保留自身关节手术治疗股骨头坏死

Joint-preserving surgical treatment for osteonecrosis of femoral head

目的:总结并分析保留自身关节手术治疗股骨头坏死的优缺点,探讨其治疗股骨头坏死的前景,以寻找最佳的治疗方法。资料来源:主要应用计算机检索Medline,OVID1996-01/2004-12关于股骨头坏死的文章。检索词“necrosis,femoralhead”并限定文章的语种类为English。资料选择:对资料进行初审,纳入标准:①关于保留自身手术对股骨头坏死的病因、病理及治疗。②对具体事件的回顾调查研究。排除标准:排除重复性研究。资料提炼:共收集到符合上述要求的文献44篇,排除10篇重复性研究,34篇符合纳入标准:其中12篇关于股骨头坏死手术治疗的综述,22篇关于股骨头坏死手术治疗的调查研究。资料综合:股骨头坏死已成为骨科临床上的常见病,股骨头缺血性坏死发病的确切机制不详,可能与创伤、激素应用、过度饮酒、血液疾病、遗传因素等因素有关。随着发病的年轻化,越来越多的学者开始重新专注于保留自身关节的手术治疗,如髓芯减压术、转子间截骨术及带血管蒂游离腓骨植骨术等。保留自身关节手术可在一定程度上保护关节,改善关节功能,延长关节寿命。结论:保留自身关节手术可在一定程度上保护关节,改善关节功能,延长关节寿命,更为重要的是患者容易接受,应是目前股骨头坏死手术治疗的趋势所在。

OBJECTIVE： To summarize and analyze the advantages and disadvantages of joint-preserving surgical treatment for osteonccrosis of femoral bead and probe into its prospects so as to find the best therapeutic method for osteonecrosis of femoral head. DATA SOURCES： Articles related to osteonecrosis of femoral bead between January 1996 and December 2004 were searched in Madline and OVID with the key words of ＂necrosis ,femoral bead＂and the language was limited to English. STUDY SELECTION： Data were selected primarily. Inclusive criteria： ①Cause and pathology of osteonecrosis of femoral head and joint-preserving surgical treatment. ②Retrospective researches on specific events. Exclusive criteria： Repetitive studies. DATA EXTRACTION： Totally 44 literatures were in accordance with the criteria, 10 repetitive studies ofwhich were excluded and 34 were in accordance with theinclusive criteria. Of which, 12 were reviews related to joint-preserving surgical treatment for osteonecrosis of femoral head and 22 were researches on joint-preserving surgical treatment for ostconccrosis of femoral head. DATA SYNTHESIS： Osteonecrosis of femoral head is a common disease in clinic, pathogenesy of avascular necrosis of femoral head is unclear, which may be relate to wound, application of hormone, excessive drinking, hematological disease, genetic factor and some other factors. With the pathogenetic age becoming younger, more and more scholars begin to pay attention to the surgical treatment with joint preserved, such as core decompression, ostcotomy and free vascularized fibular grafting etc. Jointpreserving surgical treatment could protect the joints to some extent, ameliorate function of joint and prolong the life of joint. CONCLUSION： Joint-preserving surgical treatment can protect the joint to some extent, ameliorate function of joint and prolong the life of joint. Most important is that it is easy to be accepted. It is the tendency of jointpreserving surgical treatment for ostconecrosis of femoral head so far.