的患者共53例,采用Lunar双能X线骨密度仪分别在术后1、3、6、12个月和术后2年时测定BMD。同时采用Harris评分评定THA的手术疗效。结果:术后假体周围BMD均有明显下降的趋势。BMD在远端ROI3、ROI4、ROI5区明显高于近端ROI1和ROI7区;内侧ROI5、ROI6、ROI7区明显高于外侧ROI1、ROI2、ROI3区,并且非骨水泥固定者BMD水平高于骨水泥固定的BMD水平。术后Harris评分和不同区域的BMD值均称正相关,而以股骨上段外侧ROI1区域的相关系数最高。THA术后疗效优、良、可、差者各自BMD不同,疗效越低,BMD越低。结论:全髋关节置换术后会出现假体周围骨吸收、骨密度下降。骨丢失是导致假体松动的重要原因,与术后疗效密切相关。

Objective：To observe hip arthroplasty （THA） after the bone mineral density （BMD） changes the dynamic,analysis and clinical relevance.Methods： 53 patients from January 2005 to December 2008 THA surgery in our hospital were treated with Lunar dual energy X ray absorptiometry,respectively after 1,3,6,12 months and after 2 year measured BMD. THA also adopted Harris score assessed the effect of surgical.Results：The postoperative periprosthetic BMD were significantly decreased.BMD at the distal ROI 3,ROI 4,ROI 5 areas than in proximal ROI 1 and ROI 7 areas;medial ROI 5,ROI 6,ROI 7 was significantly higher than areas outside of ROI 1,ROI 2,ROI 3 District.And the BMD non-bone cement were higher than those of bone cement fixed level of BMD.Harris score and postoperative BMD values in different regions were known positively correlated to the lateral femur ROI 1 region of highest correlation.The curative effect of THA excellent, good,fair,and poor were different from their BMD,the lower efficacy,BMD lower.Conclusion：Total hip arthroplasty appears periprosthetic bone resorption,decreased bone density.Periprosthetic bone loss leading to important reasons,and also closely relate to the curative effect.