Background： Avascular necrosis of femoral head （AVNFH） typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still con...Background： Avascular necrosis of femoral head （AVNFH） typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. Methods： This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients （98 hips） with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips （Group A） or drilling decompression alone in 34 cases/55 hips （Group B）. Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. Results： All patients were followed up for an average of 57.6 months （range： 17-108 months）. Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris＇ scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 （t = -7.21, P = 0.001） than Group B with mean Harris＇ scores improved from 69.46 ± 9.71 to 75.79± 4.13 （t = -9.47, P = 0.037） （significantly different： t = -2.54, P = 0.017）. The total surgery effective rate was also significantly different between Groups A and B （86.0% vs. 74.5%; Z2 = 3.69, P = 0.02）. Conclusion： For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.展开更多
目的:探讨中大头人工全髋关节置换术(total hip arthroplasty,THA)治疗严重髋关节疾患的早期临床疗效。方法:回顾性分析2009年1月至2011年5月在郑州大学第一附属医院行中大头THA 50例55髋;男40例43髋,女10例12髋;年龄24～86岁,平均53.6...目的:探讨中大头人工全髋关节置换术(total hip arthroplasty,THA)治疗严重髋关节疾患的早期临床疗效。方法:回顾性分析2009年1月至2011年5月在郑州大学第一附属医院行中大头THA 50例55髋;男40例43髋,女10例12髋;年龄24～86岁,平均53.6岁。参照Harris评分,髋关节活动度,X线片显示及髋关节脱位、下肢不等长等术后并发症评价疗效。结果:50例患者均获得随访,平均随访时间2.1(0.5～2.5)年,Harris评分由术前平均(43.8±6.5)分(32～56分)改善为(91.1±12.1)分(78～96分),优良率98.2%,差异有统计学意义(P<0.01)。术后无假体松动、移位,未发现透亮线及假体周围骨溶解。结论:中大头THA治疗严重髋关节疾患早期临床疗效良好,尤适用于年轻、关节活动度要求较高患者,可有效恢复髋关节功能,提高生活质量。展开更多
目的比较不同直径股骨头假体用于全髋关节置换的中期疗效差异。方法回顾分析2010年3月至2013年9月共42例初次行全髋关节置换术治疗终末期髋关节疾病的患者,其中21例采用36 mm大直径陶瓷股骨头假体(大直径组),21例采用32 mm小直径陶瓷股...目的比较不同直径股骨头假体用于全髋关节置换的中期疗效差异。方法回顾分析2010年3月至2013年9月共42例初次行全髋关节置换术治疗终末期髋关节疾病的患者,其中21例采用36 mm大直径陶瓷股骨头假体(大直径组),21例采用32 mm小直径陶瓷股骨头假体(小直径组)。随访5年以上,通过Harris髋关节评分和X线片评估疗效差异。结果所有患者平均术后随访时间为(69.71±4.03)个月。末次随访所有患者的Harris髋关节评分与术前相比均显著提高(84.48±9.06 vs 40.21±9.05,P<0.001),且大直径组的髋关节评分显著高于小直径组(89.38±9.36 vs 79.57±5.51,P<0.001)。末次随访X线片示所有患者的假体位置均良好,两组均未见假体脱位。结论大直径股骨头假体的中期临床效果满意,与小直径假体相比可更好地改善术后关节活动度。展开更多
目的探讨基于核磁三维重建技术对股骨头进行重建指导钻孔减压术治疗股骨头坏死(osteonecrosis of thefemoral head,ONFH)的临床疗效。方法选取2016-07至2017-06就诊于解放军总医院第三医学中心骨一科诊断为ONFH,并采用核磁三维重建技术...目的探讨基于核磁三维重建技术对股骨头进行重建指导钻孔减压术治疗股骨头坏死(osteonecrosis of thefemoral head,ONFH)的临床疗效。方法选取2016-07至2017-06就诊于解放军总医院第三医学中心骨一科诊断为ONFH,并采用核磁三维重建技术指导钻孔减压术患者82例作为试验组,2015-06至2016-06同样就诊于我院诊断为ONFH进行钻孔减压术的患者65例作为对照组。术后6个月及1年进行两次随访,试验组及对照组均使用视觉模拟评分法(visual analoguescore,VAS)及人工全髋关节疗效评分标准(Harris)进行疗效分析。结果试验组术后1年VAS评分(2.55±0.50)分低于对照组(3.02±0.83)分,差异有统计学意义(t=4.25,P<0.01)。Harris总分及其各项得分术后6个月及1年比较,差异有统计学意义(P<0.05)。术后1年疗效评价,试验组优良率(69.51%)高于对照组(46.15%),差异有统计学意义(χ~2=8.190,P=0.004)。结论核磁三维重建技术在指导股骨头钻孔减压及评价ONFH坏死区域体积方面具有较大的优势,在未来应进行更加深入的研究。展开更多
文摘Background： Avascular necrosis of femoral head （AVNFH） typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. Methods： This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients （98 hips） with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips （Group A） or drilling decompression alone in 34 cases/55 hips （Group B）. Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. Results： All patients were followed up for an average of 57.6 months （range： 17-108 months）. Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris＇ scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 （t = -7.21, P = 0.001） than Group B with mean Harris＇ scores improved from 69.46 ± 9.71 to 75.79± 4.13 （t = -9.47, P = 0.037） （significantly different： t = -2.54, P = 0.017）. The total surgery effective rate was also significantly different between Groups A and B （86.0% vs. 74.5%; Z2 = 3.69, P = 0.02）. Conclusion： For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.
文摘目的:探讨中大头人工全髋关节置换术(total hip arthroplasty,THA)治疗严重髋关节疾患的早期临床疗效。方法:回顾性分析2009年1月至2011年5月在郑州大学第一附属医院行中大头THA 50例55髋;男40例43髋,女10例12髋;年龄24～86岁,平均53.6岁。参照Harris评分,髋关节活动度,X线片显示及髋关节脱位、下肢不等长等术后并发症评价疗效。结果:50例患者均获得随访,平均随访时间2.1(0.5～2.5)年,Harris评分由术前平均(43.8±6.5)分(32～56分)改善为(91.1±12.1)分(78～96分),优良率98.2%,差异有统计学意义(P<0.01)。术后无假体松动、移位,未发现透亮线及假体周围骨溶解。结论:中大头THA治疗严重髋关节疾患早期临床疗效良好,尤适用于年轻、关节活动度要求较高患者,可有效恢复髋关节功能,提高生活质量。
文摘目的比较不同直径股骨头假体用于全髋关节置换的中期疗效差异。方法回顾分析2010年3月至2013年9月共42例初次行全髋关节置换术治疗终末期髋关节疾病的患者,其中21例采用36 mm大直径陶瓷股骨头假体(大直径组),21例采用32 mm小直径陶瓷股骨头假体(小直径组)。随访5年以上,通过Harris髋关节评分和X线片评估疗效差异。结果所有患者平均术后随访时间为(69.71±4.03)个月。末次随访所有患者的Harris髋关节评分与术前相比均显著提高(84.48±9.06 vs 40.21±9.05,P<0.001),且大直径组的髋关节评分显著高于小直径组(89.38±9.36 vs 79.57±5.51,P<0.001)。末次随访X线片示所有患者的假体位置均良好,两组均未见假体脱位。结论大直径股骨头假体的中期临床效果满意,与小直径假体相比可更好地改善术后关节活动度。
文摘目的探讨基于核磁三维重建技术对股骨头进行重建指导钻孔减压术治疗股骨头坏死(osteonecrosis of thefemoral head,ONFH)的临床疗效。方法选取2016-07至2017-06就诊于解放军总医院第三医学中心骨一科诊断为ONFH,并采用核磁三维重建技术指导钻孔减压术患者82例作为试验组,2015-06至2016-06同样就诊于我院诊断为ONFH进行钻孔减压术的患者65例作为对照组。术后6个月及1年进行两次随访,试验组及对照组均使用视觉模拟评分法(visual analoguescore,VAS)及人工全髋关节疗效评分标准(Harris)进行疗效分析。结果试验组术后1年VAS评分(2.55±0.50)分低于对照组(3.02±0.83)分,差异有统计学意义(t=4.25,P<0.01)。Harris总分及其各项得分术后6个月及1年比较,差异有统计学意义(P<0.05)。术后1年疗效评价,试验组优良率(69.51%)高于对照组(46.15%),差异有统计学意义(χ~2=8.190,P=0.004)。结论核磁三维重建技术在指导股骨头钻孔减压及评价ONFH坏死区域体积方面具有较大的优势,在未来应进行更加深入的研究。
