髓芯减压自体骨髓细胞结合重组合异种骨移植治疗股骨内髁骨坏死  

Core Decompression with Reconstituted Bone Xenograft Combined with Autologous Bone Marrow Cells in Treatment of Osteonecrosis of the Femoral Medial Condyle

作　　者：王卫明[1] 赵德伟[1] 

机构地区：[1]大连医科大学附属中山医院骨科,辽宁省大连市116001

出　　处：《中国骨与关节损伤杂志》2005年第2期100-101,共2页Chinese Journal of Bone and Joint Injury

摘　　要：目的　应用病灶清除髓芯减压自体骨髓细胞结合重组合异种骨移植的方法治疗股骨内髁缺血性坏死 ,探索股骨内髁骨坏死的微创治疗方法。方法　采用上述术式治疗股骨内髁缺血性坏死 11例 ,均为单侧发病。病因特发性 7例 ,激素性 4例 ;术后平均随访 2～ 4年 ,根据手术前后膝关节评分、影像学表现进行随访观察。结果　术前膝关节功能评分平均为 6 3分 ,术后平均 92分 ,优良率 81 8% ;影像学表现 9例保持稳定。结论　病灶清除自体骨髓细胞结合重组合异种骨移植治疗股骨内髁骨坏死 ,手术操作简单、减少了供区的并发症、疗效确切 ,是一种值得提倡的微创手术治疗方法。Objective To research microinvasive method in the treatment of avascular necrosis of the medial femoral condyle at earlty stages.Methods Eleven patients with avascular necrosis of the femoral medial condyle at early stages were treated with core decompression and reconstituted bone xenograft combined with autologous bone marrow cells.Of these cases,3 were males and 8 were females.According to etiology 6 were idiopathic and 5 were secondary type.According to Yamamoto classification system 9 knees were stage Ⅱ,2 were stage Ⅲ.Patients were followed from 2 to 4 years.The outcome was determined by the changes in the knee society clinical rating system,by progression in radiographic stages.Results For the entire group,the mean knee score was 63 points preoperatively and 95 points postoperatively.At the latest follow-up 9 knees were radiographically stable.Conclusion The procedure of decompression with reconstituted bone xenograft combined with autologous bone marrow cells is effective in treating patients with earlier stages of avascular necrosis of the medial femoral condyle.This method is attractive as a salvage procedure,is relatively simple and microinvasive,and it may reduce complications on donor position.

关 键 词：髓芯减压 骨髓细胞 异种骨移植 股骨内髁骨 骨坏死 并发症 异种骨 

分 类 号：R687.3[医药卫生—骨科学]