全髋关节置换术后假体周围骨密度和 骨代谢的变化及其临床意义

Clinical significance of changes of periprosthetic bone mineral density and bone metabolism after total hip arthroplasty

摘要:

目的 探讨全髋关节置换术后假体周围骨密度和骨代谢的变化及其临床意义。方法 前瞻性收 集该院收治的全髋关节置换术后患者128 例，测定患者术前、术后12 个月的骨密度和骨代谢水平，分析骨密 度和骨代谢水平与Harris 评分的相关性。结果 术后12 个月患者Harris 评分高于术前（P <0.05）。Pearson 线 性相关性分析显示，Harris 评分与感兴趣区域1（ROI 1）、ROI 7 骨密度呈正相关（P <0.05）。与术前比较， 术后12 个月ROI 1、ROI 2、ROI 3、ROI 5、ROI 6 和ROI 7 骨密度水平降低（P <0.05）；手术前后ROI 4 骨密度比较，差异无统计学意义（P >0.05）；术后12 个月抗酒石酸酸性磷酸酶5b 水平升高（P <0.05）。 结论 全髋关节置换术后假体周围骨密度降低，可能与骨破坏有关，可影响患者术后康复质量。

Abstract:

Objective To investigate the clinical significance of periprosthetic bone mineral density and bone metabolism after total hip arthroplasty. Methods A total of 128 patients with total hip replacement in our hospital were prospectively collected. The bone mineral density of the region of interest (ROI) and bone metabolism were detected, and the association between bone density and Harris score was analyzed as well. Results The Harris score of the patients 12 months after operation was higher than that before operation (P < 0.05). Pearson linear correlation analysis showed that Harris score was positively correlated with bone mineral density of ROI 1 and ROI 7 12 months after operation (P < 0.05). The bone mineral density of ROI 1, ROI 2, ROI 3, ROI 5, ROI 6 and ROI 7 at 12 months after operation was lower than that before operation (P < 0.05). There was no difference between the bone mineral density of ROI 4 before and after operation (P > 0.05). Tartrate-resistant acid phosphatase-5b increased 12 months after operation when compared with that before operation (P < 0.05). Conclusions Periprosthetic bone mineral density decreases after total hip arthroplasty, which may be associated with bone destruction. Moreover, it may affect the quality of postoperative rehabilitation.