髓芯减压术治疗早中期股骨头缺血坏死研究进展

Research Progress of Core Decompression in the Treatment of Early-to-Mid Osteonecrosis of the Femoral Head

股骨头坏死(Osteonecrosis of the Femoral Head, ONFH)是骨科常见且难治的骨坏死性疾病,关于其病因的研究,目前仍没有一种病理生理机制能够完全解释ONFH的病因。ONFH进展快,预后差,有文献报道其5年塌陷率达到70%,是青壮年致残的主要病因之一。有10%的人工全髋关节置换(Total Hip Arthroplasty, THA)也是由于ONFH导致的。因此预防股骨头塌陷成为治疗ONFH中的关键。髓芯减压术(core decompression, CD)是一种理论上降低股骨头骨内压的技术,促进局部血供恢复。其功效已被证明可延缓早期软骨下塌陷。本文通过介绍近年来国内外学者对髓芯减压治疗ONFH的各种方式及成果进行综述。

Osteonecrosis of the Femoral Head (ONFH) is a common and refractory osteonecrosis disease in or-thopedics. There is still no pathophysiological mechanism that can fully explain the etiology of ONFH. ONFH progresses rapidly and has a poor prognosis. It has been reported that the 5-year collapse rate of ONFH is up to 70%, which is one of the main causes of disability in young adults. ONFH is also responsible for 10% of Total hip arthroplasty (THA). Therefore, prevention of femoral head collapse becomes the key to the treatment of ONFH. Core decompression (CD) is a technique that theoreti-cally reduces intra-osseous pressure of the femoral head and promotes restoration of local blood supply. Its efficacy has been shown to delay early subchondral collapse. This article reviews the methods and results of core decompression in the treatment of ONFH by domestic and foreign scholars in recent years.