髋关节置换术后假体周边骨密度测量的临床研究

Measurement of periprosthetic bone mineral density after hip arthroplasty

目的 改良双能X线吸收法 (dual-energyX -rayabsorptiometry ,DEXA)并应用于临床研究。 方法 随访近 5年在本院行单侧非骨水泥型髋关节置换术患者 40例和髋关节翻修术患者 6例 ,改良DEXA法测量双侧股骨上段骨密度 ,常规摄X线片。 结果 术侧术后第 1年骨丢失最多 ,随时间延长 ,假体内侧和大转子区骨丢失最明显 ,假体柄外侧中、下部分次之 ,假体柄尖远端股骨干处骨丢失相对较少。患者本身骨密度高者骨丢失少 ,假体肩托可部分减少股骨矩的骨丢失。患者的性别、年龄和体重等对骨丢失无明显影响。 结论 改良的DEXA法是目前髋关节置换术后临床随访中准确。

Objective To measure the periprosthetic bone mineral density (BMD) after uncemented hip arthroplasty by applying the upgraded Dual energy X ray absorptiometry (DEXA) method. Methods Forty six patients who had the hip replaced in our hospital in recent 5 years were studied. All the patients had X ray and the BMD of both femurs were measured with the upgraded DEXA method. Results The BMD decreased rapidly in the first year after operation, but patients with higher BMD lost less bone. The BMD in the medial part of the stem and in the trochanter decreased most, the bone at the lateral part of the stem lost less, and at the tip of the stem the lest. The collar of the stem could reduce bone loss at the calcar region. The gender, age and weight, all these factors were not related with the bone loss. Conclusions The upgraded DEXA is a precise and reliable method in clinical follow up after hip arthroplasty.