记忆合金网球与单纯减压植骨治疗股骨头坏死的对照研究

A Comparative Study on the Treatment of Ischemic Necrosis of the Femoral Head in Adults using Memorial Metal Flexible Cage vs Decompression with Bone Grafting

目的 对比研究记忆合金网球植入与单纯减压植骨两种方法治疗成人股骨头缺血性坏死的疗效。方法 成人股骨头缺血性坏死 (FicatⅡ～Ⅲ期 ) 4 5例 ,分别采用记忆合金网球植入和单纯减压植骨 +股方肌骨瓣移植治疗 ,网球组 2 3例 2 6髋 ,减压植骨组 2 2例 2 6髋 ,分别观察两组病例的手术时间 ,术中出血量 ,术后髋关节的功能评分。结果 网球组和减压植骨组的手术时间和出血量 ,分别为 6 2 4± 2 0 5min、 5 0 8± 16 6min (P <0 0 5 )和 180 6± 38 5ml、 16 9 9± 4 5 8ml (P >0 0 5 ) ,术后所有病例经平均 32个月随访 ,采用百分评分法评价 ,网球组的优良率为 88 4 % ,减压植骨组的优良率为 5 3 8% (P <0 0 5 )。结论 记忆合金网球植入能增加股骨头的机械支撑力 ,重建股骨头血运 。

Objective To compare the results of the treatment of ischemic necrosis of femoral head using memorial metal flexible cage vs decompression with bone grafting.Methods Two surgical procedures were performed in 52 hips in 45 patients with ischemic necrosis of the femoral head (Ficat stage Ⅱ～Ⅲ).Twenty six hips in 23 patients (group A) were received memorial metal flexible cage implanting and 26 hips in 22patients (group B) were received decompression with bone grafting.Results Forty-five cases were followed up with an average period of 32 months. According to standards of Chinese Society of Osteonecrosis, in group A,12 hips were assessed as excellent,11 hips as good ,2 hips as fair,1 hip as poor, excellent and good rate was 88 4%. In group B,6 hips were assessed as excellent,8 hips as good,7 hips as fair,3 hips as poor , excellent and good rate was 53.8%(P<0 05).Conclusion The memorial metal flexible cage implanting could increase mechanical support and decrease the stress for femoral head, It could promote revascularezation and new bone formation for necrotic femoral head.