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目的探讨自人工关节关节面等处产生的磨损颗粒的迁移途径及其易聚积部位与骨溶解之间的关系。方法观察因无菌性松动行翻修术的39个国产人工髋关节的术前X线片 ,按关节类型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 ,并测算溶骨带宽度或溶骨面积。结果髋臼衬性骨溶解的发生率各区差异无显著性意义 (P>0.05) ,宽度以三区 (Delee分区法 )最大 (P<0.05) ;膨胀性骨溶解在人工股骨头和全髋关节中髋臼的发生率均以三区及坐骨缘最高 (P<0.05) ,各区溶骨面积差异无显著性意义 (P>0.05)。股骨近端衬性骨溶解除四区 (Gruen分区法 )外均连续存在 ,宽度由近及远递减 ;膨胀性骨溶解发生率亦由近关节端向远端依次递减 ,溶骨面积在人工股骨头组各区中差异无显著性意义 (P>0.05) ,全髋关节则以近关节端 (一、二、六区 )较为严重 (P<0.05) ,且外侧 (一、二区 )重于内侧 (五、六区 )。结论国产人工髋关节出现无菌性松动后,假体周围骨溶解的发生部位和严重程度与自关节面等处产生的磨损颗粒的迁移途径和易聚积部位存在一定相关性。
OBJECTIVE: To investigate the migration pathways of wear particles and the relationship between the easy accumulation sites and osteolysis in the articular surface of artificial joints. Methods To observe the preoperative X-ray of 39 artificial hip prostheses modified by aseptic loosening and revision. The incidence of lining and distending osteolysis in different areas around the prosthesis was calculated by grouping of joint types. Width or osteolytic area. Results There was no significant difference in the incidence of acetabular bone lysis between districts (P> 0.05). The width of the acetabular lining was the highest in all three districts (Delee partition method) (P <0.05). Expansion osteolysis was found in the femoral head and total hip joint The incidence of middle acetabulum was the highest in all three regions and the sciatic margin (P <0.05), and there was no significant difference in the area of osteolytic bone in each region (P> 0.05). Proximal femoral lysis of the bone except four areas (Gruen zoning method) outside the existence of continuous, the width decreased from near and far; expansion of osteolysis incidence also decreased from near the joint end to the distal, the osteolytic area in the artificial stock There was no significant difference in all regions of bone group (P> 0.05), total hip arthroplasty (P <0.05) Five, six districts). Conclusions After the aseptic loosening of domestic artificial hip joint, the location and severity of osteolysis around the prosthesis are related to the migratory pathways and easy accumulation sites of wear particles produced from the articular surface.