髋关节镜结合髓芯减压干细胞移植治疗股骨头缺血性坏死的临床研究

The clinical study on treatment of the avascular necrosis of femoral head applying hip arthroscopy with core decompression and bone marrow stem cell transplantation

目的探讨髋关节镜下行关节清理,髓芯减压自体骨髓干细胞移植治疗股骨头缺血性坏死的疗效。方法实验组23例股骨头缺血性坏死患者,经髋关节镜行关节清理,髓芯减压自体骨髓干细胞移植的方法治疗。对照组19例只行单纯髓芯减压术。结果经1～2年随访,疗效评价采用髋关节Harris功能评分标准,术后22例患者关节疼痛消失,行走正常,髋关节活动范围正常或接近正常,优良率达到86.96%。对照组优良率为52.63%。结果有显著性差异(P<0.05)。髋关节影像学检查:本组只有1例发展为Ⅳ期塌陷。对照组有4例发展为Ⅳ期塌陷。结论髋关节镜下髓芯减压自体骨髓干细胞移植治疗股骨头缺血性坏死可以获得较高的临床治愈率。术后无并发症,本法具有创伤小、准确、简便的优点,是一种有效的治疗股骨头缺血性坏死的方法。

Objective Study on the clinical effect of the avascular necrosis of femoral head treated by hip arthroscopy with core decompression and bone marrow stem cell transplantation.Methods 23 patients with the avascular necrosis of femoral head were treated by hip arthroscopy with core decompression and bone marrow stem cell transplantation.Results All patients were followed up for 1~2 years.According to the Harris scores,the excellent and good rate of the experiment group was 86.96%,compared with 52.63% in the control group（P0.05）.The radiographic appearance showed that in experiment group only 1 case had progressed to femoral head collapse as stage Ⅳ,compared to 4 hips in the control group.Conclusion Hip arthroscopy with core decompression and bone marrow stem cell transplantation can get fairly high cure rate in treatment of the avascular necrosis of femoral head.It also has such advantages like minor complications,micro-invasive,accuracy and easy manipulation.