保留股骨颈全髋关节置换术后假体周围骨密度变化  

Retrospective Study on the Bone Density around Prosthesis after Total Hip Replacement with Retained Femur Neck

作　　者：黄和涛[1] 潘建科 杨伟毅 罗明辉 刘军 HUANG He - tao, PAN Jian -ke, YANG Wei - yi, LUO Ming - hui, LIU Jun.(Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhoa 510405, Guangdong, China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广州中医药大学第二附属医院(广东省中医院)骨科,广东广州510120

出　　处：《广东医学》2018年第18期2758-2761,2766,共5页Guangdong Medical Journal

基　　金：国家工信部和国家卫计委"机器人应用中心"建设项目(编号:2017MHDOSR1008);广东省财政厅项目(编号:[2014]157号;[2018]8号);广东省医学科学技术研究基金资助项目(编号:A2017215)

摘　　要：目的比较保留股骨颈与非保留股骨颈全髋关节置换(total hip arthroplasty,THA)术后的股骨近端骨密度变化,为临床使用股骨颈保留型(collum femoris preserving,CFP)假体提供可靠的参考数据。方法基于EMR病历系统,采用回顾性队列研究方法,收集THA术后病例,按手术方式分为治疗组和对照组,比较两组术后1周内及术后1年的骨密度,评价股骨颈保留型假体在改善股骨假体周围骨密度等方面的疗效、安全性及与非股骨颈保留型假体组的差异。结果观察组术后1周及术后1年假体周围骨密度比较,ROI 3区骨密度差异无统计学意义(P> 0. 05),其他分区差异有统计学意义(P <0. 05),而对照组术后1周及术后1年假体周围骨密度在ROI 1区至ROI 7区差异均有统计学意义(P <0. 05);两组术后1年假体周围骨密度进行比较,观察组在ROI 1区、ROI 3区、ROI 6区、ROI 7区的骨密度与对照组相比差异有统计学意义(P <0. 05);两组术后1年X线影像学评价均未见假体松动、下沉、断裂等假体不良事件发生。结论股骨颈保留型THA术在术后1年减少股骨近端骨量丢失方面具有较大优势。Objective To compare the bone densities of proximal femur after total hip replacement（ THA） between reserved femoral neck and non-retained femoral neck; thus to provide reliable reference data for clinical use of the colum femoris preservice（ CFP） prosthesis. Methods Based on the EMR medical record system,the retrospective cohort study was used to collect THA postoperative cases and divided into treatment group and control group according to the surgical method. The bone density within 1 week and 1 year after the operation of the two groups was compared. The efficacy,safety and bone densities around femoral prosthesis were compared between femoral neck retention prosthesis and non-femoral neck retention prosthesis groups. Results There was no significant difference in bone density in ROI 3 region between 1 week and 1 year after operation in the treatment group（ P〉 0. 05）,but significant differences were revealed in the other regions（ P〈 0. 05）. There were significant differences in bone densities from ROI1 region to ROI7 region between 1 week and 1 year after operation in the control group（ P〈 0. 05）. There were significant differences in bone densities in ROI1,ROI3,ROI6 and ROI7 regions 1 year after operation between control group and treatment group（ P〈 0. 05）. No adverse event,including prosthesis loosening,sinking and fracture,were reported during the 1-year follow-up in the 2 groups. Conclusions The THA with femoral neck retention has a great advantage in reducing the loss of proximal femur bone density 1 year after operation.

关 键 词：保留股骨颈 全髋关节置换术 假体周围骨密度 临床研究 

分 类 号：R687.4[医药卫生—骨科学]