股骨颈头颈开窗植骨联合体外冲击波治疗早期股骨头坏死26例

26 Cases Report of Fenestration and Bone Grafting of Femoral Head and Neck Combined with Extracorporeal Shock Wave for Early Osteonecrosis of the Femoral Head

目的:探究股骨颈头颈开窗植骨联合体外冲击波治疗早期股骨头坏死的临床效果。方法:回顾2018年1月至2021年12月收治的股骨头坏死患者的临床资料。记录患者视觉模拟量表(VAS)评分、髋关节功能Harris评分及X线复查结果。结果:46例患者纳入本研究,其中26例患者接受股骨颈头颈开窗打压植骨联合体外冲击波治疗,20例患者仅接受股骨颈头颈开窗打压植骨治疗。在治疗6个月和12个月后,打压植骨联合体外冲击波治疗组VAS评分、髋关节Harris评分及髋关节X线评分优于单纯植骨治疗组,差异有统计学意义(P<0.05)。结论:股骨颈头颈开窗打压植骨联合体外冲击波治疗可减轻早期股骨头坏死患者的疼痛症状,改善髋关节功能。体外冲击波可促进植入的骨粒同宿主骨整合,提高植骨术后保头治疗的成功率。

Objective:To explore the clinical efficacy of fenestration and bone grafting of femoral head and neck combined with extracorporeal shock wave for early osteonecrosis of the femoral head.Methods:We reviewed the clinical data of patients with osteonecrosis of the femoral head from January 2018to December 2021.We recorded the patient's visual analogue scale(VAS)scores and Harris scores and X-ray results.Results:A total of 46patients were included in this study.26patients received fenestration and bone grafting of femoral head and neck combined with high focus extracorporeal shock wave therapy,and 20patients received simple bone grafting treatment.After 6and 12months of treatment,the VAS scores,Harris scores,and X-ray scores of the hip joint in the group treated with bone grafting combined with extracorporeal shock wave therapy were better than those in the group with bone grafting alone,and the differences were statistically significant(P<0.05).Conclusion:Femoral head and neck window compression and bone grafting combined with extracorporeal shock wave therapy can alleviate pain symptoms and improve hip function in patients with early femoral head necrosis.Bone grafting combined with extracorporeal shock wave therapy could alleviate pain symptoms and improve hip function in patients with early osteonecrosis of the femoral head.Extracorporeal shock wave could promote the integration of implanted bone granules with host bone and improve the success rate of femoral head preservation treatment.