晚期大骨节病全膝关节置换术后假体周围应力与骨密度的变化情况  

The change situation of periprosthetic stress and bone mineral density after total knee arthroplasty in patients with late-stage Kashin-Beck disease

作　　者：王继成 张先娇[2] 聂治军[2] 易智[2] 徐洪海[2] 刘时璋[2] 常彦海[2] 郭雄[3] WANG Ji-cheng;ZHANG Xian-jiao;NIE Zhi-jun;YI Zhi;XU Hong-hai;LIU Shi-zhang;CHANG Yan-hai;GUO Xiong(Graduate School of Xi′an Medical University,Xi′an,Shaanxi 710068,China;Dept of Orthopaedics,Shaanxi Provincial People′s Hospital,the Third Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shaanxi 710068,China)

机构地区：[1]西安医学院研究生院,陕西西安710068 [2]陕西省人民医院(西安交通大学第三附属医院)骨科,陕西西安710068 [3]西安交通大学医学院公共卫生学院,陕西西安710061

出　　处：《临床骨科杂志》2020年第6期800-804,共5页Journal of Clinical Orthopaedics

基　　金：陕西省科学技术厅社会发展科技攻关项目(编号:2018SF-059);陕西省科学技术厅科技统筹创新工程计划项目(编号:2015KTCL03-02)。

摘　　要：目的观察膝关节晚期大骨节病行全膝关节置换术后假体周围应力及骨密度的变化情况。方法采用全膝关节置换术治疗24例膝关节晚期大骨节病。将股骨和胫骨假体周围分为7个兴趣区,观察假体周围兴趣区不同时间段的应力及骨密度的变化情况。结果患者均获得随访,时间24~30个月。KSS评分术后1、3、6、12个月均高于术前(P<0.05);术后不同时间点比较比较差异均有统计学意义(P<0.05)。假体周围兴趣区各分区的应力遮挡率术后各时间点比较差异均有统计学意义(P<0.05)。术后1个月兴趣区各区骨密度与健侧比较差异无统计学意义(P>0.05),术后3、6、12个月兴趣区各区的骨密度与健侧比较差异均有统计学意义(P<0.05)。结论全膝关节置换术术后假体周围应力及骨密度会出现变化且存在相关性,采取有效方法进行评估,可对预后情况进行监测。Objective To observe the changes situation of periprosthetic stress and bone mineral density(BMD)after total knee arthroplasty(TKA)for the late-stage Kashin-Beck disease(KBD).Methods The 24 cases with late-stage KBD were treated with TKA.The prostheses of femur and tibia were divided into 7 regions of interest(ROI).The changes of stress and BMD in the prosthesis ROI at different time periods were observed.Results All patients were followed up for 24~30 months.At 1,3,6,12 months posoperation,KSS was higher than the preoperation(P<0.05);and there were statistical differences at the different time points(P<0.05).There were differences for the stress shielding rate of various regions of the periprosthetic ROI at the different time points(P<0.05).At 1 month postoperation,there were not differences in the BMD between the ROI and the health side(P>0.05);while there were differences for BMD of various ROI at 3,6,12 months postoperation(P<0.05).Conclusions The periprosthetic stress and BMD can change and exist correlation after the TKA,the effective methods can be used to evaluate the prognosis.

关 键 词：全膝关节置换术 大骨节病 膝关节 应力 骨密度 

分 类 号：R687.4[医药卫生—骨科学] R684.1[医药卫生—外科学]