应用自体股骨髁骨软骨整体移植微创治疗ARCOⅢ期股骨头缺血坏死  

Minimally invasive treatment of ARCO stage III avascular necrosis of femoral head(ANFH)using autologous femoral condylar intact bone-cartilage graft

作　　者：王娟[1] 陈伟[1] 李会杰[1] 连晓东[1] 侯志勇[1] 邵新中[1] 邵德成[1] 朱燕宾 王忠正 王宇钏 张英泽[1] Wang Juan;Chen Wei;Li Huijie;Lian Xiaodong;Hou Zhiyong;Shao Xinzhong;Shao Decheng;Zhu Yanbin;Wang Zhongzheng;Wang Yuchuan;Zhang Yingze(Hebei Institute of Orthopaedics,The Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院,河北省骨科研究所,石家庄050051

出　　处：《中华老年骨科与康复电子杂志》2022年第4期193-196,共4页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金面上项目(82072447)。

摘　　要：ARCOⅢ期股骨头缺血坏死伴有股骨头塌陷,对于年轻患者采用换髋或保髋手术治疗仍然存在争议。课题组在前期试验基础上,率先采用微创保髋手术、取自体股骨髁骨软骨整体移植骨块植骨治疗。术前根据患者X线、CT图像以及3D打印模型详细规划,术中在C型臂透视下行髓芯减压,在患者同侧股骨髁非主要负重部位使用环钻切取合适直径的自体骨软骨整体移植,将该移植物填充股骨头塌陷区域,取髂骨骨块填充股骨髁和股骨近端骨隧道。术后CT扫描显示植骨块与周围股骨头基本齐平,实现术前规划目的。该微创手术为年轻的ARCOⅢ期股骨头缺血坏死患者行保髋手术治疗提供了有益借鉴。ARCO stageⅢavascular necrosis of femoral head(ANFH)is accompanied by collapse of the femoral head.For young patients with ANFH,it is still controversial to adopt hip replacement or hippreserved surgery.Based upon our experience and previous experiments on the treatment of ANFH,the research group adopted minimally invasive hip preservation surgery.Before the operation,the detailed planning was made according to X-ray,CT images and 3D printing models.During the operation,core decompression was performed under C-arm fluoroscopy.The autologous intact bone-cartilage graft was obtained from the comparatively unimportant part of the femoral condyle,which was then transplanted to fill the collapsed area of the femoral head under C-arm.The iliac bone graft was resected to fill the tunnels in the femoral condyle and proximal femur.After the operation,the CT scan demonstrated that the intact bone-cartilage graft was flush with the surrounding femoral head,achieving the purpose of preoperative planning.This minimally invasive surgery provides a valuable and useful reference for young patients with ARCO stageⅢANFH.

关 键 词：股骨头缺血坏死 塌陷 微创保髋手术 骨软骨整体植骨块 

分 类 号：R687.3[医药卫生—骨科学]