髓芯减压植骨、钽棒植入联合BMSCs治疗早期股骨头坏死疗效观察

Early clinical observation of core decompression combined with tantalum rod and implantation of BMSCs for treatment of advanced ONFH

目的髓芯减压植骨、钽棒植入联合干细胞治疗股骨头坏死(ONFH),分析其疗效,探索该病新的保髋治疗方法。方法收集2008年8月～2010年7月在我院收治的84例(105髋)股骨头缺血性坏死患者的临床资料,分为空白对照组,骨髓芯减压植骨+干细胞组,骨髓芯减压植骨+钽棒组以及联合治疗组,采用髋关节功能评分标准(Harris评分),对治疗前后髋关节功能进行评价;统计所收集患者的股骨头塌陷情况,比较随访2年时各组股骨头塌陷率。结果骨髓芯减压植骨+钽棒+干细胞组治疗ONFH在Harris评分明显优于骨髓芯减压植骨+干细胞B组(P<0.05),以及骨髓芯减压植骨+钽棒C组(P<0.05),联合疗法2年时股骨头塌陷率明显低于单纯治疗组。结论骨髓芯减压植骨+钽棒+干细胞是早期ONFH保髋治疗的理想方法。

Objective To evaluate the therapeutic effects of core decompression combined with tantalum rod and implantation of bone marrow stem cells for osteoneerosis of the femoral head（ONFH）,and to explore new treatment of saving the head. Methods 84 patients（105 hips）with ONFH were inrolled in general hospital of PLA 476 Hospital from Augest 2008 to June 2010. All patients were divided into four groups：blank control group,core decompression and tantalum rod group,core decompression and BMSCs group and combining group. Harris score was used to evaluate hip function. The collapse rates of femoral head were compared in the two years among the four groups. Results Harris score of combining group was significantly better than B group （P 〈 0.05） and C（P 〈 0.05）. The head collapse rate of the combining group in the third year was lower than the other groups. Conclusion Core decompression combined with tantalum rod and implantation of bone marrow stem cells is an ideal method of saving the femoral head with osteonecrosis.