股骨头坏死手术治疗及其自体PRP在保髋手术中的应用进展

Current progress of surgical treatments for osteonecrosis of the femoral head and the application of autologous PRP in hip preservation surgery

股骨头坏死(ONFH)是一种骨科难治性疾病,病因复杂,病理机制不明,治疗手段繁多,治疗效果各异。外科手术是ONFH的常用治疗方式,主要有保髋手术和人工髋关节置换两类术式。保髋手术的主要目的在于延缓股骨头坏死进程,恢复髋关节功能,延迟换髋时间。自体富血小板血浆(PRP)富含高浓度的活性物质,被证实在骨修复过程中发挥重要作用。该文在介绍致病因素和发病机理的基础上,总结ONFH的手术治疗方法,综述自体PRP在保髋手术中的应用进展,为早期非创伤性ONFH治疗提供一条新的思路。

Osteonecrosis of the femoral head （ONFH） is one of refractory orthopaedic diseases, with complex etiology, unclear pathogenesis, a great variety of treatments and different therapeutic effects. Hip surgery is a kind of common methods to treat ONFH, including hip preservation surgery and hip replacement. The aim of hip preservation surgery is to delay necrotic process, restore hip function, and delay hip replacement. Autologous platelet-rich plasma （PRP） with high-concentration active substances has been proved to play an important role during bone repair process. In this paper, surgical treatments of ONFH were summarized based on introducing pathogenic factors and pathogenesis mechanisms, and current application of autologous PRP in hip preservation surgery were reviewed, which providing a new treatment idea for patients with early nontraumatic ONFH.