中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (45): 8453-8459.doi: 10.3969/j.issn.2095-4344.2012.45.017

• 干细胞移植 stem cell transplantation • 上一篇    下一篇

计算机导航辅助自体干细胞回植治疗早期股骨头坏死

崔大平1，2，赵德伟1，2   

  1. 1大连理工大学电信学院，辽宁省大连市 116085
    2大连大学附属中山医院骨科，辽宁省大连市 116001
  • 收稿日期:2012-08-22 修回日期:2012-09-03 出版日期:2012-11-04 发布日期:2013-03-16
  • 通讯作者: 赵德伟，博士，主任医师，大连理工大学电信学院，辽宁省大连市 116085；大连大学附属中山医院骨科，辽宁省大连市 116001 deweizhao.dush@gmail.com
  • 作者简介:崔大平★，男，1978年生，辽宁省大连市人，汉族，2007年遵义医学院毕业，硕士，副主任医师，主要从事显微修复外科相关研究。 cuidaping@126.com

Treatment of early osteonecrosis of femoral head with autologous stem cells transplantation by computer navigat

Cui Da-ping1, 2, Zhao De-wei1, 2   

  1. 1Telecommunications College, Dalian University of Technology, Dalian 116085, Liaoning Province, China
    2Department of Orthopedics, Zhongshan Hospital of Dalian University, Dalian 116001, Liaoning Province, China
  • Received:2012-08-22 Revised:2012-09-03 Online:2012-11-04 Published:2013-03-16
  • Contact: Zhao De-wei, Doctor, Chief physician, Telecommunications College, Dalian University of Technology, Dalian 116085, Liaoning Province, China; Department of Orthopedics, Zhongshan Hospital of Dalian University, Dalian 116001, Liaoning Province, China deweizhao.dush@gmail.com
  • About author:Cui Da-ping★, Master, Associate chief physician, Telecommunications College, Dalian University of Technology, Dalian 116085, Liaoning Province, China; Department of Orthopedics, Zhongshan Hospital of Dalian University, Dalian 116001, Liaoning Province, China cuidaping@126.com

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540

被引次数

5

摘要：

背景：如何利用组织工程技术修复股骨头塌陷的软骨，是塌陷后股骨头坏死治疗的主要研究方向。
目的：观察计算机导航辅助及关节镜监视下髓芯减压自体骨髓间充质干细胞体外培养自体回植治疗早期股骨头缺血性坏死的方法及疗效。
方法：根据世界骨循环研究学会国际骨坏死分期标准，选取早期股骨头缺血性坏死患者104例，均在计算机导航辅助下实施髓芯减压术，同时关节镜监视下进行坏死病灶清除，其中53例在此基础上二期植入体外分离培养的1×109 L-1自体骨髓间充质干细胞2 mL。
结果与结论：经平均30个月的随访及磁共振检查发现，所有患者股骨头坏死体积均明显减小，Harris评分明显提高(P < 0.05)；其中给予自体骨髓间充质干细胞回植的患者改善更明显(P < 0.05)，其临床成功率和影像学成功率分别达92%和90%，且未见明显的不良反应。说明计算机导航辅助及关节镜监视下髓芯减压自体骨髓间充质干细胞体外培养回植是一种安全、有效的治疗早期股骨头缺血性坏死的方法，效果优于单纯髓芯减压。

关键词: 股骨头缺血性坏死, 计算机导航, 髓芯减压, 关节镜, 干细胞移植, 骨髓间充质干细胞, 早期股骨头坏死, 骨关节炎, 髋关节, 髋功能障碍

Abstract:

BACKGROUND: How to use the tissue engineering technique to repair the cartilage with femoral head collapse is the main research direction in the treatment of the femoral head necrosis after collapse.
OBJECTIVE: To observe the therapeutic effect of in vitro cultured autologous bone marrow mesenchymal stem cells transplantation on the treatment of early osteonecrosis of femoral head by computer navigation and arthroscopy.
METHODS: 104 patients with early osteonecrosis of femoral head were collected according to the international classification of osteonecrosis of Association Research Circulation Osseous, all the patients received the core decompression under the aids of computer navigation, and the necrosis debridement was performed under arthroscopy. Among them, 53 patients received phase two transplantation of 2 mL in vitro isolated and cultured bone autologous bone marrow mesenchymal stem cells at 1×109 /L.
RESULTS AND CONCLUSION: After 30 months follow-up and magnetic resonance examination, the femoral head necrosis volume of all patients were reduced significantly, and the Harris score was increased significantly (P < 0.05); the femoral head necrosis volume and Harris score of the patients with autologous bone marrow mesenchymal stem cells transplantation were improved more significantly (P < 0.05), the clinical success rate and radiographic success rate was 92% and 90%, respectively; no obvious adverse reactions were observed. Core decompression and autologous bone marrow mesenchymal stem cells in vitro culture and transplantation by computer navigation and arthroscopy is a safe and effective method for the treatment of early avascular necrosis of femoral head, and the effect is better than the core decompression.

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