髓芯减压多孔钽棒植入术与带蒂股方肌肌骨瓣移植术治疗Ficat Ⅱ期成人股骨头坏死的疗效比较

The porous tantalum screw and quadratus femoris muscle-pedicle bone graft in treating Ficat stage Ⅱ necrosis of the femoral head

目的探讨髓芯减压多孔钽棒植入术与带蒂股方肌肌骨瓣移植术治疗Ficat II期成人股骨头缺血坏死的临床疗效。方法选择2006年7月至2009年4月我院收治的非创伤性成人股骨头缺血坏死早期患者36例(46髋),男29例,女7例,26～59岁,平均39.2岁。其中12例(16髋)采用髓芯减压多孔钽棒植入术治疗。24例(30髋)采用减压加带蒂股方肌肌骨瓣移植术治疗。记录两种手术方法的患者术前、术后一般状况、X线平片、Harris评分。并对36例病例进行回顾性分析。结果所有病例均获得术后随访8～32个月。X线平片显示,髓芯减压多孔钽棒植入术组患者有1例发生股骨头塌陷,术后Harris评分平均为91.4分。带蒂股方肌肌骨瓣移植术组有11例发生股骨头塌陷,术后Harris评分平均为80.7分。结论髓芯减压多孔钽棒植入术在治疗Ficat II期成人股骨头缺血坏死中的临床疗效明显优于带蒂股方肌肌骨瓣移植术。

Objective To compare the clinical effect between the porous tantalum screw and quadratus femoris musclepedicle bone graft in treating Ficat stage II necrosis of the femoral head.Methods 36 cases（46 hips） of Ficat stage II necrosis of the femoral head,from July 2006 to April 2009,were studied,including 29 males and 7 females.The aver-age age was 39.2（26-59） years.12 cases（16 hips） underwent porous tantalum screw insertion while 24 cases（30 hips） received quadratus femoris muscle-pedicle bone graft transplantation.The X-ray results and Harris score after the operations were evaluated.Results The duration of follow-up was 8-32 months.There was one collapse of the femoral head in the screw group and eleven collapses in the graft group.The post-operation Harris score was 91.4 and 80.7,respectively.Conclusion Compared with the quadratus femoris muscle-pedicle bone graft,the porous tantalum screw shows more satisfactory results in treating Ficat stage II necrosis of the femoral head.