【摘要】 目的探讨带旋髂深血管蒂髂骨瓣和骨形态发生蛋白(bone morphogenetic prote in,BMP)人工骨移植治疗股骨头缺血性坏死的方法及临床疗效。方法2000年1月~2006年8月采用带旋髂深血管蒂髂骨瓣联合BMP人工骨移植治疗股骨头缺血性坏死25例(29髋),左髋18例,右髋11例。按F icat分期:Ⅰ期8例(10髋),Ⅱ期14例(16髋),Ⅲ期3例(3髋)。结果术后平均随访37.6(24~60)个月。移植骨瓣与股骨颈均愈合,平均愈合时间3.6(3~8)个月。按Harris评分,优15例16髋,良7例10髋,可3例3髋,优良率89.7%。结论带旋髂深血管蒂髂骨瓣和BMP人工骨移植能有效重建股骨头的血运、清除死骨、降低髓腔压力、支撑股骨头关节软骨面和BMP能诱导成骨的特点,能有效治疗股骨头缺血性坏死。更多还原

【Abstract】 Objective To explore the therapeutic methods and effects of avascular necrosis of the femoral head treated by transplantation of vascularized iliac bone with deep iliac circumflex blood vessel and artificial bone with bone morphogenetic protein(BMP). Methods From January 2000 to August 2006,25 adult patients with avascular necrosis of the femoral head were treated by transplantation of vascularized iliac bone with deep iliac circumflex blood vessel and artificial bone with BMP.Total 29 coxaes were involved,including 18 of left coxaes and 11 of right coxaes.There were 8 cases(10 coxaes) of stage Ⅰ,14 cases(16 coxaes) of stage Ⅱ and 3 cases(3 coxaes) of stage Ⅲ according to Ficat Staging. Results All patients were followed up from 24 to 60 months(average,17.8 months).The grafting iliac bone and femoral head were healed in 3 to 8 months(average,3.6 months).According to Harris score standard,the result revealed excellence in 15 cases(16 coxaes),good in 7 cases(10 coxaes),fair in 3 cases(3 coxaes),and the fineness rate was 89.7%. Conclusion Transplantation of vascularized iliac bone with deep iliac circumflex vessel and artificial bone with BMP can restore the blood supply of the femoral head,eliminate the necrotic bones,decompress the marrow cavity,support the femoral head and BMP bone,and induce osteogenesis,and it is an effective method for avascular necrosis of femoral head in adult.更多还原