多孔钽棒置入联合髓芯减压治疗 成人早期股骨头坏死近期疗效观察

    The short-term effect of porous tantalum implant combined with core decompression in the treatment of adult early osteonecrosis of the femoral head

    • 摘要: 目的:探讨多孔钽棒置入联合髓芯减压治疗早期股骨头坏死(ONFH)的近期临床效果。方法:采用多孔钽棒置入联合髓芯减压治疗成人早期ONFH 11例11髋,其中ⅠB期1髋,ⅠC期1髋,ⅡA期2髋,ⅡB期6髋,ⅡC期1髋。术前Harris评分平均(53.89.7)分。随访时以Harris评分、影像学检查及股骨头生存率作为疗效评价指标。结果:手术时间30~50 min,出血量50~100 ml。术后随访12~21个月。术后Harris评分为(84.27.3)分,较治疗前明显提高(P0.01)。1例伴有系统性疾病长期服用激素患者术后9个月发生了股骨头塌陷及关节间隙狭窄,其余病例股骨头外形完整,无股骨头变扁、塌陷或坏死加重。结论:多孔钽棒置入联合髓芯减压治疗成人早期ONFH能有效避免坏死区股骨头塌陷,近期疗效满意。

       

      Abstract: Objective:To explore the short-term effects of porous tantalum implant combined with core decompression in the treatment of early osteonecrosis of the femoral head(ONFH).Methods:The clinical data of 11 hips treated with porous tantalum implant combined with core decompression from 11 patients with early ONFH were retrospectively analyzed from March 2012 to January 2013,11 hips included stage ⅠB in 1 hip,stage ⅠC in 1 hip,stage ⅡA in 2 hips,stage ⅡB in 6 hips and stage ⅡC in 1 hip.The average preoperative Harris score of all cases was(53.89.7).The clinical effects in all cases were evaluated by the Harris score,imaging examination and femoral head survival rate.Results:The operative time and blood loss of all cases were from 30 to 50 min and from 50 to 100 ml,respectively.All cases were followed up for 12 to 21 months,the mean follow-up time was 15.8 months.Compared with the preoperative score,the postoperative mean Harris score(84.27.3) in all cases significantly increased(P0.01).The collapse of femoral head and joint space narrowing in 1 patient with systemic disease patients with long-term use of hormone was found by X-ray in 9 months after operation,complete femoral head and no flat collapse or aggravating necrosis of femoral head were verified in other patients.Conclusions:The effects of porous tantalum implant combined with core decompression in the treatment of adult early ONFH are good,which can avoid the collapse of ONFH.

       

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