全髋关节置换术后骨性关节炎患者腰椎Hounsfield单位值与骨密度的关系

IF 2.1 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-06-23 DOI:10.1016/j.artd.2025.101756

Masanori Nishi MD, PhD, Yasushi Yoshikawa MD, PhD, Ichiro Okano MD, PhD, Yuki Usui MD, PhD, Hajime Nishida MD, Shota Nakamura MD, Koichiro Tashiro MD, Yoshifumi Kudo MD, PhD

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引用次数: 0

摘要

背景：髋关节骨关节炎（OA）和骨质疏松症经常共存，由于退行性改变使骨矿物质密度（BMD）评估复杂化。我们的目的是研究腰椎Hounsfield单位（HU）值在髋关节OA患者行全髋关节置换术（THA）中的应用。方法本研究纳入了行原发性全髋关节置换术和术前双能x线骨密度测量的髋关节OA患者。测量全髋（TH）、股骨颈、腰椎（L2-L4）和桡骨远端骨密度。通过术前髋关节计算机断层扫描评估L4和L5的HU值，进行三维术前规划。为了评估关节炎和畸形的影响，我们比较了有和没有OA的髋部。使用相关系数来评估HU值与t分数之间的关系。结果共分析了218例髋关节。腰椎HU值与所有测量部位的t评分均存在中度相关性，其中L5 HU值与非关节炎TH的t评分相关性最强(rho = 0.64, P <；. 01)。无关节炎髋的受试者操作特征分析得出L4和L5曲线下面积分别为0.76和0.77（最佳截断值分别为96.6 HU和92.6 HU）。在患有骨关节炎的髋关节中，L4和L5的曲线下面积分别为0.82和0.83（截断值分别为118.9 HU和100.8 HU）。结论slumbar HU值与各测点骨密度呈中等相关性，TH测点尤为明显。这可能作为髋关节骨关节炎患者THA前骨质疏松症的有用筛查工具。

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Relationship Between Lumbar Spine Hounsfield Unit Values and Bone Mineral Density in Patients With Osteoarthritis Undergoing Total Hip Arthroplasty

Background

Hip osteoarthritis (OA) and osteoporosis often coexist, complicating bone mineral density (BMD) assessment because of degenerative changes. We aimed to examine the utility of lumbar spine Hounsfield unit (HU) values in patients with hip OA undergoing total hip arthroplasty (THA).

Methods

This study included patients with hip OA who underwent primary THA and preoperative BMD measurements with dual-energy X-ray absorptiometry. BMD was measured in the total hip (TH), femoral neck, lumbar spine (L2-L4), and distal radius. HU values at L4 and L5 were evaluated using preoperative computed tomography of the hip joints for 3-dimensional preoperative planning. To assess the effect of arthritis and deformity, we compared the hips of those with and without OA. Correlation coefficients were used to assess the relationship between the HU values and T-scores.

Results

Overall, 218 hips were analyzed. Moderate correlations were found between lumbar HU values and T-scores at all measurement sites, with the strongest correlations between L5 HU values and T-scores of the nonarthritic TH (rho = 0.64, P < .01). Receiver operating characteristic analysis of nonarthritic hips yielded area under the curves of 0.76 for L4 and 0.77 for L5 (optimal cut-off values: 96.6 HU and 92.6 HU, respectively). In osteoarthritic hips, area under the curve values were 0.82 for L4 and 0.83 for L5 (cut-off values: 118.9 HU and 100.8 HU, respectively).

Conclusions

Lumbar HU values moderately correlated with BMD at all measurement sites, especially at the TH. This may serve as a useful screening tool for osteoporosis before THA in patients with hip OA.

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.