骨密度降低是女性患者全髋关节置换术后非骨水泥髋臼杯移位的高危因素
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作者Author单位AddressE-Mail
刘嘉 LIU Jia 遵义医学院 遵义学院第三附属医院, 贵州 遵义 563000 Zunyi Medical College, the Third Affiliated Hospital of Zunyi College, Zunyi 563000, Guizhou, China  
邓江 DENG Jiang 遵义医学院 遵义学院第三附属医院, 贵州 遵义 563000 Zunyi Medical College, the Third Affiliated Hospital of Zunyi College, Zunyi 563000, Guizhou, China DJ3666@126.com 
韩小松 HAN Xiao-song 遵义医学院 遵义学院第三附属医院, 贵州 遵义 563000 Zunyi Medical College, the Third Affiliated Hospital of Zunyi College, Zunyi 563000, Guizhou, China  
徐林 XU Lin 遵义医学院 遵义学院第三附属医院, 贵州 遵义 563000 Zunyi Medical College, the Third Affiliated Hospital of Zunyi College, Zunyi 563000, Guizhou, China  
期刊信息:《中国骨伤》2017年,第30卷,第1期,第33-37页
DOI:10.3969/j.issn.1003-0034.2017.01.008
基金项目:
中文摘要:

目的:探讨骨密度降低在女性患者中对非骨水泥臼杯位移的影响。

方法:收集2013年10月至2015年11月遵义医学院第三附属医院骨科一病区收治的34例全髋关节置换术患者,均为女性,均为髋关节骨性关节炎。基于术前双能X线骨密度仪测量(DXA)的最低值,将患者分为骨密度正常组或低骨密度组(-3.5≤T≤-1)。骨密度组正常10例,年龄55~64岁;低骨密度组24例,年龄58~72岁。两组患者行全髋关节置换术时均植入非骨水泥陶瓷对陶瓷髋关节假体(Depuy美国),内衬系统均为Pinnacle杯。术中髋臼杯保持外展角45°、前倾角15°,基于立体影像测量分析(RSA)追踪术后3、6、12和24个月髋臼杯位移情况。

结果:低骨密度组与正常骨密度组在臼杯位移的RSA测量差异有统计学意义。低骨密度组较正常骨密度组在术后前3个月内,臼杯的迁移差异有统计学意义。位移主要发生在X轴(95%置信区间0.01~0.31,P=0.006)和Y轴(95%置信区间0.20~0.39,P=0.003)。最初的旋转发生在单独的Z轴(95%置信区间-0.26~0.81,P=0.006)。

结论:女性患者在全髋关节置换术后3个月,骨密度降低增加了非骨水泥杯的位移。
【关键词】骨密度  关节成形术,置换,髋  骨关节炎,髋  病例对照研究
 
Bone mineral density decreased is a high risk factor for uncemented acetabular cups migration in female total hip arthroplasty patients
ABSTRACT  

Objective: To investigate the decrease of bone mineral density in female patients, effects on acetabular displacement.

Methods: From October 2013 to November 2015, a total of 34 patients underwent total hip replacement in the Department of orthopedics, the Third Affiliated Hospital of Zunyi Medical College.The two groups of patients were female and the patients were treated with hip osteoarthritis.Based on the lowest value of preoperative dual energy X-ray bone mineral density (DXA), the patients were divided into normal group and low bone mineral density (-3.5≤T≤-1).There were 10 patients in the normal group, ranging in age from 55 to 64 years old, with an average of (58.00±4.22) years old.There were 24 patients in the low bone density group, ranging in age from 58 to 72 years old, with an average age of (65.71±8.19) years old.All the patients received a THA implant with ceramic-on-ceramic bearings (Depuy America).The lining system was Pinnacle cup.During the operation, the acetabular cup was maintained at abduction 45 degree and anteversion 15 degree.Analysis (RSA) of acetabular components in 3, 6, 12, and 24 months after surgery.

Results: There was a statistically significant difference in cup migration between patients with normal BMD and those with low BMD.At 3 months, compare to the normal group, the low bone mineral density (BMD) occurred in the X axis (95% confidence interval, 0.01 to 0.31;P=0.006) and Y (95% confidence interval 0.20 to 0.39;P=0.003).The initial rotation occurs in a separate Z axis (95% confidence interval-0.26 to 0.81;P=0.006).

Conclusion: It has produced that increaseed migration of uncemented cups in female patients with low systemic BMD in 3 months after surgery.
KEY WORDS  Bone density  Arthroplasty,replacement,hip  Osteoarthritis,hip  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:刘嘉,邓江,韩小松,徐林.骨密度降低是女性患者全髋关节置换术后非骨水泥髋臼杯移位的高危因素[J].中国骨伤,2017,30(1):33~37
英文格式:LIU Jia,DENG Jiang,HAN Xiao-song,XU Lin.Bone mineral density decreased is a high risk factor for uncemented acetabular cups migration in female total hip arthroplasty patients[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(1):33~37
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