髓芯减压联合空心钉+自体骨植骨植入术治疗成人早期股骨头缺血性坏死的效果

Clinical efficacy of core decompression combined with cannulated screw and autologous bone graft on early avascular necrosis of the femoral head in adults

目的探讨髓芯减压联合空心钉+自体骨植骨植入术治疗成人早期股骨头缺血性坏死(ANFH)的效果。方法选取2010年2月至2020年1月南阳市骨科医院120例(150髋)ANFH患者作为研究对象,所有患者均行髓芯减压联合空心钉+自体骨植骨植入术治疗,随访1年,比较患者手术前后髋关节功能评分(Harris评分)、疼痛评分(视觉模拟评分法,即VAS),随访治疗效果及股骨头生存率。结果患者术后3个月、6个月、1年Harris评分均高于术前,差异有统计学意义(P<0.05)。与术前比较,患者术后3个月、6个月、1年VAS评分明显降低,差异有统计学意义(P<0.05)。治疗后显效92例,有效20例,总有效率为93.3%(112/120);术后1年影像学复查显示,股骨头生存率达到80.83%(97/120)。结论髓芯减压联合空心钉+自体骨植骨植入术应用于ANFH治疗,在改善患者髋关节功能、缓解疼痛方面有着突出效果,有利于提高股骨头生存率。

Objective To investigate the effect of core decompression combined with cannulated screw and autologous bone grafting on early avascular necrosis of the femoral head(ANFH)in adults.Methods One hundred and twenty patients(150 hips)with ANFH in Nanyang Orthopedic Hospital from February 2010 to January 2020 were selected as the research objects.All patients were treated with core decompression combined with cannulated screw+autologous bone graft implantation.They were followed up for 1 year.The hip function score(Harris score),pain score(VAS score),follow-up treatment effect and femoral head survival rate were compared before and after operation.Results The Harris scores at 3 months,6 months and 1 year after operation were significantly higher than those before operation(P<0.05).Compared with that before operation,the VAS score of patients decreased significantly at 3 months,6 months and 1 year after operation(P<0.05).After treatment,92 cases showed remarkable effect,20 cases were effective,and the total effective rate was 93.3%(112/120);One year after operation,the survival rate of femoral head was 80.83%(97/120).Conclusions Core decompression combined with cannulated screw+autologous bone graft implantation in the treatment of ANFH has a prominent effect on improving hip function and relieving pain,which is conducive to improving the survival rate of femoral head.