钽棒置入治疗早期股骨头坏死的中期随访  

Mid-term outcome of patients with early-stage osteonecrosis of the femoral head treated with porous tantalum implant

作　　者：陈元良[1] 张寿[1] 钟海波[1] 

机构地区：[1]海南省海口市人民医院骨科中心关节外科570100

出　　处：《中国矫形外科杂志》2013年第21期2146-2150,共5页Orthopedic Journal of China

摘　　要：[目的]分析钽棒治疗早期股骨头坏死的中期临床疗效，探讨影响生存率的临床因素。[方法]收集2007年2月～2011年2月间本院钽棒治疗早期股骨头坏死病例89例（98髋），男48例，女41例；平均年龄（34．88±5．21）岁（24～46岁）。根据ARCO分期，Ⅰ期52髋和Ⅱ期46髋，其中双侧9例。对所有患者进行Harris评分和影像学评估，计算坏死指数。将Harris评分70分以下、再次手术、影像学病变进展（股骨头由非塌陷变塌陷或塌陷加重）视为钽棒失败。对数据进行统计学分析。[结果]共随访到78例85髋，平均随访时间（42．08±12．71）个月（24～58）个月，术前平均Harris评分为（61．82±7．54）个月，术后为（79．15±7．80）个月（P〈0．01）。失败率为28．24％，优良率为71．76％。多重Logistic回归分析显示坏死指数〉33％、术前Harris评分低于50是手术失败的风险因素，病因、性别、年龄、坏死部位对钽棒治疗早期股骨头坏死的临床疗效无明显影响。[结论]钽棒治疗早期股骨头坏死中期随访疗效较佳。影响钽棒治疗早期股骨头坏死临床疗效的因素是坏死指数（〉33％）、术前Harris评分〈50。[ Objective] To evaluate the clinical and radiographic midterm outcomes of patients with early- stage osteonecrosis of the femoral head （ONFH） treated with porous tantalum implants. [ Methods ] Total 89 patients with ONFH （98 hips） were treated with porous tantalum implants. Harris score, radiography, and clinical outcomes were used for evaluating outcomes. Revision was considered as the endpoint of porous tantalum implantation. [ Results] Seventy -eight patients （85 hips） were available for follow - up at a mean of （42. 08 ±12. 71 ） months （24 ± 58 months） . According to the analysis of multinomial logistic, the necrosis index and preoperative Harris score were independent risk factors for failure. [ Conclusion] Our results indicate good outcomes for the mid - term outcome of patients with early - stage ONFH treated with porous tantalum implants. The survival rate after treatment of early - stage ONFH with porous tantalum implantationis is affected by the necrosis index and preoperative Harris score.

关 键 词：股骨头坏死 钽棒 坏死指数 HARRIS评分 

分 类 号：R681.8[医药卫生—骨科学]