多孔涂层钽金属棒系统治疗成人股骨头缺血性坏死

Porous coating tantalum rod system for adult avascular necrosis of the femoral head

背景:多孔涂层钽金属棒系统是专一应用于股骨头缺血性坏死的新型内植物系统,其良好的生物力学特性可为塌陷前股骨头提供必要的软骨下骨支撑,同时具有较好的生物相容性,并可采用微创方式置入,有广阔的应用前景。目的:评价多孔涂层钽金属棒系统治疗成人股骨头缺血性坏死的效果和应用价值。方法:自2008-05/2010-06对22例成人股骨头缺血性坏死患者施行多孔涂层钽金属棒系统固定治疗。其中男17例,女5例,平均年龄39.5岁。病变分期中FicatⅠ期3例,FicatⅡ期19例。单侧17例,双侧5例。置入前髋关节症状以疼痛和跛行为主,Harris评分平均52.5分。结果与结论:置入后随访2-25个月。患者切口均一期愈合,无感染、内植物松动等并发症发生。在随访期间内X射线检查未发现明显股骨头塌陷及囊变区扩大等病变进展迹象,患者疼痛、跛行等症状缓解明显。终末随访时Harris评分为85.5分,与置入前相比差异有显著性意义。主观满意度:优17例,良3例,中2例,总体优良率91%。结果可见多孔涂层钽金属棒系统置入治疗FicatⅠ、Ⅱ期成人股骨头缺血性坏死可取得良好的早、中期效果。

BACKGROUND：Porous coating tantalum rod system is a new-type implantation system,which is specialized to treat avascular necrosis of the femoral head.Its good biomechanical characteristics can provide the indispensable support of subchondral bone for the femoral head before collapse.Besides,it has good biocompatibility and can be implanted by minimally invasive method,which has wide application foreground.OBJECTIVE：To evaluate the effect and application value of the porous coating tantalum rod system on adult avascular necrosis of the femoral head.METHODS：Twenty-two adult patients （17 male,5 female,the average age was 39.5 years old） with avascular necrosis of the femoral head received porous coating tantalum rod system treatment from 2008-05 to 2010-06.In disease stage,three cases were in stage Ⅰ and 19 cases in stage Ⅱ.Seventeen cases underwent unilateral implantation,and five cases received bilateral implantation.The main symptoms were pain in the hip joint and limp before implantation.Average Harris score was 52.5.RESULTS AND CONCLUSION：The average follow-up period was 19.5 months after implantation.All of the incisions were healed at stageⅠ.No infection and loosen complications occurred.The X-ray during the follow-up showed that there were no various collapses and enlargements of the cysts in the femoral head.Pain and limp were alleviated obviously after surgery.Harris score at final follow-up was 87.5,which had significant differences compared with that before implantation.In terms of subjective satisfaction,17 cases were excellent,three were good and two were fair.The overall excellent and good rate was 91%.These findings suggest that porous coating tantalum rod system for adult avascular necrosis of the femoral head in Ficat stages Ⅰ and Ⅱ can achieve good short-term and mid-term results.