摘要
目的应用髓芯减压自体骨髓细胞结合重组合异种骨移植的方法治疗早期股骨头缺血性坏死,探索早期股骨头缺血性坏死的微创治疗方法。方法自2000～2002年采用上述术式治疗早期股骨头缺血性坏死患者48例(64侧),年龄19～56岁,平均37岁;ARCO分期为Ⅰc期8侧,Ⅱa期23侧,Ⅱb期19侧,Ⅱc期14侧,全部病例均行髓芯减压自体骨髓细胞结合重组合异种骨移植术。术后随访2～4年,根据手术前后Harris评分变化,X线影像学表现及是否需要进一步治疗进行随访观察。结果术后患者Harris评分平均提高16分(平均术前79分,术后95分),影像学表现49侧保持稳定,2例(3侧)分别于术后9～20个月改行人工全髋关节置换术或带血管蒂骨瓣股骨头修复术而治愈。结论髓芯减压自体骨髓细胞结合重组合异种骨移植治疗早期股骨头缺血性坏死,手术操作简单、减少了供区的并发症、术后恢复快,是一种值得提倡的微创手术方法。
Objective To investigate microinvasive method in the treatment of avascular necrosis of femoral head at early stage. Methods From 2000 to 2002, 48 patients （64 hips） with osteonecrosis of femoral head at early stage were treated by decompression and reconstituted bone xenograft combined with autologous bone marrow cells. The mean age was 37 years （range, 19 to 56 years）. According to ARCO classification system,8 hips were at stage Ⅰc,23 hips were at stage Ⅱa,19 hips were at stage Ⅱb and 14 hips were at stage Ⅱc. Patients were followed up from 2 to 4 years. The outcome was evaluated by the changes of Harris hip score, the progression in radiographic stages, and the need for additional treatment. Results The postoperative mean Harris hip score was improved to 95 points from preoperative 79 points. The recent followup showed that 49 hips were radiologieal stable. The additional treatment was needed only in 3 hips （2 patients）. Conclusion The procedure of decompression with reconstituted bone xenograft combined with autologous bone marrow cells was effective in treating patients with avaseular necrosis of femoral head at early stage. The method is attractive as a salvage procedure. It＇s relative simple and , and reduced donor side morbidity
出处
《中国骨与关节损伤杂志》
2005年第10期670-672,共3页
Chinese Journal of Bone and Joint Injury
