髋关节表面置换术后股骨近端及髋臼骨密度初步研究

A priliminary study of bone mineral densities of the proximal femur and acetabulum after hip resurfacing arthroplasty

目的 评价髋关节表面置换术（RSAH）对股骨近端及髋臼侧骨量的影响.方法 选择符合入组标准的单侧RSAH病人26例,于术后1年行髋关节手术侧及健侧的股骨近端和髋臼的骨密度检查,参考Taylor及Wilkinson方法分别将术后股骨近端及髋臼分为6个（1～6区）和3个（A1～A3）兴趣区,测量各兴趣区骨密度,用t检验对各区手术侧与健侧骨密度值进行比较.结果 手术侧的股骨近端5、6区的骨密度值大于健侧的,两者差异有统计学意义（P＜0.05）;1、2、3、4区的骨密度值在手术侧与健侧间的差异无统计学意义（P＞0.05）.髋臼侧全部区域中髋臼头侧（A1区）密度值,手术侧小于健侧,两者差异有统计学意义（P＜0.05）;手术侧与健侧的髋臼内侧及尾侧（A2、A3区）的骨密度比较,其差异无统计学意义（P＞0.05）.结论 关节表面置换术后股骨近端骨量可以得到有效保存和恢复,而髋臼侧骨质有丢失可能.

Objective To evaluate periprosthetic bone mineral densities of the femur and acetabulum after hip resurfacing arthroplasty （RSAH）. Methods A comparative study was carried out in 26 patients who underwent RSAH. The bone mineral density was measured with dual energy X-ray absorptiometry 1 year after RSAH. Both the operated and unoperated hips were scanned. In the dual femur bone mineral density analysis, 9 regions of interests （ROIs） were defined： ROIs 1-6 were determined according to Taylor regions; ROIs A1-A3 were determined according to Wilkinson regions. The Student t test was used for comparing differences in bone mineral density between the operated and unoperated sides. Results The bone mineral densities of the proximal femur in ROIs 5 and 6 medial to the stem were significantly increased in the operated side compared to the unoperated side （P〈0.05）, but no significant differences were found in ROIs 1, 2, 3, and 4 of the proximal femur between two sides （P〉0.05）. The bone mineral density of acetabulum in cranial ROI A1 of the operated side was significantly decreased compared to the unoperated side （P〈0.05）, while in the medial and caudal ROIs A2 and A3 showed no significantly differences between two sides （P〉0.05）. Conclusion The bone stock of proximal femur can be well preserved and recovered after RSAH.