摘要
目的 分析强直性脊柱炎股骨近段的形态学改变，及其改变对全髋关节置换术假体选择的意义。方法1999年1月～2004年6月，将13例（16髋）强直性脊柱炎患者设为选择组，患者均已出现关节强直，需行全髋关节置换术。另16例（19髋）为对照组，为非强直性脊柱炎患者而拟行全髋关节置换术。两组患者均摄髋关节正侧位X线片，测量Singh指数、髓腔张开指数、皮质形态指数及皮质骨指数，并进行统计学分析。结果选择组Singh指数、髓腔张开指数及皮质形态指数分别为：3．81±0．54、2．63±0．41及2．02±0．38，对照组分别为4．63±0．62、3．03±0．27及2．76±0．28，两组比较差异均有统计学意义（P〈0．05）。选择组皮质骨指数为1．69土0．69，对照组为2．12土0．24，两组比较差异无统计学意义（P〉0．05）。选择组患者髓腔呈烟囱型10例13髋，普通型3例3髋；对照组烟囱型3例3髋，普通型13例16髋。结论强直性脊柱炎的全髋关节置换术应采用骨水泥型人工关节假体，并根据患者髓腔形态使用定制型骨水泥假体，以达到更好的近段固定效果。对于有严重骨质疏松者应按关节翻修术处理。
Objective To investigate the effect of the morphological changes in the proximal femur on the prothesis selection in the total hip arthroplasty in the patients with ankylosing spondylitis. Methods The experimental group was composed of 13 patients （16 hips） with ankylosing spondylitis, which was treated with the total hip arthroplasty, and the control group was composed of 16 patients （19 hips）with non-ankylosing spondylitis, which was also treated with the total hip arthroplasty. In the two groups, the measurements of Singh index,canal flare index, morphological index of the cortex and cortical index were performed in the two groups. Results The results of the statistical analysis on Singh index, canal flare index, morphological index of the cortex and cortical index in the experimental group were 3.81±0. 54, 2.63±0.41, 2.02±0.38 and 1.69±0.69, respectively, but 4.63±0.62, 3.03±0. 27, 2.76±0. 28 and 2.12±0.24, respectively in the control group. There was a significant difference in Singh index, canal flare index, and morphological index of the cortex between the two groups （P 〈0. 05）, while there was no statistical difference in cortical index between the two groups （P〉0. 05）. The patients with ankylosing spondylitis had more serious osteoporosis in their proximal femur. Conclusion Cemented femoral prosthesis should be used in the total hip replacement in patients with ankylosing spondylitis, and the revision total hip arthroplasty should be performed on patients with more serious osteoporosis.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2006年第4期448-450,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
强直性脊柱炎
股骨近段
形态学
全髋关节置换术
假体选择
Ankylosing spondylitis Proximal femur Morphology Total hip arthroplasty Prothesis seleetion
