关节镜下髓芯减压骨膜骨颗粒移植治疗股骨头坏死  

Treatment for Osteonecrosis of Femoral Head with Morselized Periosteum and Bone Grafting after Arthroscopic Core Decompression

作　　者：李亚屏[1] 赵庆安 许海平[1] 石福明[3] 史增元[1] 刘振新[1] 刘慧松 

机构地区：[1]宁波大学附属医院,浙江省宁波市315020 [2]厦门市集美医院 [3]洛阳正骨医院

出　　处：《中国骨与关节损伤杂志》2007年第11期902-904,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察关节镜下髓芯减压骨膜骨颗粒坚实充填移植治疗青壮年股骨头坏死的临床效果。方法对25例(36髋)股骨头坏死于X线机透视下在股骨大转子下经股骨颈打1条通向病灶的骨隧道,经该隧道放置关节镜并行病灶清除;用约3mm×3mm×3mm的自体髂骨颗粒与1mm3的胫前骨膜颗粒的混凝物坚实充填股骨头骨洞。参照百分法进行疗效分析。结果X线片多显示较好的骨修复,疼痛及功能多改善明显。总优良率为72.2%,其中Ⅰ期(3髋/3髋)、Ⅱ期(15髋/19髋)、ⅢA和ⅢB期(7髋/11髋)患者治疗效果较好,ⅢC期较差(1髋/3髋)。结论初步观察该方法可用于治疗Ⅰ期、Ⅱ期、ⅢA期、ⅢB期青壮年股骨头坏死患者。Objective To observe the clinical effect of arthroscopy core decompression and morselized bone and periosteum grafting for treatment of ostconecrosis of femoral head （ONFH）. Methods A tunnel to the focus was made in the femoral neck under radioscopy, through which the focus was eliminated under arthroscopy supervision. The morselized bones （3 mm×3 mm×3 mm） from the ilium and the morselized periosteum （ 〈 1 mm^3） from anterior tibia periosteum （6-12 cm^2, approximately equaled to the surface area of cavity in femoral head） were obtained, and they were concreted by a little fibrin glue and stuffed firmly into the cavities of the femoral heads. Results According to the Harris criteria, the rate of excellent and good results was 72.2%. The results were better in Stage Ⅰ （3/3）, Stage Ⅱ （15/19） and Stage Ⅲ A, B （7/11）, and were poor in Stagem C （1/3）. Conclusion Such method can be used in the young and middle aged patients with ONFH in Stage Ⅰ , Stage Ⅱ and Stag Ⅲ A, B.

关 键 词：关节镜 髓芯减压 颗粒骨膜 颗粒骨 股骨头坏死 

分 类 号：R681.8[医药卫生—骨科学]