同种异体骨加螺钉支撑治疗早期股骨头坏死

The Effect of Allogeneic Bone and Screw Support on Osteone Crosis of the Femoral Head in Early Stage

目的:探讨同种异体骨加螺钉支撑术治疗早期股骨头缺血性坏死的疗效。方法:采用同种异体骨加螺钉支撑术治疗Ⅰ～Ⅲ期股骨头缺血性坏死62例78髋,其中男40例,女22例。年龄22～61岁。术前疼痛时间2～24个月,平均11个月。所有患者于术前及术后15d,3个月和6个月行双髋关节功能、常规X线片、ECT、CT和MRI检查。结果:患者均获随访3～24个月,平均15个月。57例临床症状缓解明显,Harris评分从术前平均76分升至术后92.8分。57例X线片显示髋关节形态基本保持完好,无明显坏死进展。ECT、CT和MRI检查均见植骨成骨征象。有2例4髋于1年半后改行人工全髋关节置换术。另有3例5髋症状有所加重,但未行人工关节置换术。结论:同种异体骨加螺钉支撑术治疗早期股骨头缺血性坏死,手术损伤小,术后关节功能2～4周即可恢复或超过术前水平,临床症状改善。

Objective： To study the effect of allogeneic bone and screw support on osteone crosis of the femoral head in early stages. Methods：62 patients with necrosis of the femoral head （78 hips） were treated with allogeneic bone and screw support,indluding 40 males and 22 females.Necro sisw as classified as Stages Ⅰ-Ⅲ according to ARCO classification system.Their ages ranged from22 to 61 years and pain duration was 2 to 24 months preoperatively （11months on average）,The regular examinations of joint function,X-ray, ECT, CT andMRI were conducted before surgerg and after 15 days,3 month s,and 6 monthsof surgery.Results：All patients were followed up for 3 to 24 months（15months on average）.Symptoms 57 of the patients were relieved evidently.Harris hip score from 76 points preoperatively to 92.8 points.The X-ray films 58 of the patients showed that the geography of the hip joint kept intact with no deterioration.Osteogenesis was observed by regular examinations.Two cases（4 hips,10.25%）w ere revised by to tal hip rep lacement,and 3 eases（5 hips,10.25%） without THR worsened postoperatively.Conclusions：The method is less traumatic than common procedures.The joint function can be recovered with in 2-4 weeks.Clinical symptom sore greatly improved.