【作者】 杨述华； 许伟华； 杨操； 李进； 叶树楠； 吴星火；

【Author】 Yang shu-hua,Wu xing-huo,Yang cao,et al.Department of Orthopedics,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China 430022

【机构】 华中科技大学同济医学院附属协和医院骨科；

【摘要】 目的回顾性分析髓心减压及异体螺纹骨笼结合脱钙骨基质和自体骨植入治疗早期股骨头坏死的临床疗效,探讨其影响因素。方法我院于2000年2月至2005年8月间收治早期股骨头坏死37例(39髋),均采用髓心减压及异体螺纹骨笼结合脱钙骨基质和自体骨植入,术后预防性的静脉给予抗生素及抗凝治疗,并限制负重。临床评估采用Harris评分系统,评估术后患髋功能的改善情况,并定期行X线检查。结果37例患者(39髋)均获得随访,在术后24个月进行疗效评估。参考Harris评分系统,本组优21髋,良9髋,可4髋,差5髋。患者术前的平均Harris评分为63.5分,术后平均评分为81.1分,平均提高了17.6分(P<0.001)。髋关节影响学表现稳定,股骨头无坏死进展。结论髓心减压及异体螺纹骨笼结合脱钙骨基质和自体骨植入术治疗早期股骨头坏死临床效果满意,有利于骨坏死的修复和重建,适合于Ⅰ期和Ⅱ期股骨头坏死的患者。更多还原

【Abstract】 Objective To evaluate the clinical outcome associated with core decompression in combination with allograft threaded cage insertion incorporated with decalcified bone matrix and autogenous bone in a consecutive series of patients with osteonecrosis of the femoral heads retrospectively.Methods From February 2000 to August 2005,a series of 37 patients(39 hips) who had undergone core decompression in combination with allograft threaded cage insertion in our hospital were involved in this study. Postoperative care consisted of prophylactic intravenous antibiotic and anticoagulation therapy.All patients were evaluated both clinically and radiographically.The primary clinical outcome of this study was functional improvement assessed with the Harris hip score.Resluts All thirty - seven patients(thirty - nine hips) were retrospective studied after 24 - month follow up.According to the Harris hip score system,"excellent" for 21 hips,"good" for 9 hips,"fair" for 4 hips and "poor" for 5 hips.The mean pre - operative score was 63.5,the mean post - operative score was 81.1,with a mean improvement of 17.6 points(P<0.001).? All hips were radiologically stable,with on progress of necrosis.Conclusions Core decompression in combination with allograft threaded cage insertion incorporated with decalcified bone matrix and autogenous bone provides a surgical treatment option to treat early stage osteonecrotic hips with perfect clinical outcomes,which is recommended in almost all patients of femoral head necrosis with stageⅠandⅡ.更多还原