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全髋关节置换术后股骨皮质的肥厚反应 |
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任先军 G.A Fuchs Jürgen Wacker
摘 要：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。
关键词：髋假体； 骨水泥和非骨水泥股骨假体； 皮质肥厚，股骨
Femoral cortical hypertrophy after total hip arthroplasty
REN Xianjun G.A Fuchs Jürgen Wacker
（Dept. of Orthopaedic Surgery, Xinqiao Hospital,The Third Military Medical University, Chongqing 400037, China）
Abstract：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.
Key words：Hip prosthesis； Single-designed bone-cemented and nonbone-cemented femoral prosthesis； Cortical hypertrophy, femoral▲
人工髋关节置换术后，由于应力的再分布，股骨将会发生重塑（remodeling），在不同区域内出现不同的骨密度改变。股骨远端皮质的肥厚反应（cortical hypertrophy）是一种较为特殊的现象，这种现象有无临床意义，是临床医师关心的问题。目前，国内对这一研究的报道较少。1993年1月～1995年8月，德国拜罗伊特医学中心（Klinikum Bayreuth）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。最近，笔者对这组病人进行了回顾性临床随访，并着重观察两类假体植入后股骨皮质的不同重塑反应。
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