羟基磷灰石梯度涂层复合重组人骨形态发生蛋白-2股骨柄与SL-PLUS MIA股骨柄对全髋关节置换术后患者骨密度的影响

Effects of HA Gradient Composite BMP Femoral Shank and SL-PLUS MIA Femoral Shank on Postoperative Bone Mineral Density in Patients with Total Hip Arthroplasty

目的研究分析羟基磷灰石(HA)梯度涂层复合重组人骨形态发生蛋白-2(BMP)股骨柄与SLPLUS MIA股骨柄对全髋关节置换术(THA)后患者骨密度(BMD)的影响。方法选取2015年2月—2016年2月期间在息县人民医院行THA的60例患者(60髋)为研究对象,按照随机单盲法分为观察组(n=30)和对照组(n=30),对照组患者采用SL-PLUS MIA股骨柄,观察组采用HA梯度涂层复合BMP股骨柄,观察髋关节活动度、BMD、并发症发生率、Harris评分标准变化情况。结果术后12个月两组患者髋关节活动度和Harris评分高于术前(P<0.05);观察组患者术后各时间点BMD比较,差异无统计学意义(P>0.05),对照组术后6、12个月1、2、6、7区BMD低于术后1个月(P<0.05);观察组患者假体松动发生率低于对照组(P<0.05)。结论 HA梯度涂层复合BMP股骨柄与SL-PLUS MIA股骨柄行THA均具有不错的疗效,有利于改善髋关节功能,提高髋关节活动度,但HA梯度涂层复合BMP股骨柄术后骨量丢失少,假体松动发生风险小,安全性更高。

Objective To research and analyze the effects of hydroxyapatite( HA) gradient composite recombinant human bone morphogenetic protein-2( BMP) femoral shank and SL-PLUS MIA femoral shank on postoperative bone mineral density( BMD) in patients with total hip arthroplasty( THA). Methods A total of 60 patients( 60 hips) with THA in Xixian County people's Hospital were selected from February 2015 to February 2016 and all patients were divided into observation group( n = 30) and control group( n = 30) randomly. The SL-PLUS MIA femoral shank was used in the control group,while the observation group was treated with HA gradient coated BMP femoral shank, and the changes of hip joint activity, BMD,complication rate and Harris score were been observed. Results The hip joint activity and Harris score of two groups 12 months after the operation were higher than that before operation( P < 0. 05); each time point BMD of patients in the observation group,the difference was not statistically significant( P > 0. 05); In the control group,1,2,6,and 7 BMD after 6,12 months of operation were lower than 1 months( P < 0. 05),and the incidence of prosthesis loosening in the observation group was lower than that in the control group( P < 0. 05). Conclusion HA gradient coated BMP femoral shank and SL-PLUS MIA femoral shank THA both have good curative effect,which is helpful to improve hip function and improve hip mobility. However,patients treated with HA gradient coated BMP femoral stem with less bone loss,less risk of prosthesis loosening,and higher safety.