髓芯减压加膨胀式硫酸钙人工骨植入治疗股骨头坏死临床研究

Clinical Research of the Treatment for the Osteonecrosis of the Femoral Head by Pulp Core Decompression Combined with Expanding Calcium Sulfate Artificial Bone Implantation

目的:研究使用股骨头髓芯减压加膨胀式硫酸钙人工骨植入术治疗股骨头缺血性坏死的效果。方法:选取早期股骨头坏死患者60例,随机分为对照组和治疗组各30例。治疗组采用髓芯减压配合可膨胀人工骨植入治疗,对照组采用髓芯减压联合钽棒植入治疗。术后3、12个月记录患者Harris髋关节评分和影像学检查结果,对比疗效。结果:所有病人随访9~15个月,平均12个月。术后3个月两组患者Harris评分对比,治疗组高于对照组(P<0.05);术后1年对比,治疗组明显高于对照组(P<0.05);两组患者术前与术后1年对比,治疗后均好于治疗前(P<0.05);两组患者术后1年随访,治疗组痊愈7例,有效20例,无效3例,总有效率为90.0%;对照组痊愈2例,有效18例,无效10例,总有效率为66.7%。两组患者影像学评分比较,治疗组明显好于对照组,差异具有统计学意义(P<0.05)。结论:股骨头髓芯减压加膨胀式硫酸钙人工骨植入术治疗股骨头缺血性坏死具有手术创伤小、关节功能恢复快、临床疗效显著、短期效果满意的优点,且长期疗效值得期待。

Objective：To explore the clinical effects of the treatment for the osteonecrosis of the femoral head by pulp core decom- pression combined with expanding calcium sulfate artificial bone implantation. Methods： Sixty patients with early femoral head nec- rosis were selected and divided into the control group and the treatment group each with 30 cases. As for the treatment group, femo- ral medullary core decompression combined with expanding calcium carbonate artificial bone implantation was used for the treatment~ and the control group was treated with femoral medullary core decompression combined with the tantalum rob implantation. Re- suits：All patients were followed up for 9 to 15 months with an average of 12 months. Comparing the Harris scores at 3 and 12 month after operation, the effects of the treatment group were better than that of the control group （P〈0.05）. After 12 months treatment, the effects of both groups were better than before （P〈0.05）. After 12 months follow-up, as for the treatment group, 7 cases were cured, 22 cases were effective, and 3 cases were ineffective, the total effective rate was 90%3 while for the control group, 2 cases were cured, 18 cases were effective and 10 cases were invalid, and the total effective rate was 66.7%. The imaging score of the treatment group was significantly better than that of the control group （P〈0.05）. Conclusion： The treatment of is- chemic necrosis of femoral head by pulp core decompression combined with expanding calcium sulfate artificial femoral head bone im- plantation has series of advantages of light surgical trauma, rapid recovery of the joint function, significant clinical efficacy and satisfactory short-term effect. What＇s more, it is worth to look forward to the long-term efficacy.