摘要
[目的]比较全髋关节置换术后早期新型生物活性骨水泥即含锶羟基磷灰石骨水泥（Sr—HA）与传统的聚甲基丙烯酸甲酯骨水泥（PMMA）对假体固定的效果。[方法]从2008年5月～2009年12月在香港玛丽医院行全髋关节置换术的9例（10膝）患者随机分为观察组和对照组，分别使用Sr—HA骨水泥与PMMA骨水泥固定股骨柄，于术后1周、3个月、6个月及12个月随访使用放射立体照相测量分析技术（RSA）测量股骨柄相对于股骨的位移，记录Harris髋关节评分，并于实验室使用显微CT扫描测量两种骨水泥的孔隙率进行比较。[结果]所有患者手术经过顺利，无血管神经损伤、肺栓塞等并发症。RSA结果显示Sr—HA组有3例假体的下沉均超过1mm，而PMMA组假体的下沉全部在1mm以内。两组患者的Harris髋关节评分在术后均有明显改善。显微CT扫描结果显示Sr—HA骨水泥的孔隙率高于PMMA骨水泥，两者之间差异有统计学意义（P〈0．01）。[结论]两组患者术后均无明显临床症状，含锶羟基磷灰石骨水泥相对较高的孔隙率可能是导致全髋关节置换术后早期假体位移的原因。
[ Objective] To compare cemented prosthesis stability fixed between bioactive bone cement, the strontium containing hydroxyapatite （Sr- HA） and conventional polymethyl methacrylate （PMMA） bone cement at the early stage after total hip replacement （THR） surgery. [ Methods] Nine patients with ten knees received THR in Hong Kong Queen Mary Hospital during May 2008 to December 2009. They were randomly divided into experimental and control groups （5 knees in each group）, receiving cemented THR with Sr - HA and PMMA bone cement respectively. Prosthesis migration was measured with radiostereo- metric analysis （RSA） technique at 1 week, 3 months, 6 months and 12 months after surgery. Meanwhile, Harris hip score （HHS） was also taken. Additionally, cement porosity was scanned and analyzed with Micro -CT for both cements. [ Results ] None of nerve, vesse 1 injury or pulmonary embolism was observed. The migration of 3 prostheses in Sr - HA group exceeded 1 mm, while all prosthesis in in PMMA group migrated within 1 mm. The HHS improved significantly in all patients. Micro - CT scan revealed that cement porosity in Sr - HA group was significantly higher than in PMMA group （p 〈 0. 01 ） . [ Conclusion] Significant complication was not observed in all patients. The relative higher prosthesis migration of Sr - HA group at early stage after THR surgery was probably due to higher porosity of Sr - HA cement.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2011年第13期1077-1081,共5页
Orthopedic Journal of China
基金
香港创新科技署资助(GHP/009/06)
