Selection of femoral prosthesis in total hip replacement for ankylosing spondylitis

强直性脊柱炎全髋关节置换术中股骨假体的选择

Twenty-four patients (36 hips) admitted for cementless total hip replacement (THR) because of AS were enrolled in this study along with the control group of 30 patients (45 hips) without AS.

二十四例（36髋）为非骨水泥型全髋关节置换（THR） ，对照组30例（45髋）

Measurement of the Singh index, canal flare index, morphological index of the cortex, cortical index and stem-canal fit was performed in the two groups on the basis of roentgenograms.

对singh指数、髓腔大小、皮质形态指数、皮质指数、假体与骨干的匹配在影像学上进行对比。

The AS patients had more serious osteoporosis in their proximal femur.

AS患者股骨近端有更严重的骨质疏松。

There were significant differences between the two groups in Singh index, canal flare index, morphological index of the cortex and stem-canal fit (P<0.05), but not in the cortical index (P>0.05).

两组对比有显著的差异，皮质指数无明显差异。

The AS patients were found to have severe osteoporosis in the upper femur and massive spongy bone loss, so that the morphology of the canal was almost orthostatic in the upper femur because of the thinned femoral cortex.

AS患者在股骨上部有严重的骨质疏松症和大量的海绵状骨丢失，因为骨皮质变薄，因此髓腔的形态几乎是直的。

Cemented prosthesis is recommended for AS patients with severe osteoporosis, who should be treated with revised THR to ensure good fit of the prosthesis to the canal. Cementless prosthesis, however, can still achieve good therapeutic effect in AS patients without significant morphologic changes in the proximal femurs.

对于严重骨质疏松的患者，推荐使用骨水泥假体，以确保假体与运河的良好吻合。            

非骨水泥假体，然而，如果股骨近端没有形态学变化用非骨水泥型可以取得良好的治疗效果。

Computer-aided design and manufacture of individualized prosthesis better suits the AS patients than the currently available prosthesis.

计算机辅助设计和个性化设计的假体是最适合AS患者的，比目前市场常规的假体要好。