唑来膦酸对髋关节置换后股骨侧假体下沉的影响  

Effect of zoledronic acid on femoral implant subsidence after hip arthroplasty

作　　者：陈拥[1] 孙阳[1] Chen Yong;Sun Yang(Department of Orthopedics,Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,Liaoning Province,China)

机构地区：[1]沈阳医学院附属中心医院骨科,辽宁省沈阳市110024

出　　处：《中国组织工程研究》2022年第12期1812-1815,共4页Chinese Journal of Tissue Engineering Research

基　　金：辽宁省自然基金指导计划(2019-ZD-0329),项目负责人:孙阳。

摘　　要：背景:髋关节置换后假体下沉是导致手术失败的主要原因,唑来膦酸对改善髋关节置换后非骨水泥型股骨假体周围的骨量及骨密度具有良好的作用,推测其可减少假体下沉。目的:分析唑来膦酸对髋关节置换后股骨假体下沉的影响。方法:选择2019年4月至2020年4月沈阳医学院附属中心医院收治的绝经后骨质疏松性髋部骨折女性患者50例,采用随机数字表法分为2组,试验组25例全髋关节置换后1周接受静脉滴注唑来膦酸,对照组25例全髋关节置换后未给予唑来膦酸治疗。髋关节置换后1年,通过X射线片测量股骨假体下沉距离,通过双能X射线骨密度仪检测股骨假体周围骨密度,采用Harris评分系统评价髋关节功能。结果与结论:(1)试验组患者置换后1年的股骨假体下沉距离少于对照组(P<0.05),置换后1年的股骨假体周围平均骨密度高于对照组(P<0.05);(2)两组患者置换后1年的髋关节功能Harris评分均高于置换前(P<0.05),两组间比较差异无显著性意义(P>0.05);(3)用药3 d内,试验组有8例患者出现发热症状,口服布洛芬混悬液及大量饮水后症状缓解;(4)提示:唑来膦酸能够有效减少非骨水泥型股骨假体周围骨密度丢失,提高髋关节置换后假体的稳定性。BACKGROUND:Implant subsidence after hip arthroplasty is the main cause of surgical failure.Zoledronic acid has a good effect on improving bone mass and bone density around cementless femoral prosthesis after hip arthroplasty,and it is speculated that zoledronic acid can reduce implant subsidence.OBJECTIVE:To analyze the effect of zoledronic acid on femoral implant subsidence after hip arthroplasty.METHODS:Totally 50 female patients with postmenopausal osteoporotic hip fracture who underwent hip arthroplasty in Central Hospital Affiliated to Shenyang Medical College from April 2019 to April 2020 were selected and randomly assigned to two groups.The 25 patients in the trial group received intravenous infusion of zoledronic acid 1 week after total hip arthroplasty,and 25 patients in the control group did not receive zoledronic acid treatment after total hip arthroplasty.At 1 year after arthroplasty,X-ray was used to record the femoral implant subsidence distance.The bone mineral density around the femoral prosthesis was measured using dual energy X-ray bone densitometer.Harris scoring system was used to assess hip joint function.RESULTS AND CONCLUSION:(1)The femoral implant subsidence distance was less in the trial group than that in the control group at 1 year after arthroplasty(P<0.05).The average bone mineral density around the femoral prosthesis was higher in the trial group than that in the control group at 1 year after arthroplasty(P<0.05).(2)Harris hip function score in the two groups was higher at 1 year after arthroplasty than that before arthroplasty(P<0.05),and there was no significant difference between the two groups(P>0.05).(3)Eight patients in the trial group developed fever within 3 days,and the symptoms were relieved after oral administration of ibuprofen suspension and drinking plenty of water.(4)It is indicated that zoledronic acid can effectively reduce the loss of bone mineral density around cementless femoral prosthesis and improve the stability of prosthesis after hip arthroplasty.

关 键 词：骨质疏松 全髋关节置换 唑来膦酸 髋部骨折 股骨假体 骨密度 假体下沉 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]