人工全髋关节置换术对骨质疏松症患者骨密度的影响

Influence Mixed or Biological Artificial Total Hip Replacement on Bone Mineral Density in Elderly Patients

目的探讨混合型与生物型人工全髋关节置换术(total hip arthroplasty,THA)对老年骨质疏松症患者骨密度的影响。方法选取老年股骨头无菌性坏死需行THA患者68例,随机分为混合型组与生物型组,每组各34例。混合型组选用混合型假体,Palacos抗生素骨水泥固定股骨柄假体,髋臼假体采用非骨水泥固定;生物型THA组选用Depuy公司人工关节。术后1、3、6、12个月及2年时患者来院复诊测定骨密度(bone densitometry,BMD),将假体分7个测量兴趣区(region of interest,ROI)。结果两组各测量兴趣区主要数据从术后1个月、术后3个月、术后6个月递减,以术后6个月或术后12个月降至最低,至术后2年又呈现升高趋势;在假体周围,ROI 4 BMD值最高,ROI 7、ROI1 BMD值最低。且两组术后BMD变化及趋势,以及各测量兴趣区BMD值比较,均无统计学差异(P>0.05)。结论混合型与生物型THA术对老年骨质疏松症患者骨密度可能不具有差异性的影响,术后至6个月或12个月内BMD值呈逐渐降低的趋势,2年后又逐渐升高,但骨质疏松性质未发生改变。

Objective To explore the influence on elderly osteoporosis patients＇ bone mineral density （BMD） by mixed or biological artificial total hip replacement （THA）. Methods 68 elderly patients with aseptic necrosis of femoral head undergoing THA were selected,and randomLy divided into mixed group and biological group. There were 34 cases in each group. Patients in mixed group were given mixedprosthesis ,femoral stem prosthesis were fixed by Palacos antibiotic bone cement,and acetabular prosthesis were fixed by cementless material,yet artificial joint of Depuy were used in biological group. BMD （including ROI I^ROI 7） of two groups were tested on patients＇return visit of 1,3,6,12 months and 2 years after sugery. Results Major data of two groups ROI eclined on 1 month, 3 months and 6 months after sugery,and the minimum was on 6 months or 12 months ,yet it increased 2 years later after sugery. Surrounding the prosthesis,ROI 4＇s BMD was highest,and ROI 7 or ROI lts BMD.was lowest. There was no statistical difference on BMD changes and trends ,as well as every ROIrs BMD in two groups （P〉 0.05）. Conclusion There is maybe no difference on elderly osteoporosis patients＇ BMD by mixed or biological artificial THA,and patients＇ BMD decrease gradually until postoperative 6 months or 12 months,and it increase gradually 2 years later,yet osteoporosis properties has no changes.