髓芯减压、空心钛钉植入治疗股骨头坏死

Autologous Red Bone Marrow Tissue Engineering Complex Combine with Bouche Decompression and Implant of Hollow Titanium Screws for the Treatment of ANFH

目的研究自体红骨髓组织工程复合物联合髓芯减压、空心钛钉植入治疗早期股骨头坏死临床应用的疗效。方法本组12例,男性9例,女性3例,双侧股骨头3例,右单侧7例,左单侧2例。术前均行X线摄片、CT、MRI检查,ARCO分期,期4髋,期11髋;C型臂X线透视下行股骨头坏死区和囊性变区定位、髓芯减压,关节镜监视下刮除坏死骨,送病理;植入由自体红骨髓与骨诱导活性材料复合成的非细胞型组织工程骨,空心钛钉支撑股骨头软骨下骨质。结果本组12例均获得随访,随访时间12～24个月,平均18个月。采用12分法评分系统评定,优8髋,良5髋,可2髋,差0髋,优良率为86.66%。结论髓芯减压、自体红骨髓非细胞型组织工程骨植入、空心钛钉支撑治疗早期股骨头坏死在减轻疼痛、改善关节功能、防止股骨头塌陷方面具有较好的作用。

Objective To estimate the clinical effect of autologous red bone marrow tissue engineering complex combine with bouehe decompression and implant of hollow titanium screws for the treatment of ANFH. Methods 12 patients including male 9 male and 3 female were conducted in this study. 3 patients were suffered from both side of ANFH, 7 were righe side and 2 were left side. X-ray,CT and MRI were performed before the surgery. 4 hips were classified as ARCO stage 1,11 hips were 2. All the patients were treated as follows：the area of NFH and eystis degen eration was detected and bouche decompression was done through X-ray with C-arm, and the necrotic bone was cleared for the pathologic diagnosis under the monitoring of arthroscopy. And then the non-cell based tissue engineering bone,which was the complex of autologous red bone marrow and osteoinductice absorbing material, was transplanted in the body. Finally,the hollow titanium screws were used to pedestal the sclerotin. Results All the patients were followed up for an averaged 18 months （12 months to 24 months）. 12 scores were used to estimate the clinical rescult ： 8 excellent, 5 good, 2 acceptable and 0 bad. Those who were categorized as excellent and good accounted for 86.66G. Conclusions Autologous red bone marrow tissue engineering complex combine with bouche decompression and implantation of hollow titanium screws shows satisfactory rescult for the treatment of ANFH.