经皮头颈开窗人工骨支撑植骨术治疗早期股骨头坏死Artificial bone grafting through percutaneous fenestration for treatment of early osteonecrosis of femoral head
谢林;马俊;邓立庆;康鹏德;
摘要(Abstract):
[目的]探讨经皮头颈开窗人工骨支撑植骨术治疗早期股骨头坏死(塌陷前期)的近期临床疗效。[方法]2010年8月~2012年1月,本组共46例(51髋)患者接受经皮头颈开窗人工骨支撑植骨术治疗早期股骨头坏死(ACROⅡ期),其中男31例,女15例,平均年龄36.4岁,29例为酒精性ONFH,17例为激素性ONFH。术后第1、2、3、6个月、1年及以后每年门诊定期随访、X线片复查,依据Harris髋关节评分及优良率评估疗效。[结果]经过至少2年(25~52个月,平均38.6个月)随访,共44例(49髋)得到末次随访(失访率4.08%)。Harris评分由术前(73.50±6.81)分提高到末次随访时的(87.30±9.62)分,优良率由术前32.65%提高至末次随访时的87.75%,其中ACROⅡA期由37.50%提高到100%,ⅡB期由34.78%提高到91.30%,ⅡC期由27.77%提高到77.77%,手术前后优良率的差异具有统计学意义(P<0.05)。该组共有8.16%(4/49)的患者最终行全髋关节置换术,其中ACROⅡA期0例,ⅡB期1例,ⅡC期3例;影像学显示共有14.29%(7/49)的患者发生影像学进展,其中ACROⅡA期0例,ⅡB 3例,ⅡC期4例。[结论]经皮头颈开窗人工骨支撑植骨术治疗早期股骨头坏死的近期疗效满意,具有操作简单、手术创伤小、恢复快及并发症少等优点,但中远期临床效果尚待进一步观察。
关键词(KeyWords): 股骨头坏死;钻孔减压;植骨;治疗
基金项目(Foundation): 国家自然科学基金面上项目(编号:81271976/H0605、81171763);; 卫生部卫生行业科研专项基金项目(编号:2013020007);; 四川省应用基础研究项目(编号:2013JY0151)
作者(Author): 谢林;马俊;邓立庆;康鹏德;
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DOI:
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