摘要
目的探讨髋关节镜直视下髋关节清理、富血小板血浆(platelet-rich plasma,PRP)精准注入联合钽棒植入术治疗早期股骨头坏死(osteonecrosis of the femoral head,ONFH)的临床疗效。方法选取2020年10月至2022年10月收治的早期ONFH患者50例(62髋),随机分为两组,其中观察组25例(32髋)采用关节镜直视下髋关节清理、PRP精准注入联合钽棒植入术治疗,对照组25例(30髋)采用单纯髓芯减压钽棒植入术治疗。术后第1、2、3、6、12个月门诊复查髋关节X线片,观察股骨头密度的变化,对髋关节Harris评分及疼痛视觉模拟评分(visual analogue scale,VAS)等指标进行评估。结果术后12个月髋关节X线片示,观察组患者股骨头外形良好,没有出现囊性变扩大或股骨头塌陷,内植物与骨整合良好,无松动移位发生;对照组有6例发生了股骨头塌陷,内植物与骨整合差,界限明显。末次随访时观察组效果明显优于对照组。观察组髋关节Harris评分由术前的(68.13±6.45)分提高到末次随访时的(89.64±7.14)分,对照组髋关节Harris评分由术前的(68.73±7.15)分提高到末次随访时的(78.64±7.14)分;观察组疼痛VAS评分由术前的(4.5±1.3)下降到末次随访时的(1.8±1.1)分,对照组疼痛VAS评分由术前的(4.3±1.2)下降到末次随访时的(2.3±1.3)分,均P<0.05。两组患者治疗后Harris和VAS评分对比差异具有统计学意义(P<0.05)。结论与单纯髓芯减压钽棒植入术相比,关节镜直视下髋关节清理、PRP精准注入联合钽棒植入术治疗早期股骨头坏死可以明显减轻患髋的疼痛症状、改善患髋的活动功能,并能促进新生骨长入,短期疗效显著,为临床治疗早期ONFH提供了一种新的方法。
Objective To investigate the clinical effect of precise platelet-rich plasma(PRP)injection combined with tantalum rod implantation under arthroscopy in the treatment of early osteonecrosis of femoral head(ONFH).Methods From October 2020 to October 2022,50 patients with early femoral head necrosis(62 hip joints)were divided into two groups,of which 25 cases(32 hips)in the observation group were treated with arthroscopy assisted PRP injection combined with tantalum rod implantation,and 25 cases in the control group(30 hip joints)were treated with simple core decompression and tantalum implantation.The X-ray films of the hip joints were reviewed at 1,2,3,6 and 12 months after the operation,and the changes of the femoral head density were observed.The Harris score of the hip joints and the VAS score of the pain were evaluated.Results The X-ray films of the hip joints 12 months after the operation showed that the femoral head in the observation group had good shape without cystic enlargement or the collapse of the femoral head,the integration of the internal plants and bone was good,and no loosening of the displacement occurred.In the control group,there were 6 cases of collapse of the femoral head,and the difference between the plant and bone integration was obvious.In the last follow-up,the effect of the observation group was significantly better than that of the control group.The Harris scores of the hip joints in the observation group were increased from(68.13±6.45)points before surgery to(89.64±7.14)points at the last follow-up.The Harris scores of the hip joints in the control group were increased from(68.73±7.15)points before surgery to(78.64±7.14)points at the last follow-up.The pain scores of VAS in the observation group decreased from(4.5±1.3)points to(1.8±1.1)points at the last follow-up.The VAS pain scores in the control group decreased from(4.3±1.2)points before surgery to(2.3±1.3)points at the last follow-up.The difference between the two groups before and after the treatment was statistically significant(P<0.05),and the difference between the two groups after the treatment was statistically significant(P<0.05).Conclusion Arthroscopy assisted PRP injection combined with tantalum rod implantation and pure core decompression for early femoral head necrosis can significantly reduce the pain symptoms of the hips,improve the activity of the hips,and promote the growth of the new bones,with the short-term effects significant.It provides a new method for the clinical treatment of osteonecrosis of the femoral head.
作者
姜良斌
田玲
王楠
吴海燕
JIANG Liangbin;TIAN Ling;WANG Nan;WU Haiyan(Linyi People's Hospital,Linyi 276000,Shandong,P.R.China;Weigao Group Co.,Ltd.,Weihai 264200,Shandong,P.R.China;Affiliated Hospital of Shandong Medical College,Linyi 276002,Shandong,P.R.China)
出处
《滨州医学院学报》
2025年第4期374-379,共6页
Journal of Binzhou Medical University
关键词
关节镜
富血小板血浆
股骨头坏死
钽棒
髓芯减压
arthroscopy
platelet rich plasma
osteonecrosis of the femoral head
tantalum rod
core decompression
