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探讨不同固定方式假体周围骨溶解X线征象差异与磨损颗粒迁移特点及其易聚积部位之间的联系 ,分析磨损颗粒在假体无菌性松动中的作用。方法 :观察因无菌性松动行翻修术的 39个国产人工髋关节术前X线片 ,按部位及固定方式分组统计假体周围不同区域衬性和膨胀性骨溶解的发生率 ,并测算溶骨带宽或溶骨面积。结果 :非骨水泥固定髋臼假体周围各区 (Delee分区法 )衬性骨溶解发生率明显高于骨水泥固定组 (P <0 0 5 ) ,溶骨带宽以三区最重 (P <0 0 5 )并大于骨水泥固定组对应区 (P <0 0 5 ) ;膨胀性骨溶解以三区发生率最高 (P <0 0 5 ) ,但两种固定方式各对应区之间发生率及溶骨面积均无显著性差异 (P >0 0 5 )。柄周衬性骨溶解宽度人工股骨头组除一、四区 (Gruen分区法 )、全髋关节组除三、四区无显著性差异 (P >0 .0 5 )外 ,其它各对应区均以骨水泥固定组较重 (P <0 .0 5 ) ;膨胀性骨溶解发生率以一、七区最高 (P <0 .0 5 ) ,两种固定方式各对应区之间溶骨面积差异无显著性意义 (P >0 .0 5 )。结论 :无菌性松动假体周围骨溶解的发生部位及严重程度与磨损颗粒迁移和聚集的部位有关 ,固定方式不同骨溶解的X线表现亦有差异。阻断磨损颗粒的扩散可能是防止骨溶解发生的有效方法之一。
To explore the relationship between the differences of X-ray signs and the characteristics of migrating particles and their easy accumulation sites in different fixed prostheses, and to analyze the role of wear particles in aseptic loosening of prostheses. Methods: To observe the preoperative X-ray films of 39 domestic artificial hip prostheses modified by aseptic loosening and revision surgery. The incidences of lining and swollen osteolysis in different areas around the prosthesis were calculated by grouping and fixation. Bone width or osteolytic area. Results: The incidence of lining osteolysis around the non-cemented fixed acetabular component was significantly higher than that of the cement-fixed group (P <0 05) (P <0 05). The highest incidence of osteolysis in the three districts was found (P 0 05). However, the incidence rates of the corresponding areas of the two fixation methods and There was no significant difference in the area of osteolytic bone (P> 0.05). In addition to the first and fourth zones (Gruen zoning method), there was no significant difference in the total hip joint group except the third and fourth zones (P> 0.05) (P <0.05). The incidence of intratumoral osteolysis was the highest in the first and seventh districts (P <0.05), the difference in the area of osteolytic bone between the two fixation methods No significant (P> 0.05). Conclusion: The location and severity of osteolysis around aseptic loosening prosthesis are related to the site of migration and aggregation of wear particles. X-ray manifestations of osteolysis in different fixation methods are also different. Blocking the diffusion of abrasive particles may be one of the effective ways to prevent osteolysis.