中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (39): 7295-7298.doi: 10.3969/j.issn.1673-8225.2010.39.018

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

骨小梁金属AVN重建棒在早期股骨头坏死中的应用：2年45髋临床观察

张治宇1，蔡郑东2，王立强3，吴  军4，崔  岩1   

  1. 1中国医科大学附属第四医院骨科，辽宁省沈阳市  110034；2解放军第二军医大学长海医院骨科，上海市  200433；3卫生部北京中日友好医院骨科，北京市  10001；4解放军沈阳军区空军崇山路干休所门诊，辽宁省沈阳市  10032
  • 出版日期:2010-09-24 发布日期:2010-09-24
  • 作者简介:张治宇☆，男，1972年生，辽宁省沈阳市人，汉族，2009年解放军第二军医大学博士后出站，博士后，副教授，主要从事关节外科，骨肿瘤外科的基础与临床研究。davidzhang77@sohu.com

Application of trabecular metal AVN reconstruction rod for early osteonecrosis of the femoral head: Clinical observation of 45 hips in 2 years

Zhang Zhi-yu1, Cai Zheng-dong2, Wang Li-qiang3, Wu Jun4, Cui Yan1   

  1. 1 Department of Orthopedics, Fourth Hospital of China Medical University, Shenyang  110034, Liaoning Province, China; 2 Department of Orthopedics, Changhai Hospital of Second Military Medical University, Shanghai  200433, China; 3 Department of Orthopedics, China-Japan Friendship Hospital, the Ministry of Health, Beijing  10001, China; 4 Outpatient Clinic of Cadre Reset Institute, Shenyang Military Area Command of Chinese PLA, Shenyang  100032, Liaoning Province, China
  • Online:2010-09-24 Published:2010-09-24
  • About author:Zhang Zhi-yu☆, Doctor, Associate professor, Department of Orthopedics, Fourth Hospital of China Medical University, Shenyang 110034, Liaoning Province, China davidzhang77@sohu.com

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摘要：

背景：以往股骨头骨坏死的治疗方法多采用髓芯减压和某种植骨。但单纯髓芯减压缺少对软骨下骨板的结构支撑，血管蒂腓骨移植容易出现包括取骨区伴发的病损、延长的手术时间、失血以及在康复过程中的并发症。
目的：评定采用多孔钽置入联合髓芯减压治疗股骨头坏死髋关节的生存率。
方法：选择股骨头坏死Ⅰ期和Ⅱ期塌陷前的患者40例(45髋)，男32例，女8例，年龄29.5(20~40)岁。采用联合多孔钽置入联合髓芯减压治疗股骨头坏死，置入前后Harris评分评价髋关节功能，影像学评估并发症情况。
结果与结论：40例患者手术均顺利完成，无意外发生，均获得随访，12例随访24个月，18例随访12个月，10例随访6个月。40例患者术后关节功能均较术前明显改善，影像学显示坦棒均正确置入相应区域，未出现异常的骨密度、塌陷、假体松动及放射性透光线的表现。说明采用多孔钽置入物联合髓芯减压治疗股骨头坏死，可延缓或预防关节软骨的逐渐塌陷。

关键词: 多孔钽, 股骨头坏死, 置入, 手术, 髓芯减压, 医学植入物

Abstract:

BACKGROUND: Core decompression and bone grafting have been used to treat osteonecrosis of the femoral head. However, core decompression alone has no adequate supports to bone plate beneath cartilage, and blood vessel pedicle fibular grafting induces damage in donor region, prolonged operation time, blood loss and complications during rehabilitation.
OBJECTIVE: To judge the survival rate of core decompression and tantalum rod to treat the osteonecrosis of the femoral head.
METHODS: A total of 40 patients (45 hips) with osteonecrosis of the femoral head at stage I and II before collapse, comprising 32 males and 8 females, aged 29.5 (20-40) years, were selected. The combination of core decompression and Tantalum rod method was used to treat the femoral head osteonecrosis. Harris scores were used to evaluate hip function and imaging was performed to evaluate complications. 
RESULTS AND CONCLUSION: All 40 patients completed the operation successfully, with no events. All patients were followed up, including 12 for 24 months, 18 for 12 months, and 10 for 6 months. The joint function of all patients was significantly improved following treatment. Imaging data showed that the tantalum rod was well placed in corresponding region, with no abnormal density, collapse, prosthesis loosening and radioactive lucency. Results show that core decompression and tantalum rod in the treatment of osteonecrosis of femoral head can delay or prevent continuous sinking of joint cartilage.

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