全髋关节置换术与髓芯减压治疗缺血性股骨头坏死的效果对比

Effect comparison of total hip arthroplasty and myeloid core decompression treating ischemic necrosis of femoral head

目的：比较全髋关节置换术（THA）与髓芯减压治疗缺血性股骨头坏死的临床效果。方法回顾性分析普宁市人民医院2010年1月-2013年9月收治的缺血性股骨头坏死84例患者的临床资料，按照手术方式不同分为THA组（n=32）及髓芯减压组（n=52），比较两组末次随访的疗效、Harris评分及术后骨科并发症发生情况。结果THA组末次随访的总有效率为93.8%，显著高于髓芯减压组（73.1%）（P〈0.05），THA组末次随访的疗效显著优于髓芯减压组（P〈0.01）；两组末次随访的Harris评分显著高于治疗前，THA组末次随访的Harris评分为（92.7±5.3）分，显著高于髓芯减压组[（83.4±10.8）分]（P〈0.01）；THA组患者术后1例出现人工股骨头脱落，1例出现假体松动；髓芯减压组3例出现股骨头塌陷，两组的并发症发生情况比较，差异无统计学意义（P〉0.05）。结论 THA治疗缺血性股骨头坏死的效果显著优于髓芯减压术，值得推广。

Objective To compare clinical effect of total hip arthroplasty （THA） and myeloid core decompression treat-ing ischemic necrosis of femoral head. Methods Clinical data from 84 cases with ischemic necrosis of the femoral head admitted into Puning People’s Hospital from January 2010 to September 2013 were retrospectively analyzed.According to different surgical method,they were divided into THA） group （n=32） and myeloid core decompression group （n=52）. The curative effect of last follow-up,Harris score,and postoperative orthopedic complication between two groups were compared. Results The total effective rate of last follow-up in THA group （93.8%） was obviously higher than that in myeloid core decompression group （73.1%） （P〈0.05） and the effect of last follow-up in THA group was obviously supe-rior to that in myeloid core decompression group （P〈0.01）.Harris score in two groups of last follow-up was greatly high-er than that of before treatment,and Harris score in the THA group of last follow-up was significantly higher than that in myeloid core decompression group [（92.7±5.3） points v s （83.4±10.8） points,P〈0.01）.In THA group,1 case appeared with artificial femoral head shedding and 1 case with prosthesis loosening after surgery while in myeloid core decom-pression group,there were 3 cases with femoral head collapse and there was no statistical difference of complication （P〉0.05）. Conclusion Effect on treating ischemic necrosis of the femoral head by THA surgery is significantly superior to that by myeloid core decompression operation,and it is worthy of expansion.