股骨头坏死保髋手术治疗研究进展

Research progress of hip-reserving surgery for osteonecrosis of the femoral head

股骨头坏死,又称股骨头缺血性坏死,是由不同病因造成的一种病理状态,包括滥用激素、酗酒、创伤、血管损伤及一些特发性疾病。股骨头坏死造成了股骨头软骨下骨血供的减少,从而导致了成骨细胞的死亡及关节面的塌陷。股骨头一旦发生塌陷,大部分患者将不可避免地进行髋关节置换手术。但髋关节置换手术并不是每个患者的最佳选择,除了关节假体本身的因素外,部分患者的年龄与疾病特点可能会面临人工关节多次翻修的风险,因而一些学者更提倡股骨头坏死的保髋治疗。目前,股骨头坏死的保髋手术治疗主要包括截骨术、髓芯减压术、植骨术、钽棒置入术和干细胞治疗等,文章从不同机制上对近年来常见的一些保髋手术进行综述。

Osteonecrosis of the femoral head （ONFH） , also known as femoral head avascular necrosis, is a pathological state due to different etiologies including steroid administration, alcohol abuse, traumatic events, vascular injury and idiopathic origins. ONFH reduces the blood supply of the subchondral bone of the femoral head, which results in osteoeyte death and collapse of the articular surface. Once the collapse happens, the majority of patients inevitably need total hip replacement. But hip replacement surgery is not the best choice for each patient. Expect for joint prosthesis factors, the patient＇s age and disease characteristics may result in several renovations. Therefore, some scholars suggest that the femoral head had better be reserved. Currently, hip-reserving procedures for ONFH include osteotomy, core decompression, bone graft surgery, tantalum rods surgery and stem cell therapy. This review aims to summarize the hip- reserving procedures for ONFH by different mechanisms from a new perspective.