数字技术联合髓芯减压人工骨植入治疗早中期股骨头坏死

Digital Technology with Decompression and Bone Graft for the Treatment of the Early and Middle Stage Osteonecrosis of the Femoral Head

目的:回顾性分析在早中期股骨头坏死患者中,使用数字技术结合髓芯减压、人工骨植骨的临床疗效。方法:选取2013.01-2017.01符合纳入及排除标准的共计21名股骨头早中期患者。所有的股骨头坏死患者均统一按照国际股循环研究会标准,评定为ARCO Ⅰ期或者Ⅱ期。所有纳入患者均采用数字技术进行相关的术前准备,导板制作。然后术中行髓芯减压,死骨刮出,人工骨植骨术。术后通过视觉模拟评分和髋关节Harris评分系统对患者的疼痛和功能进行判定。结果:所有患者均接受至少半年的随访。患者在术后3个月及6月的Harris功能评分较术前具有显著的改善(P<0.05)。21例患者中,优:12例,良:7例,尚可:2例。优良率为90.5%。股骨头保存率为100%。患者在术后1月、3月及6月的VAS疼痛评分较术前具有显著的降低(P<0.05)。结论:与传统技术相比,使用数字技术结合髓芯减压,人工骨植骨在轻中度股骨头坏死患者的治疗中可显著改善功能,减轻疼痛,具有较明显的优势。

Objective： Objective the outcome of the digital technology with decompression and bone graft for the treatment of the early and middle stage osteonecrosis of the femoral head. Methods： Retrospective analysis of 2013.01 to 2017.01 since the diagnosis and treatment of 21 patients with the early and middle stage osteonecrosis of the femoral head. The necrosis stage was divided into the Association Research Circulation Osseous（ARCO）Ⅰstage andⅡstage. All patients were accepting digital technology to have the preoperative preparation and guide production. Then the patients received core decompression, sequestrum erasion, impaction of artificial bone filling particles. Hip Harris Score（HHS） was used to evaluate the postoperative improvement of the hip function and the Visual Analogue Scale（VAS） to assess the intensity of pain. Results： In this study, 21 cases were followed up for at least 6 months. HHS were significantly increased when compared before surgery in the 3 th month and 6 th month after the treatment（P〈0.05）. The excellent function was obtained in 12 hips, good function in 7 hips, and fair function in 2 hips, the good rate was 90.5%, the survival rate of the femoral head was100%. VAS 2 were significantly reduced when compared before surgery in the 3 th month and 6 th month after the treatment（P〈0.05）.Conclusions： Compared with the traditional treatment, the digital technology with decompression and bone graft for the treatment of the early and middle stage osteonecrosis of the femoral head has advantages in induce process of injury repair in the femoral head, promoting the function of hip joint, and play a very good prevention and treatment role for hip pain fracture healing time.