全膝关节置换术后腰椎和髋部骨密度与人工关节无菌性松动的关系OA
Association between lumbar and hip bone mineral density after total knee arthroplasty and aseptic loosening of the prosthesis
目的 探讨全膝关节置换术(TKA)患者术后腰椎和髋部骨密度的变化,并分析TKA患者骨密度变化与人工关节无菌性松动(AL)的相关性.方法 选取2017年8月至2020年7月在我院接受TKA的患者302例,按照术后3个月是否发生人工关节AL分为AL组(31例)和非AL组(271例),随访3年,比较2组患者手术前后腰椎和髋部骨密度变化.结果 AL组患者术后1年、2年、3年的L2、L3、L4骨密度较术前均降低(P<0.05),非AL组患者术后1年、3年的L2骨密度较术前升高(P<0.05),非AL组患者术后2年、3年的L3骨密度较术前升高(P<0.05),且AL组患者术后1年、2年、3年的L2、L3、L4骨密度明显低于非AL组(P<0.05).AL组患者术后1年、2年、3年的股骨颈骨密度、大粗隆骨密度较术前均降低(P<0.05),非AL组患者术后3年的股骨颈骨密度较术前升高(P<0.05),非AL组患者术后1年、2年、3年的大粗隆骨密度较术前均升高(P<0.05),且AL组患者术后1年、2年、3年的股骨颈、大粗隆骨密度明显低于非AL组(P<0.05).结论 TKA术后发生AL的患者腰椎和髋部骨密度明显降低,且AL与腰椎和髋部骨密度呈负相关.
Objective To investigate the changes in lumbar and hip bone mineral density in patients after total knee arthroplasty(TKA),and the correlation between bone mineral density changes and aseptic loosening(AL)of the prosthesis in TKA patients was analyzed.Methods A total of 302 patients who underwent TKA in our hospital from August 2017 to July 2020 were enrolled.They were divided into the AL group(31 cases)and the non-AL group(271 cases)according to the occurrence of prosthesis AL at 3 months postoperatively.All patients were followed up for 3 years,and the changes in lumbar and hip bone mineral density before and after surgery were compared between the two groups.Results Compared with preoperative values,bone mineral density of L2,L3 and L4 were significantly decreased at 1,2 and 3 years after surgery in the AL group(P<0.05).In the non-AL group,bone mineral density of L2 was significantly increased at 1 and 3 years after surgery compared with preoperative values(P<0.05),and bone mineral density of L3 was significantly increased at 2 and 3 years after surgery compared with preoperative values(P<0.05).Moreover,bone mineral density of L2,L3 and L4 in the AL group were significantly lower than those in the non-AL group at 1,2 and 3 years after surgery(P<0.05).In the AL group,bone mineral density of the femoral neck and greater trochanter were significantly decreased at 1,2 and 3 years after surgery compared with preoperative values(P<0.05).In the non-AL group,bone mineral density of the femoral neck was significantly increased at 3 years after surgery compared with preoperative values(P<0.05),and bone mineral density of the greater trochanter were significantly increased at 1,2 and 3 years after surgery compared with preoperative values(P<0.05).Moreover,bone mineral density of the femoral neck and greater trochanter in the AL group were significantly lower than those in the non-AL group at 1,2 and 3 years after surgery(P<0.05).Conclusion Patients with AL after TKA have significantly decreased bone mineral density of the lumbar spine and hip,and AL is negatively correlated with lumbar and hip bone mineral density.
尹识渊;黄朝明;裴儒;何仁豪;张杰
江苏省人民医院宿迁医院骨科,江苏 宿迁 223800江苏省人民医院宿迁医院骨科,江苏 宿迁 223800江苏省人民医院宿迁医院骨科,江苏 宿迁 223800江苏省人民医院宿迁医院骨科,江苏 宿迁 223800江苏省人民医院宿迁医院骨科,江苏 宿迁 223800
医药卫生
全膝关节置换术腰椎髋部骨密度人工关节无菌性松动
total knee arthroplastylumbarhipbone mineral densityprosthesisaseptic loosening
《局解手术学杂志》 2026 (4)
294-298,5
宿迁市科研计划项目(Z2024082)
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