中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (34): 6445-6448.doi: 10.3969/j.issn.1673-8225.2011.34.043

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

多孔钽棒置入治疗股骨头坏死16例

方  锐，梁治权，孟庆才，邓迎杰   

  1. 新疆医科大学第四附属医院 关节外科 ，新疆维吾尔自治区乌鲁木齐市  830000
  • 收稿日期:2010-12-02 修回日期:2011-01-30 出版日期:2011-08-20 发布日期:2011-08-20
  • 通讯作者: 梁治权，硕士，新疆医科大学第四附属医院关节外科，乌鲁木齐市 830000 xjlzq7028@sina.com.cn
  • 作者简介:方锐☆，男，1974年生，锡伯族，2009年上海中医药大学毕业，博士，副主任医师，研究生导师，主要从事骨关节疾病方面的研究。 xjlzq7028@sina.com.cn

Porous tantalum rod insertion for treatment of femoral head necrosis in 16 cases

Fang Rui, Liang Zhi-quan, Meng Qing-cai, Deng Ying-jie   

  1. Department of Joint Surgery, Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi  830000, Xinjiang Uygur Autonomous Region, China
  • Received:2010-12-02 Revised:2011-01-30 Online:2011-08-20 Published:2011-08-20
  • Contact: Liang Zhi-quan, Master, Department of Joint Surgery, Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China xjlzq7028@sina.com.cn
  • About author:Fang Rui☆, Doctor, Associate chief physician, Postgraduate’s supervisor, Department of Joint Surgery, Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China xjlzq7028@sina.com.cn

PDF

321

被引次数

16

摘要：

背景：髓心减压及钽棒置入治疗早期股骨头坏死的手术方法，尤其适合于股骨头坏死SteinbergⅠ期和Ⅱ期，既可以解决疼痛又可以防治股骨头的塌陷延缓坏死的进展，是一种值得尝试的新方法。
目的：探讨多孔钽棒置入治疗股骨头坏死的适应症及其临床疗效。
方法：纳入股骨头坏死16例18髋，根据Steinberg分期：Ⅰ期5髋，Ⅱ期12髋，Ⅲ期A 1髋。采用侧方小切口入路，行髓心减压及多孔坦棒置入。置入后6周内禁止负重，6~10周部分负重，逐步过渡至完全负重。采用Harris评分系统评估患者置入后髋关节功能改善情况；置入后24 h、1，3，6，12个月摄正侧位X射线平片，观察股骨头修复情况及有无坏死进展。
结果与结论：16例18髋获得随访，随访时间7~13个月。置入后末次随访进行疗效评估，优：11例12髋，良：4例5髋，可：1例1髋。患者Harris评分由置入前49~83分，平均(65.3±8.6)分，提高至置入后75~97分，平均(88.2±9.3)分，治疗前后比较差异有显著性意义(P < 0.05)。随访摄片髋关节影像学表现稳定，股骨头无坏死进展。提示，多孔钽棒假体置入治疗股骨头坏死疗效确切，尤其是对于SteinbergⅠ期，Ⅱ期及塌陷较小的 ⅢA期股骨头坏死的患者。

关键词: 钽棒, 假体, 置入, 股骨头骨坏死, 髓芯减压

Abstract:

BACKGROUND: Pith decompression and tantalum rod insertion for treatment of early femoral head necrosis, especially suitable for femoral head necrosis Steinberg Ⅰ and Ⅱ, which not only can solve the pain, but also can prevent and cure the collapse of the femoral head necrosis in the progress of delay, and is a worthwhile new method.
OBJECTIVE: To explore indication and clinical curative effect on porous tantalum rod insertion for treatment of femoral head necrosis.
METHODS: Sixteen cases of 18 hips with femoral head necrosis were included. According to Steinberg staging: Ⅰperiod 5 hips, Ⅱ period 12 hips, Ⅲ period A1hip. The lateral small incision approach was used to undergo pith decompression and porous tantalum rod insertion. After 6 weeks, weight loading was prohibited, part weight loading was allowed from 6 to 10 weeks, and gradually transition to full weight loading. The improvement of hip joint function after insertion was systematically evaluated by Harris rating system. At 24 hours, 1, 3, 6, 12 months after insertion, lateral X-ray film was disturbed, and the repair and necrosis progress was observed.
RESULTS AND CONCLUSION: Sixteen cases of 18 hips were obtained for follow-up (7-13 months). The last follow-up after insertion was undergo clinical efficacy evaluation, optimal for 11 patients of 12 hips, benign for 4 patients of 5 hips, general for 1 patient of 1 hip. Patients with Harris score preoperative 49-83 points, the average 65.3±8.6 points, increased to the postoperative 75-97 points, the average 88.2±9.3 points, there was significant difference between preoperative and postoperative (P < 0.05) . Follow-up radiography hip imaging displayed stably and no necrosis progress in femoral head. The curative effect on porous tantalum rod prosthesis insertion for treatment of femoral head necrosis is confirmed, especially for Steinberg Ⅰ period,Ⅱ period and collapse of smaller Ⅲ A period femoral head necrosis of patients.

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