中国骨伤2018，Vol.31Issue(1)：56-61,6.DOI:10.3969/j.issn.1003-0034.2018.01.010
关节镜引导下髓芯减压植骨联合选择性动脉灌注治疗早期股骨头坏死
Arthroscopy-guided core decompression and bone grafting combined with selective arterial infusion for treatment of early stage avascular necrosis of femoral head
摘要
Abstract
Objective:To observe the clinical effects of arthroscopy-guided core decompression and bone grafting combined with selective arterial infusion for early stage avascular necrosis of femoral head.Methods:From January 2010 to December 2014,76 patients (76 hips) diagnosed as Ficat Ⅱ stage avascular necrosis of femoral head were randomly divided into experimental group and control group.In the experimental group,there were 27 males and 8 females aged from 24 to 55 years old with an average of (43.96±6.81) years,treated with arthroscopic-guided core decompression and bone grafting combined with selective arterial infusion.Along the direction of the femoral neck,an 8 mm-diameter tunnel to necrotic areas was drilled,then curettage of necrotic bone was performed under arthroscope,and the iliac bone was grafted.In the control group,there were 29 males and 12 females aged from 26 to 56 years old with an average of (44.62±7.33) years,treated with percutaneous core decompression combined with selective arterial infusion.The preoperative and postoperative Harris scores were recorded and the changes of X-rays were analyzed.Results:All the patients were followed up with an average of 30 months.Postoperative follow-up at 12 months showed that there was significant difference in imaging outcome between two groups (P＜0.05),the experimental group was better than that of control group.According to Harris hip score system,at the final follow-up,Harris score of the experimental group was 86.72±4.37 on average,6 cases got excellent results,24 good,4 fair and 1 poor.Harris score of the control group was 78.62±5.62 on average,2 cases got excellent results,20 good,15 fair and 4 poor.After Ridit analysis,there was significant difference in the effect between the two groups (P＜0.05).By pairing sample t test,there was significant difference between the preoperative and postoperative Harris score in the both groups (P＜0.05).Between the two groups,there was no significant difference in preoperative Harris score (P＞0.05),but there was significant difference in postoperative Harris score (P＜0.05).Conclusion:The two surgical procedures for early femoral head necrosis are effective.Using arthroscopic-guided core decompression method,the necrotic bone can be positioned and scraped more accurately,and can obtain better results.关键词
股骨头坏死/关节镜/减压术,外科/血液灌注Key words
Femur head necrosis/Arthroscopes/Decompression, surgical/Hemoperfusion引用本文复制引用
郭浩山,田义军,刘刚,安龙,周占国,刘焕珍..关节镜引导下髓芯减压植骨联合选择性动脉灌注治疗早期股骨头坏死[J].中国骨伤,2018,31(1):56-61,6.基金项目
国家中医临床研究基地业务建设第二批科研专项课题(编号:TDEX2015282) （编号:TDEX2015282）
中国中医科学院科技创新团队建设项目(编号:YS1304)National Traditional Chinese Medicine Clinical Research Base of the Second of Research Projects (No.JDEX2015282) （编号:YS1304）
