钽棒植入远端中心点与骨坏死中心区域距离对股骨头坏死手术效果影响初步研究  

Effects of the distance between the center of tantalum rod implantation and osteonecrosis region on femoral head necrosis surgery outcomes

作　　者：朱文明 邸腾飞 于宝占 张昊[1] ZHU Wen-ming;DI Teng-fei;YU Bao-zhan;ZHANG Hao(Department of Orthopedics,Baoding Second Hospital,Baoding,Hebei,071051,China)

机构地区：[1]保定市第二医院骨二科,河北省071051

出　　处：《中国骨与关节杂志》2025年第3期248-253,共6页Chinese Journal of Bone and Joint

基　　金：保定市科技支撑计划项目(17ZF319)。

摘　　要：目的探讨钽棒植入远端中心点与骨坏死中心区域距离对Ficat Ⅱ期股骨头坏死患者手术效果影响。方法回顾分析2018年9月至2021年12月在我院手术的90例Ficat Ⅱ期股骨头坏死患者的临床资料,根据钽棒植入远端中心点与骨坏死中心区域距离将患者分为3~6 mm组(60例)和>6 mm组(30例),比较两组患者术后12个月髋关节恢复情况,评估并比较两组术前、术后6个月和12个月以及末次随访时间点Harris髋关节评分和视觉模拟评分(visual analogue scale,VAS),记录两组患者术后并发症发生率及塌陷率。结果钽棒植入远端中心点与骨坏死中心区域距离为3~6 mm组患者术后髋关节恢复优良率显著高于>6 mm组(96.67%vs.80.00%,P<0.05);术后6个月、12个月以及末次随访时,3~6 mm组患者VAS评分显著低于>6 mm组(P<0.05),且末次随访时3~6 mm组Harris评分高于>6 mm组(86.12±6.77 vs.81.45±6.26,P<0.05);3~6 mm组患者术后并发症及塌陷发生率显著低于>6 mm组,差异均有统计学意义(P<0.05)。结论钽棒植入术中钽棒植入远端中心点与骨坏死中心距离对早期股骨头坏死术后疗效存在显著影响,且保持该距离为3~6 mm更有利于延缓股骨头坏死后塌陷。Objective To explore the effect of the distance between the distal center point of tantalum rod implantation and the central area of bone necrosis on the surgical effect of patients with Ficat Ⅱ femoral head necrosis.Methods The clinical data of 90 patients with Ficat Ⅱ femoral head necrosis who underwent surgery in our hospital from September 2018 to December 2021 were retrospectively analyzed.According to the distance between the distal center point of tantalum rod implantation and the central area of bone necrosis,all patients were divided into 3-6 mm group(60 cases)and>6 mm group(30 cases).The hip joint recovery of the two groups was compared12 months after surgery.The Harris hip score and VAS score(visual analogue scale,VAS)before surgery,6 months,12 months after surgery and at the last follow-up were evaluated and compared between the two groups.The incidence of postoperative complications and collapse rate of the two groups were recorded.Results The postoperative hip joint recovery rate of patients in the group with a distance of 3-6 mm was significantly higher than that in the>6 mm group(96.67%vs.80.00%,P<0.05);at 6 months,12 months after surgery and at the last follow-up,the VAS scores of patients in the 3-6 mm group were significantly lower than those in the>6 mm group(P<0.05),and the Harris score in the 3-6 mm group was higher at the last follow-up(86.12±6.77 vs.81.45±6.26,P<0.05);the incidence of postoperative complications and collapse in the 3-6 mm group was significantly lower than that in the>6 mm group,and the differences were statistically significant(P<0.05).Conclusions During tantalum rod implantation,the distance between the tip of the tantalum rod and the center of necrosis has a significant impact on the postoperative efficacy of early femoral head necrosis.Keeping the distance at 3-6 mm is more conducive to delaying the collapse of the femoral head after necrosis.

关 键 词：股骨头坏死 假体和植入物 治疗结果 钽棒 

分 类 号：R687.3[医药卫生—骨科学]