股骨头坏死和骨关节炎患者初次全髋关节置换后髋臼假体周围的骨密度差异

摘要

BACKGROUND:Failure rate is higher in patients with osteonecrosis of femoral head than in osteoarthritis patients after primary total hip arthroplasty, especial y acetabular prosthesis. Bone mineral density around the prosthesis is a key factor for quality of life of the prosthesis. OBJECTIVE:To observe the difference in periprosthetic bone mineral density between patients with osteonecrosis of the femoral head and osteoarthritis patients and the exact location of differences after primary total hip arthroplasty. METHODS:Fifty patients with osteonecrosis of femoral head and fifty osteoarthritis patients were enrol ed in this study. Dual energy X-ray absorptiometry examination was used to compare bone mineral density 5 years after total hip arthroplasty. In accordance with De Lee’s and Charnley’s methods, images of acetabulum were divided. The bone mineral density of different areas of the acetabulum was compared between the two groups. RESULTS AND CONCLUSION:(1) Periprosthetic bone mineral density:Bone mineral density in the lower part and upper part of the acetabulum was significantly lower in the osteonecrosis group than in the osteoarthritis group (P<0.05). No significant difference in bone mineral density in the middle of the acetabulum was detected between the two groups. (2) Results confirmed that the bone mineral density in the lower and the upper parts of the acetabular component was significantly lower in patients with osteonecrosis of femoral head than in patients with osteoarthritis.%背景：股骨头坏死患者初次全髋关节置换后失败率高于骨关节炎患者，特别是髋臼侧假体，假体周围骨密度是影响假体生存质量的重要因素。目的：观察初次全髋关节置换后，股骨头坏死患者以及骨关节炎患者髋臼假体周围骨密度的差异以及存在差异的具体部位。方法：共纳入股骨头坏死患者和骨关节炎患者各50例，利用双能X射线吸收检查，比较经相同的全髋关节置换后5年患者的髋臼假体周围骨密度。按照De Lee和Charnley描述的方法将髋臼部位影像分区，对比分析两组研究对象髋臼不同分区的骨密度。结果与结论：①髋臼假体周围骨密度：股骨头坏死组在髋臼下部和上部的骨密度明显低于骨关节炎组(P<0.05)，而两组髋臼中部骨密度差异无显著性意义；②结果证实：股骨头坏死患者的髋臼假体髋臼下部以及上部区域骨密度显著低于骨关节炎患者。