人工骨与骨水泥混合植入治疗青壮年股骨头缺血性坏死18例(英文)

Artificial bone and cement implantation for young patients with avascular necrosis of the femoral head 18 cases of report

目的:观察采用人工骨(羟基磷灰石)与骨水泥混合植入治疗各种不同原因所致的青壮年股骨头缺血性坏死的疗效。方法:广西中医学院第三附属医院骨科于2003-10/2008-07对FicatⅡ～Ⅲ期的18例(23髋)股骨头缺血性坏死患者行死骨清除人工骨与骨水泥混合植入治疗。术后门诊随访3个月～5年,平均24.6个月,采用改良Merled’Aubigne评分法对患髋功能进行评价,并摄X射线片观察。结果:23髋由术前平均11.65分改善至术后平均15.09分。术后X射线片示股骨头塌陷均有所恢复,外形改善,复查时大部分患者的股骨头仍能维持术后的形态,坏死范围未见扩大,患者均对治疗结果感到满意。结论:人工骨与骨水泥混合植入法能防止股骨头进一步塌陷,保留髋关节功能,适用于FicatⅡ～Ⅲ期患者,尤其适用于年轻患者。

OBJECTIVE： To investigate the clinical outcomes of artificial bone （hydroxyapatite） and bone cement implantation in treating young patients with avascular necrosis of the femoral head caused by different reasons. METHODS： A total of 18 patients （23 hips） with Ficat stage III and II avascular necrosis of the femoral head were treated with dead bone debridement, artificial bone and cement implantation in Department of Orthopedics, Third Affiliated Hospital of Guangxi Traditional Chinese Medical College from October 2003 to July 2008. The patients were followed up for 24.6 months （ranging 3 months to 5 years）. The affected hip function was evaluated by modified Merled＇Aubigne Scores and X-ray. RESULTS： Mean hip scores improved significantly from 11.65 to 15.09 after surgery. Postoperative radiographs demonstrated the improved collapse and restoration of femoral head sphericity. The femoral heads of most patients remained the appearance after surgery, and the necrosis range did not enlarge. The patients were satisfactory to the treatment results. CONCLUSION： Artificial bone and cement implantation could restore head sphericity and prevent further collapse. The method can be used as an alternative for treatment of avascular necrosis of femoral head at Ficat stage Ⅱ and Ⅲ, especially for young patients.