脐带间充质干细胞与纳米仿生骨材料联合治疗早期股骨头缺血坏死的中期疗效观察

Medium-term efficacy of the implantation of a novel nanoscaled core decompression rod combined with umbilical cord mesenchymal stem cells on the treatment of early osteonecrosis of the femoral head

目的回顾性分析脐带间充质干细胞与纳米仿生骨材料联合治疗早期股骨头缺血坏死的中期临床疗效。方法选定诊断为股骨头坏死（Osteonecrosis of the femoral head,ONFH）（FicatⅡ期）,接受纳米仿生骨材料髓芯减压棒联合脐带间充质干细胞移植治疗的成人患者。本组共12例（12髋）,患者年龄22-53岁,平均39.4岁,男9例,女3例。术前、术后采用Harris评分系统进行患髋评分并进行配对检验。通过其影像学改变进行疗效评估。结果本组11例患者获得完整随访,Harris评分由术前（54.16±4.23）分提高到术后24个月随访时的（82.68±2.05）分（P〈0.05）,所有获得随访的患者均未发现减压棒脱出,未出现股骨头明显坏死塌陷。结论髓芯减压基础上应用新型纳米仿生骨材料联合脐带间充质干细胞移植治疗早期股骨头坏死的中期临床疗效满意,远期临床疗效仍需进一步观察随访。

Objective A study has been made on the medium-term efficacy of a novel nanoscaled core decompression rod combined with mesenchymal stem cells on the treatment of the osteonecrosis of the femoral head（early stage of collapse）.Methods Adult patients with early osteonecrosis of femoral head（at the stage of FicatⅡ） received treatment using the implantation of a novel nanoscaled core decompression rod combined with mesenchymal stem cells.There were9 males and 3 females with an average age of 39.4 years（range,22 to 53 years）.The scoring of patients＇ hip was scored by Harris marking system before and after the operations,and paired t-test was also conducted.We made an assessment about the curative effects based on the change of imaging of patients before and after the operation.Especially,the survival rate of femoral head was assessed 24 months after the operation.Results Complete follow-up was obtained in11 cases.According to the standard of Harris Scoring,the average grade of hip joint before operation was（54.16±4.23）points while average grade of hip joint 24 months after operation was（82.68±2.05） points.The abscission had never occur in this group over 24 months after surgery.Obvious collapse did not happen to any 11 cases 24 months after surgery.Conclusion The implantation of a novel nanoscaled core decompression rod combined with mesenchymal stem cells has satisfactory clinical effects,suggesting that this implantation is effective to treat early osteonecrosis of the femoral head.