中国组织工程研究2017，Vol.21Issue(22)：3464-3469,6.DOI:10.3969/j.issn.2095-4344.2017.22.004
自体骨髓基质干细胞联合带血管蒂髂骨瓣转移多孔钽棒植入治疗股骨头缺血性坏死
Autologous bone marrow stromal stem cells combined with vascular pedicle iliac bone flap and tantalum rob implantation for osteonecrosis of the femoral head
摘要
Abstract
BACKGROUND:There are a variety of treatments for femoral head necrosis,but their efficacy is not confirmed and unified.How to improve the differentiation ability of osteoblasts in the femoral head and improve the biomechanical support after the repair of the femoral head is an urgent problem to be solved.OBJECTIVE:To explore the clinical outcome of stem cells combined with vascularized iliac bone flap and tantalum rod implantation for the treatment of osteonecrosis of the femoral head (ONFH).METHODS:Totally 28 cases (36 hips) of non-traumatic ONFH admitted at the Zhongshan Hospital of Dalian University from January 2010 to January 2011 were enrolled.Bone marrow samples were extracted from each patient to isolate bone marrow stromal stem cells which were cultured in vitro for 2 weeks.Tantalum rod implantation with vascularized iliac bone graft was conducted to restore the femoral head shape,and then,prepared stem cell suspension were injected into the iliac bone flap and into the subchondral space of the femoral head.RESULTS AND CONCLUSION:All the 28 cases (36 hips) were followed up for 6-20 months (average 12 months),and their Harris hip scores and visual analogue scale scores at postoperative 6 and 12 months were significantly higher than the baseline (P ＜ 0.05).The Harris hip score at postoperative 12 months was significantly higher than that at postoperative 6 months (P ＜ 0.05),but there was no significant difference in the visual analogue scale scores at 6 and 12 months postoperatively (P ＞ 0.05).At the end of 12-month follow-up,clinical outcomes were excellent in 13 hips,good in 15 hips,fair in 4 hips,and poor in 4 hips,with an excellent and good rate of 90％.These findings indicate that autologous bone marrow stromal stem cell transplantation with vascularized iliac bone flap and tantalum rob implantation is an effective method with high clinical success rate for the treatment of ONFH.关键词
生物材料/骨生物材料/骨髓基质干细胞/带血运骨瓣/多孔钽棒/股骨头缺血性坏死/显微外科/目测类比评分/Harris髋关节功能评分分类
医药卫生引用本文复制引用
谢辉1,2,王子华2,赵德伟1,2,黄诗博2,王本杰2,王威2,覃开蓉1,崔大平2..自体骨髓基质干细胞联合带血管蒂髂骨瓣转移多孔钽棒植入治疗股骨头缺血性坏死[J].中国组织工程研究,2017,21(22):3464-3469,6.基金项目
国家十三五“国家重点研发计划”项目(2016YFC1102000)the National Key Research and Development Plan of China during the Thirteenth Five-Year Plan,No.2016YFC1102000 （2016YFC1102000）
