全髋关节置换术后股骨皮质的肥厚反应

Femoral cortical hypertrophy after total hip arthroplasty

目的 观察全髋置换术后股骨皮质的肥厚反应及其临床意义。 方法 １９９３ 年１月～１９９５ 年８ 月，应用同一设计的骨水泥和非骨水泥股骨假体，共施行２４６ 髋全髋关节置换术。骨水泥组１１７ 髋，平均随访４ ．５ 年；非骨水泥组１２９ 髋，平均随访４ ．１ 年。 结果 骨水泥组无一例有股骨皮质肥厚，髋关节功能优良率８８．９％ ，无一例假体松动；非骨水泥组３６ 髋（２７ ．９％ ）出现股骨远侧皮质肥厚反应，髋关节功能优良率９５ ．３％ ，假体均无松动。 结论 股骨皮质肥厚反应多见于非骨水泥股骨假体，该现象与假体松动和髋关节功能无相关性。

Objective To observe the femoral cortical hypertrophy and its clinical importance after total hip arthroplasty. Methods Between January 1993 and August 1995, 246 primary total hip arthroplasties were performed by using single designed bone cemented and nonbone cemented femoral prosthesis. There were 117 cases with bone cemented stems followed up for average 4.5 years; and 129 with nonbone cemented stems were followed up for average 4.1 years. Results In the bone cemented group, femoral cortical hypertrophy was not seen in any hip. The excellence rate of hip function was 88.9%. No stem was definitely loose. In the nonbone cemented group, femoral cortical hypertrophy was seen in 36 hips ( 27.9 %). The clinical outcome showed that 95.3% of hips were good. No stem was unstable. Conclusions Cortical hypertrophy was more common in nonbone cemented stems, which does not associate with radiographic loosening and the function of hip joint.