摘要
目的探讨多孔钽金属棒植入微创治疗早期(ARCOⅠ期、Ⅱ期)股骨头坏死的临床疗效。方法 2007年2月至2008年9月治疗早期股骨头坏死3 1例(39髋),采用经大转子下1.5cm小切口,在C臂透视下通过股骨颈钻隧道至股骨头骨坏死区,将多孔钽金属棒经隧道置入骨坏死区直至软骨下骨约5mm处。术前ARCO分期:Ⅰ期16髋,Ⅱ期23髋。双髋8例,单髋23例。结果所有患者随访13-32个月,平均21.6个月。以最后1次随访资料作为最终评价依据。按髋关节Harris评分评价手术效果,术前优良率为48.4%(15/31),术后优良率为90.3%(28/31)。并观察有无影像学进展及进一步治疗的需要。结论多孔钽金属棒植入微创治疗成人早期股骨头坏死操作简单、创伤小,手术时间短,出血少;可以改善关节功能,有效防止股骨头塌陷、延缓股骨头缺血性坏死的发展,近期效果良好。
Objective To investigate the clinical efficacy of the minimally invasive treatment with implantation of porous tantalum rod for femur head necrosis in the early stage （ARCO Stage I and ARCO Stage II）. Methods From February 2007 to September 2008, 31 patients （39 affected hips） with femur head necrosis in the early stage underwent treatment as below. A small incision was made 1.5 cm beneath the greater trochanter. Under the the perspective of C-arm, a tunnel from the femoral neck to the osteonecrosis zone of the femoral head was made. Through the tunnel, the porous tantalum rod was implanted into the osteonecrosis zone of the femoral head for about 5 mm beneath the subchondral bone. The pre-operative ARCO staging of the affected hips were Stage I （n=16） and Stage II （n=23）. Among the 31 patients, 8 sustained lesion in both hips, and 23 in a single hip. Results All the patients were followed up within a period from 13 to 32 months, with 21.6 months on average. The final evaluation was made according to the last followup data. The efficacy of the surgery was evaluated according to the Harris hip score （HHS）. The pre-operative excellent and good rate was 48.4% （15/31）, while the post-operative one was 90.3% （28/31）. Meanwhile, observations were made in order to know whether there were imaging developments, and whether further treatments were needed. Conclusions The minimally invasive treatment with implantation of porous tantalum rod for adult femur head necrosis in the early stage has the advantages of simple operations, small wound, short operation time, and less blood loss. The treatment can improve the function of the joint, efficiently prevent the collapse of the femoral head, and delay the development of the avascular necrosis of the adult femoral head. The short-term efficacy is good.
出处
《中国骨肿瘤骨病》
CAS
2011年第2期155-158,共4页
Chinse Journal Of Bone Tumor And Bone Disease
关键词
股骨头坏死
多孔钽
微创
Femur head necrosis
Porous tantalum
Minimally invasive
