介入+异体腓骨移植治疗成人股骨头缺血性坏死

Intervention therapy and heterogeneous bone transplantation for adult avascular necrosis of femoral head

目的 探讨介入 +异体腓骨移植治疗成人股骨头缺血性坏死近期疗效。方法 12例 18髋 ,结合影像学分期 :FicatⅠ期 11髋 ,Ⅱ期 6髋 ,Ⅲ期 1髋 ,分别先进行介入治疗 ,2周后行病灶清除+异体腓骨移植手术。结果 按成人股骨头坏死疗效的百分评价方法 ,对 12例 18髋随防 12～ 4 8个月 ,平均随防 2 9个月 ,优 9髋 ,良 8髋 ,差 1髋 ,优良率 94 4 %。结论 介入 +异体腓骨移植不但改善股骨头血运 ,同时彻底清除死骨 ,减压植骨增加股骨头负重区软骨下骨的机械支撑 ,有利于股骨头坏死的重建修复 ,适用于FicatⅠ、Ⅱ期患者。

Objective To investigate a good method to treat avascular necrosis of femoral head (AVNFH) by intervention therapy and heterogeneous bone transplantation. Methods 12 patients (18 hips) with AVNFH were treated with interventional therapy and focal cleaning and heterogeneous bone graft after two weeks. According to image and Ficat staging, the group included 11 FicatⅠ hips, 6 Ficat Ⅱ and 1 Ficat Ⅲ. Results The follow up ranged from 12 to 48 months, with an average of 29 months. The clinical outcomes were excellent in 9 hips, good in 8 and poor in 1. The excellent and good rate was 94 4%. Conclusion It has synergistic effect in the treatment of AVNFH with intervention therapy and heterogeneous bone transplantation. It improves not only the revascularization but also the focal cleaning ,decompression and provides mechanic buttress in the weight loaded area, which is beneficial for femoral head reconstruction. It is suitable for osteonecrosis of femeral head at stage Ⅰ and stage Ⅱ.