Mont Michael A, Ragland Phillip S, Etienne Gracia
Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Reconstruction, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.
Clin Orthop Relat Res. 2004 Dec(429):131-8. doi: 10.1097/01.blo.0000150128.57777.8e.
Osteonecrosis is a disease with a wide ranging etiology and poorly understood pathogenesis seen commonly in young patients. Core decompression has historically been used in patients with small-sized or medium-sized precollapse lesions in an attempt to forestall disease progression. Typically, an 8-10 mm wide cannula trephine is used to do this procedure. The authors report on a new technique using multiple small drillings with a 3-mm Steinman pin to effectuate the core decompression. In this report, there were 32 of 45 hips (71%; 35 patients) with a successful clinical result at a mean followup of 2 years (range, 20-39 months). Twenty four of 30 Stage I hips (80%; 23 patients) had successful outcomes compared with 8 of 15 Stage II hips (57%; 12 patients) with no surgical complications occurring with this technique. This procedure is technically straightforward and led to minimal morbidity with no surgical complications. It may be effective in delaying the need for total hip arthroplasty in young patients with early (precollapse) stages of femoral head osteonecrosis.
骨坏死是一种病因广泛且发病机制尚不明确的疾病，常见于年轻患者。从历史上看，髓芯减压术一直用于治疗中小型塌陷前期病变的患者，试图延缓疾病进展。通常，使用直径8 - 10毫米的套管环锯进行此手术。作者报告了一种新技术，即使用3毫米的斯氏针进行多次小钻孔来实现髓芯减压。在本报告中，45例髋关节中有32例（71%；35例患者）在平均2年（范围20 - 39个月）的随访中获得了成功的临床结果。30例I期髋关节中有24例（80%；23例患者）取得了成功的结果，而15例II期髋关节中有8例（57%；12例患者）取得了成功结果，该技术未发生手术并发症。此手术在技术上简单直接，发病率极低且无手术并发症。对于早期（塌陷前期）股骨头骨坏死的年轻患者，它可能有效地延迟全髋关节置换术的需求。
