特立帕肽对全髋关节置换后股骨侧假体周围骨密度及假体下沉的影响  

Effect of teriparatide on femoral periprosthetic bone mineral density and prosthesis subsidence after total hip arthroplasty

作　　者：黄军刚 杨立峰[1] HUANG Jungang;YANG Lifeng(Department of Traumatic Orthopedics,3201 Hospital Afiliated to Xi'an Jiaotong University School of Medicine,Hanzhong,Shaanxi 723000,China)

机构地区：[1]西安交通大学医学院附属三二〇一医院创伤骨科,陕西汉中723000

出　　处：《中国骨与关节损伤杂志》2024年第6期566-570,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的分析特立帕肽对全髋关节置换后股骨侧假体周围骨密度及假体下沉的影响。方法纳入自2020-01-2020-12于西安交通大学医学院附属三二〇一医院行初次无骨水泥全髋关节置换术治疗的55例绝经后骨质疏松性股骨颈骨折,随机分为2组,其中观察组28例术后均接受特立帕肽联合碳酸钙D3治疗,对照组27例术后接受碳酸钙D3抗骨质疏松治疗。比较两组术后股骨侧假体周围骨密度、股骨侧假体下沉距离及髋关节功能Harris评分。结果所有患者均获得随访,观察组随访时间为(11.89±0.79)个月,对照组随访时间为(12.11±0.85)个月,两组随访时间差异无统计学意义(t=-0.991,P=0.459)。两组术后3个月股骨侧假体下沉距离差异无统计学意义(P>0.05),但观察组术后6个月、1年股骨假体下沉距离较对照组小,差异有统计学意义(P<0.05)。两组术后3个月、术后6个月及术后1年髋关节功能Harris评分差异无统计学意义(P>0.05)。观察组术后6个月及术后1年Gruen 1区、4区、6区及7区骨密度下降速度明显较对照组缓慢,差异有统计学意义(P<0.05);两组术后3个月Gruen1~7区、术后6个月及术后1年Gruen 2区、3区、5区骨密度下降速度差异无统计学意义(P>0.05)。结论皮下注射特立帕肽可以减少绝经后骨质疏松性股骨颈骨折全髋关节置换术后股骨侧假体周围骨密度丢失并延缓股骨侧假体下沉时间。Objective To analyze the effect of teriparatide on femoral periprosthetic bone mineral density and prosthesis subsidence after total hip arthroplasty.Methods Fifty-five postmenopausal patients with osteoporotic femoral neck fractures who underwent primary uncemented total hip arthroplasty at the 3201 Hospital of Xi'an Jiaotong University Medical College from January 2020 to December 2020 were included.They were randomly divided into two groups:the observation group(n=28)received teriparatide combined with calcium carbonate and vitamin D3 treatment postoperatively while the control group(n=27)received calcium carbonate and vitamin D3 treatment alone for osteoporosis.Periprosthetic bone density,distance of prosthetic sinking,and Harris hip scores were compared between the two groups postoperatively.Results All patients were followed up,with a mean follow-up time of(11.89±0.79)months in the observation group and(12.11±0.85)months in the control group,showing no statistically significant difference between the two groups(t=-0.991,P=0.459).There was no significant difference in the distance of prosthetic sinking at 3 months postoperatively between the two groups(P>0.05).However,at 6 months and 1 year postoperatively,the distance of prosthetic sinking was smaller in the observation group compared to the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in Harris hip scores at 3 months,6 months,and 1 year postoperatively between the two groups(P>0.05).The observation group showed a significantly slower rate of bone density decline in Gruen zones 1,4,6,and 7 at 6 months and 1 year postoperatively compared to the control group(P<0.05).There was no statistically significant difference in the rate of bone density decline in Gruen zones 1-7 at 3 months postoperatively,Gruen zones 2,3,and 5 at 6 months and 1 year postoperatively between the two groups(P>0.05).Conclusion Subcutaneous injection of teriparatide can reduce periprosthetic bone density loss and dela

关 键 词：股骨颈骨折 特立帕肽 全髋关节置换 股骨假体 骨密度 假体下沉 

分 类 号：R687.3[医药卫生—骨科学]