髋关节镜手术治疗股骨头缺血性坏死

The Operative Treatment of Ischemic Necrosis of Femoral Head under the Supervision of Arthroscope

目的 探讨应用髋关节镜手术治疗股骨头缺血坏死的疗效。方法 对 33例Ⅱ期或Ⅲ期的股骨头缺血坏死患者 ,进行了关节镜下髓心减压入路 ;游离骨膜及骨柴植入或经关节囊带血管蒂髂骨瓣转移的方法治疗 ,平均随访 1年 9个月。结果 所有病人疼痛消失 ,行走正常 ,髓关节活动范围正常或接近正常 ,X线片示股骨头轮廓清晰 ,囊性变消失 ,骨密度均匀 ,关节间隙正常。结论 关节镜下手术治疗股骨头缺血性坏死具有损伤小、准确、有效。

Objective To discuss the effects of operative treatment of ischemic necrosis of femoral head under the supervision of arthroscope.Methods Thirty three patients with ischemic necrosis of femoral head inⅡ or Ⅲ stage were treated by medullary center decompression and free periosteum implantation under the supervision of arthroscope or transplantation of iliac bone flap with vascular pedicle through joint capsule.The average period of follow-up is 1 year and 9 months.Results The pain of all patients disappeare and all the patients can walk normally.The movement range of the hip joint is normal or approximate normal.X-ray films showed the outline of the femoral head being clear and cystic degeneration disappeare.The density of the femoral head was well-distributed and the joint space was normal.Conclusions The operative treatment of ischemic necrosis of femoral head under the supervision of arthroscope has the advantage of damaging lightly,accuracy,effectiveness and simplicity.