生物骨科材料与临床研究2018，Vol.15Issue(3)：45-49,后插3,6.DOI:10.3969/j.issn.1672-5972.2018.03.012
应用关节镜技术微创治疗股骨头早期坏死
Minimally invasive to treat the early necrosis of femoral head with the application of arthroscopic technique
杨新明 1石蔚 1杜雅坤 2张磊 3胡长波 1姚尧 4孟宪勇1
作者信息
- 1. 河北北方学院附属第一医院
- 2. 河北省儿童医院
- 3. 河北医科大学第四医院
- 4. 河北北方学院研究生学院,河北 张家口,075000
- 折叠
摘要
Abstract
Objective To evaluate curative effect of precise focal clearance, bone graft and titanium rod support treated the early osteonecrosis of the femoral head with the assist of minimally invasive arthroscope. Methods A total of 58 patients(74 hips) diagnosed as stage Ⅱ ONFH according to the ARCO staging system during 2003 ～ 2013 were enrolled in this study. There were15 hips at stage ⅡA, 34 hips at stage ⅡB and 25 hips at stage ⅡC. Minimally invasive percutaneous decompression and focal clearance within the femoral head were accurately performed by the C-arm and arthroscopy, and then the OAMcomposite of autologous bone marrow was implanted and the femoral head was supported using the hydroxyapatite coated hollow titanium rod. VAS pain score, Harris hip score, X-ray examination and clinical efficacy were assessed at 6, 12, 24 and 36 month postoperatively. Results 24 ～ 36 months follow-up, average 32 months, including 10 cases at the time of the last follow-up show femoral head collapse and then underwent THRA, its pathogenic cause was hormone. All cases of postoperative pathological histology shows as osteonecrosis. The VAS score and the Harris score after operation were better than preoperative, the difference had statistical significance (P< 0. 05), showing thismethod can reduce pain, improving the function of hip joint. As for the X-ray staging, 5 cases (5 hips) progressed from stage ⅡB to stage ⅡC, four cases of them further progressed to stage Ⅲ and then underwent totail hip arthroplasty. The femoral head of 6 cases (6 hips) staged ⅡC collapsed at 24 months after the operation and then underwent THRA after 30 months. In this study, the total improvement rate after the surgery was 79. 72％ (93. 33％ for IIA, 82. 35％ for IIB and 68％ for ⅡC). Conclusion Precise focal clearance, bone graft and titanium rod support treated the early osteonecrosis of the femoral head with the assist of minimally invasive arthroscope can get accurate positioning, minimally invasive surgery, thorough removal of lesions, reconstruction of bone structure and permanent mechanical support effect. In addition to stage ⅡC patients who had a history of the use of hormone, other stage Ⅱ patients in improving efficacy and preventing joint surface collapse effect is better.关键词
股骨头坏死/微创/关节镜/植骨/钛棒/临床疗效Key words
Femur head necrosis/Minimally invasive/Arthroscopy/Bone graft/Titanium rod/Clinicad effect分类
医药卫生引用本文复制引用
杨新明,石蔚,杜雅坤,张磊,胡长波,姚尧,孟宪勇..应用关节镜技术微创治疗股骨头早期坏死[J].生物骨科材料与临床研究,2018,15(3):45-49,后插3,6.
