关节镜下自体干细胞体外培养回植治疗早期股骨头坏死的临床研究

Clinical on arthroscope treatment of early osteonecrosis of femoral head by autograft of mesenchymal stem cells

目的探讨关节镜监视下髓芯减压自体骨髓间充质干细胞体外培养自体回植治疗早期股骨头缺血性坏死的方法及疗效。方法根据ARCO分期，选取早期股骨头缺血性坏死病例13例，其中ⅠC期2例，ⅡA期4例，ⅡB期5例，ⅡC期2例。在实施髓芯减压术的同时植入体外分离培养获得的骨髓间充质干细胞。结果经1．5年随访及磁共振检查，股骨头坏死体积由32．5％降至5．7％，Harris评分显著提高。结论关节镜监视下髓芯减压并自体骨髓间充质干细胞体外培养回植安全、有效，对早期股骨头缺血性坏死患者为一种有效的治疗选择。

Objective To observe the therapeutic effect on the treatment of early osteonecrosis of femoral head by core decompression with autograft of mesenchymal stem cells （MSCs）on arthroscope. Methods Thirteen patients with early osteonecrosis of femoral head,including 2 cases of phase IC,4 cases of phase Ⅱ A, 5 cases of phase IⅡ B and 2 cases of phase Ⅱ C based on ARCO classification,were treated with core decompression with autograft of MSCs on arthroscope. Results The patients were followed up for one and half year. The average ratio of necrosis zone diminished from 32.5% to 5.7%. The Harris hip score was increased significantly. Conclusion The treatment of core decompression with autograft of MSCs is safe and effective, and it deserves to application in early necrosis of femoral head.