钽棒植入治疗早期股骨头骨坏死的临床研究  

Clinical study of avascular necrosis of the femoral head with implantation of a porous tantalum rod

作　　者：邵世坤[1] 邢林卿[1] 张宝龙[1] 刘军[1] 

机构地区：[1]郑州人民医院骨一科,河南郑州450003

出　　处：《中国伤残医学》2013年第6期11-13,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:分析应用钽棒植入治疗早期股骨头坏死的疗效及方法,探讨股骨头坏死保髋治疗的新方法。方法:2008年5月～2008年11月,对8例股骨头坏死早期患者(FicatⅠ、Ⅱ期),通过大转子下钻股骨颈隧道至股骨头坏死区,髓心减压,自体骨植骨,植入钽棒至软骨下骨约3～5 mm处。观察手术前后Harris评分、X线、CT、MRI影像学表现。结果:7例患者获得随访,平均随访时间28个月(17～36个月),以最后一次随访资料作为最终评价依据。术前Harris评分56分,术前优良率为25.0%(2/8),术后Harris评分88.3分,术后优良率为85.7%(6/7)。7个髋关节影像学表现保持稳定,无并发症发生。结论应用钽棒植入治疗早期股骨头坏死,有利于股骨头坏死的修复与重建,能有效预防股骨头塌陷,具有创伤小,操作简单,值得临床推广使用。Objective：To investigate the method in the treatment of avascular necrosis of femoral head at early stage.Methods：We treated 8 patients（8 hips） with stageⅠ,Ⅱavascular necrosis of the femoral head,according to the Ficat Classification System,from May 2008 to November 2008.The hips were treated with modified core decompression,autogenous bone transplantation and an implantation of porous tantalum rod until 3～5 mm beneath the articular cartilage.7 patients were followed and the outcomes were evaluated by the changes of the Harris hip scores,the progression in radiographic stages,CT,MRI.Results：All the patients were followed up for a mean of 28 months（range,17～36 months）.The rate of excellent -or-good results in the Harris hip scores was improved from 25.0%（2/8） preoperatively to 85.7.%（6/7 ） postoperatively.A total of 7 hips was radiologically stable.No major complications occurred. Conclusion：The implantation of porous tantalum rod might be one of favorable alternatives that can prevent the necrosis femoral head from progressing to collapse and promote revascularization and promote new bone formation by direct mechanical support.The technique is suitable for the treatment of avascular necrosis of femoral head at stageⅠ～Ⅱ.

关 键 词：股骨头坏死 钽棒 外科治疗 

分 类 号：R683[医药卫生—骨科学]