非创伤性股骨头坏死的国外研究进展

Nontraumatic osteonecrosis of the femoral head

非创伤性股骨头坏死在国内外均被列为尚未解决的难治性疾病之一,本文中作者综合近几年的研究对非创伤性股骨头坏死的病因及手术和非手术治疗方法进行最新的阐述。非创伤性股骨头坏死的发病有遗传学基础,各种危险因素及遗传易感性的相互作用将决定病情的转归。早期诊断及在股骨头出现塌陷之前进行干预是关节保留治疗能否得到良好结果的关键。关节是否保留取决于放射影像学表现。对于股骨头已经塌陷的患者,行关节置换术的满意度优于关节保留治疗。最新的药物治疗方法如生长分化因子可能会改变作者目前的治疗方法,但是有待于临床研究结果及长期的随访。

In this review,concepts concerning etiology and nonoperative and operative treatment methods have been analyzed.This article is based almost exclusively on peer-reviewed studies.The etiology of nontraumatic osteonecrosis of the femoral head may have genetic basis.The interaction between certain risk factors and a genetic predisposition may determine whether this disease will develop in a particular individual.Early diagnosis and intervention prior to collapse of the femoral head is key to a successful outcome of joint-preserving procedures.The rational for use of joint-sparing procedure in the treatment of this disease is based on radiographic measurements and findings with other imaging modalities.The results of joint-preserving procedures are less satisfactory than the results of total hip arthroplasty for femoral head than have already collapsed.New pharmacological measures as well as the use of growth and differentiation factors for the prevention and treatment of this disease may ...更多eventually alter our treatment approach,but it is necessary to await results of clinical research with long-term follow-up of these patients.