髓芯减压术与髓芯减压并钽棒植入术治疗早期股骨头缺血坏死的近期疗效比较

Short term efficacy comparison of core decompression and core decompression with tantalum rod implantation in treating early-stage avascular necrosis of femoral head

目的探讨两种不同手术方法对股骨头缺血坏死的疗效及其应用价值。方法随访髓芯减压术治疗的股骨头缺血性坏死患者16例(20髋)和髓芯减压并钽棒植入术治疗的股骨头缺血性坏死患者21例(26髋),随访1～3年。观察手术前后Harris评分变化,对手术疗效进行比较、评估。结果所有患者均获随访,髓芯减压术治疗组患者的手术前、后Harris评分及平均随访时间分别为(80.8±3.2)分、(90.4±4.2)分、(29.0±3.2)个月,髓芯减压并钽棒植入术治疗组患者的手术前、后Harris评分及平均随访时间分别为(79.6±3.8)分、(93.7±2.9)分、(29.5±3.2)个月。两种手术方法治疗前后的Harris评分结果相互比较均有显著差异(P<0.05);术前两治疗组的Harris评分结果相互比较未见明显差异(P>0.05),术后髓芯减压并钽棒植入术组Harris评分结果优于单纯髓芯减压术组(P<0.05)。结论髓芯减压并钽棒植入术较髓芯减压术在逆转股骨头坏死趋势,延缓股骨头缺血坏死进程方面更有优势。

Objective To evaluate the efficacy and application value of two different surgical methods in treating early- stage avascular necrosis of femoral head （ANFH）. Methods 16 cases （20 hips） who suffered from ANFH and treated with core decompression and 21 cases（26 hips） who suffered from ANFH and treated with core decompression with tantalum rod implanta- tion were followed up 1 ~3 years. Evaluated and compared the efficacy of two different surgical methods by observing the changes in Harris score before and after surgery. Results All patients were followed up. The preoperative Harris score ,after operation Harris score and the mean follow-up time of patients who treated with core decompression respectively were （80.8±3.2）, （90.4±4.2） and （29.0±3.2）months. The preoperative Harris score, after operation Harris score and the mean follow-up time of patients who treated with core decompression with tantalum rod implantation respectively were （79.6±3.8）, （93.7±2.9） and （29.5±3.2） months. There were significant differences between preoperative Harris score and after operation Harris score in two different sur- gical treatment groups （P〈0.05）; there were no difference in preoperative Harris between two different surgical treatment groups （P〉0.05）; after operation Harris score of core decompression with tantalum rod implantation group was better than the core de- compression group（P〈0.05）. Conclusion Comparing to core decompression, core decompression with tantalum rod implantation have the advantage of reversal and delay the process of osteonecrosis of the femoral head.