富血小板血浆联合生物陶瓷系统治疗ARCO Ⅱ期股骨头坏死  

Effect of platelet-rich plasma with bioceramic system on the treatment of ARCO stage Ⅱ osteonecrosis of the femoral head

作　　者：柴乐 丁晓 王斌[1] 陈旭[1] 郭甲瑞[1] 朱光普[1] 余进伟[1] Chai Le;Ding Xiao;Wang Bin;Chen Xu;Guo Jiarui;Zhu Guangpu;Yu Jinwei(The Second People’s Hospital of Jiaozuo City,Jiaozuo 454150,Henan Province,China)

机构地区：[1]焦作市第二人民医院,河南省焦作市454150

出　　处：《中国组织工程研究》2022年第15期2347-2351,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:生物陶瓷系统可通过多孔结构引导大转子附近及股骨颈血运至股骨头促进坏死修复,部分恢复股骨头颈力学性能,目前已被广泛应用于早期股骨头坏死的治疗。富血小板血浆对早期股骨头坏死的治疗具有一定的积极作用。目的:探讨富血小板血浆联合生物陶瓷系统置入治疗ARCOⅡ期股骨头坏死的临床疗效。方法:选择2016年7月至2020年5月焦作市第二人民医院收治的60例单侧ARCOⅡ期股骨头坏死患者,采用随机数字表法分2组,对照组30例接受生物陶瓷系统置入治疗,试验组30例接受自体富血小板血浆联合生物陶瓷系统置入治疗。治疗后定期复查患肢正位X射线片,判断股骨头形态变化;治疗后随访对比两组患者疼痛与髋关节功能。结果与结论:①两组患者治疗后均获得随访,随访时间12个月,其中试验组中1例出现股骨头塌陷,对照组中5例出现股骨头塌陷,予以髋关节置换手术,该6例患者被剔除,最终54例患者进入结果分析;随访期间,54例患者未发生材料宿主反应;②试验组治疗后3,6,12个月的目测类比评分均低于对照组(P<0.05),治疗后3,6,12个月的髋关节功能评分均高于对照组(P<0.05);③结果表明,富血小板血浆联合生物陶瓷系统微创治疗ARCOⅡ期股骨头坏死可促进坏死修复,有效改善患者髋部疼痛与关节功能。BACKGROUND:The bioceramic system can guide the blood supply near the greater trochanter and the femoral neck to the femoral head through the porous structure,there by promoti ng the repair of osteonecrosis and pa rtially restoring the mechanical properties of the femoral head and neck.It has been widely used in the treatment of early osteonecrosis of the femoral head.Platelet-rich plasma has a certain positive effect on the treatment of early osteonecrosis of the femoral head.OBJECTIVE:To investigate the clinical effect of platelet-rich plasma with the bioce ramic system on the treatment of Association Research Circulation Osseous(ARCO) stage Ⅱ osteonecrosis of the femoral head.METHODS:Sixty patients with ARCO stage Ⅱ osteonecrosis of the femoral head who were admitted to the Second People’s Hospital of Jiaozuo City from July2016 to May 2020 were randomly divided into two groups(n=30 per group):a control group and a test group.Patients in the control group received bioceramic system implantation.Patients in the test group received autologous platelet-rich plasma with bioceramic system implantation.After the treatment,the anteroposterior X-ray film of the affected limb was regularly reviewed to determine the morphological changes of the femoral head;and the severity of pain and hip joint function of patients in the two groups were compared.RESULTS AND CONCLUSION:Both groups of patients were followed up for 12 months.There was one patient in the test group and five patients in the control group who developed femoral head collapse.After hip arthroplasty,these six patients were excluded from the trial.Finally 54 patients were included in the result analysis.During the follow-up period,54 patients had no material host reaction.In the test group,the visual analogue scale scores were all lower than those in the control group at 3,6,and 12 months after treatment(P <0.05),and the hip function scores were all higher than those in the control group at 3,6,and 12 months after treatment(P <0.05).To conclude,platelet-ric

关 键 词：富血小板血浆 植入物 股骨头坏死 生物陶瓷 髓芯减压 植骨 髋关节功能 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]