机器人导航系统辅助髓芯减压植骨治疗早期股骨头缺血性坏死  

Robot navigation system assisted core decompression and bone grafting on early-stage osteonecrosis of the femoral head

作　　者：张才东 罗晓中[1] 丁勇[1] 童祎[1] 石维祥[1] 王佳琦 ZHANG Cai-dong;LUO Xiao-zhong;DING Yong;TONG Yi;SHI Wei-xiang;WANG Jia-qi(Dept of Orthopaedics,Zigong Fourth People′s Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院骨科,四川自贡643000

出　　处：《临床骨科杂志》2025年第1期56-60,共5页Journal of Clinical Orthopaedics

基　　金：四川省自贡市科技局重点研发计划(编号:2021YLSF17)。

摘　　要：目的探讨机器人导航系统辅助髓芯减压植骨治疗早期股骨头缺血性坏死(ONFH)的疗效。方法将34例早期ONFH患者按照随机数字表法分为机器人导航组(采用机器人导航系统辅助髓芯减压植骨治疗,18例,25髋)和传统组(采用传统髓芯减压植骨治疗,16例,21髋)。比较两组手术情况、保髋情况。采用疼痛VAS评分评价疼痛情况,采用Harris评分评价髋关节功能恢复情况。结果患者均获得随访,时间12~28(17.3±4.2)个月。术中钻孔次数、术中透视次数及手术时间机器人导航组均少(短)于传统组(P<0.05)。3例3髋(机器人导航组1例1髋、传统组2例2髋)保髋失败,保髋失败率两组比较差异无统计学意义(P>0.05);其余31例(43髋)股骨头坏死进展均比较缓慢。剔除保髋失败者,疼痛VAS评分、Harris评分:两组术后各时间点均优于术前(P<0.05),术后各时间点两组组内及组间比较差异均无统计学意义(P>0.05)。结论髓芯减压植骨治疗早期ONFH能延缓骨坏死进展,减少股骨头塌陷,减轻患者疼痛并改善髋关节功能,短期疗效肯定。与传统方式相比,机器人导航系统辅助具有术中透视及钻孔次数减少、手术时间缩短、电离辐射伤害降低的优势。Objective To investigate the efficacy of robot navigation system assisted core decompression and bone grafting for treatment of early-stage osteonecrosis of the femoral head(ONFH).Methods Thirty-four patients with early-stage ONFH were randomly divided into two groups:the robot navigation group(18 cases,25 hips)and the conversational group(16 cases,21 hips),the robot navigation group was performed with the robot navigation system assisted the core decompression and bone grafting,and the conversational group was treated with conversational core decompression and bone grafting.The situation of operation and hip preservation were compared between the two groups.The pain condition was evaluated with pain VAS,and the hip function was assessed by Harris scores.Results All patients were followed up for 12~28(17.3±4.2)months.The frequency of intraoperative drilling and fluoroscopy,operation time in the robot navigation group were less(shorter)than those in the conversational group(P<0.05).The 3 cases with 3 hips(there were 1 case with 1 hip in the robot navigation group,and 2 cases with 2 hips in the conversational group)failed hip preservation,there was no statistical difference in the failure rate of hip preservation between the two groups(P>0.05);while in the other 31 cases(43 hips),the progress of ONFH was slower.Except of the failure patients of hip preservation,the scores of VAS and Harris:At various time-points after operation,the two groups were better than the preoperation(P<0.05),and there were no statistical differences between the two groups and intra-group of two groups(P>0.05).Conclusions Core decompression and bone grafting for treatment of early-stage ONFH can delay the progress of osteonecrosis,reduce the collapse of femoral head,relieve pain and improve hip function.Compared with the conversational method,the robot navigation system assistant has the advantages of less intraoperative frequency fluoroscopy and drilling,shorter operation time and less ionizing radiation injuries.

关 键 词：早期股骨头坏死 机器人导航 髓芯减压 植骨 

分 类 号：R681.8[医药卫生—骨科学] R687.3[医药卫生—外科学] R319[医药卫生—临床医学]