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[三隧道髓芯减压联合骨髓基质细胞(bMSCs)及脱钙骨基质(DBM)植入治疗早期股骨头坏死]

[Three-tunnels core decompression with implantation of bone marrow stromal cells (bMSCs) and decalcified bone matrix (DBM) for the treatment of early femoral head necrosis].

作者信息

Ji Wei-feng, Ding Wei-hang, Ma Zheng-chuan, Li Ju, Tong Pei-jian

机构信息

Department of Orthopaedics and Traumatology, the Hospital of Zhejiang Province of TCM, Hangzhou 310006, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2008 Oct;21(10):776-8.

Abstract

OBJECTIVE

To analyse retrospectively 3-tunnels core decompression with implantation of bone marrow stromal cells(bMSCs) and decalcified bone matrix (DBM) for treatment of femoral head necrosis in early stages, and to study its therapeutic results and indications.

METHODS

According to the University of Pennsyvania system of classification and staging,to treat the patients with 3-tunnels core decompression with implantation of bone marrow stromal cells (bMSCs) and decalcified bone matrix (DBM) for treatment of early femoral head necrosis. Among the total 87 patients (103 hips), the male was 71 (86 hips) and the female 16 (17 hips) with the average age of 47 years old. The average course of disease was 1.3 year. The effect was evaluated by the clinical symptoms, the Harris' scores and the manifestations of radiology before and after operation.

RESULTS

All the patients were followed up more than 2 years (average 26 months). The average Harris' scores increased from preoperation 47.3 to postoperation 74.0. The average rate of excellent and good results was 75.7%. The rate of excellent and good was 88% (22/25) in type I, 78.7% (37/47) in type II and 61.3% (19/31) in type III. No severe complications were observed.

CONCLUSION

Three-tunnels core decompression with implantation of bMSCs and DBM not only removal the focus of disease, but also use DBM the induction of bone and autologous hone marrow stem cells to differentiate the functions of the femoral head can be resumed loading structure, eliminate pain,improve joint function. It is an effective method for early femoral head necrosis.

摘要

目的

回顾性分析三隧道髓芯减压联合植入骨髓基质细胞(bMSCs)和脱钙骨基质(DBM)治疗早期股骨头坏死的疗效及适应证。

方法

按照宾夕法尼亚大学分类分期系统,采用三隧道髓芯减压联合植入骨髓基质细胞(bMSCs)和脱钙骨基质(DBM)治疗早期股骨头坏死患者。87例患者(103髋)中,男性71例(86髋),女性16例(17髋),平均年龄47岁,平均病程1.3年。通过术前、术后临床症状、Harris评分及影像学表现评估疗效。

结果

所有患者随访均超过2年(平均26个月)。Harris评分平均由术前47.3分提高至术后74.0分。优良率平均为75.7%。Ⅰ型优良率为88%(22/25),Ⅱ型为78.7%(37/47),Ⅲ型为61.3%(19/31)。未观察到严重并发症。

结论

三隧道髓芯减压联合植入bMSCs和DBM不仅能清除病灶,还利用DBM诱导成骨及自体骨髓干细胞分化的功能,使股骨头恢复负重结构,消除疼痛,改善关节功能。是治疗早期股骨头坏死的有效方法。

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