镍-钛记忆合金网球治疗成人股骨头缺血性坏死初步报告

Memorial metal ball for the treatment of avascular necrosis of femoral head

目的探讨记忆金属网球植入治疗成人股骨头缺血性坏死的手术方法及初步疗效。方法设计采用记忆金属网球植入坏死塌陷的股骨头内，取同侧髂骨松质骨植入网球内并顶起已塌陷的股骨头，并以带旋髂深动脉及静脉的髂骨骨块植入治疗成人股骨头缺血性坏死。结果经临床应用２２例２８个髋关节，初步随访６～２０个月，并按成人股骨头缺血性坏死疗效百分评价法进行评价，优良率为９０９％。结论记忆金属网球植入治疗成人股骨头缺血性坏死具有以下优点：（１）彻底清除死骨减压；（２）重建股骨头血运；（３）增加股骨头负重区软骨下骨的机械支撑，降低局部应力，有利于股骨头坏死的修复及重建。该手术方法适用于股骨头坏死Ｆｉｃａｔ分期的Ⅰ、Ⅱ、Ⅲ期患者；对于部分Ⅳ期年轻患者及不宜行关节置换的晚期病例。

Objective To introduce a new method for the treatment of avascular necrosis of the femoral head. Method A technique has been developed what the memorial metal ball, and where the graft of the wing of the ilium is harvested with the deep circumflex iliac vascular pedicle and implanted into the avascular area of the femoral head. This procedure has been performed in 28 hips in 22 patients. Result Preoperatively, 8 hips were of Ficat Arlet Stage Ⅱ and twenty stage Ⅲ.Postoperatively,eighteen patients were pain free,3 had mild pain,and 1 had moderate pain.The radiographic appearance improved in 2 cases.No major complications occurred. Conclusion It is one of the better alternatives that can prevent the necrotic femoral head from progressing to collapse and promote revascularization and new bone formation by direct mechanical support.The technique is suitable for the treatment of avascular necrosis of femoral head of stage Ⅰ to Ⅲ.