关节镜监视下髓芯减压术治疗早期股骨头坏死的研究

OUTCOME OF CORE DECOMPRESSION WITH ARTHROSCOPY IN TREATING EARLY-STAGE OSTEONECROSIS OF FEMERAL HEAD

目的分析关节镜引导下髓芯减压术治疗早期股骨头坏死的疗效。方法选取2008年3月—2009年5月股骨头坏死患者32例(40髋),随机分为对照组即传统髓芯减压组15例(20髋),试验组即关节镜监视下髓芯减压组17例(20髋),比较术前术后Harris评分,进行影像学评价,并分析随访数据。结果术后随访42～58个月,平均48.7个月。未见感染、股骨近端骨折以及血管神经损伤等并发症。试验组和对照组术后Ha而s评分分别为(79.6±7.3)、(73.5±6.2)分,差异有统计学意义(P<0.05)。试验组和对照组临床成功率分别为80.0%(16/20)、65.0%(13/20)。结论关节镜监视下髓心减压术能够有效地清除坏死骨组织,达到有效治疗早期股骨头坏死的目的 。

Objective The analysis was performed in the effect of the core decompression with arthroscopy for early-stage osteonecrosis of the femeral head. Methods We selected 32 cases （40 hips） who were osteonecrosis of the femeral head patients in our hospital during the period of diagnosis and treatment from March 2008 to May 2009. The patients were randomly divided into core decompression group,15 cases （20 hips） and core decompression with arthroscopy group, 17 cases （20 hips）. The preoperative and postoperative Harris scores and imagings of two groups postoperative Harris scoring, and imaging were compared. Results All the patients received follow-up 42 - 58 months, an average of 48.7 months, No infection, proximal femoral fractures and vascular complications such as nerve damage occurred. Postoperative Harris scores in experimental group, and control group showed significant difference, （79.6 ± 7.3 ） scores and （ 73.5 ± 6.2 ） scores （ P 〈 0.05 ）. The clinical success rates of two groups were respectively 80.0% （16/20） and 65.0% （13/20）. Conclusion The core decompression with arthroscopy can effectively remove necrotic tissue. The clinical effect is good for early-stage osteonecrosis of the femeral head.