Korompilias A V, Lykissas M G, Beris A E, Urbaniak J R, Soucacos P N
Department of Orthopaedic Surgery, School of Medicine, University of Ioannina, Panepistimioupoli Street, Ioannina, P. C. 45110 Greece.
J Bone Joint Surg Br. 2009 Mar;91(3):287-93. doi: 10.1302/0301-620X.91B3.21846.
The management of osteonecrosis of the femoral head ranges from symptomatic therapy to total hip replacement. Conservative treatment is effective only in small, early-stage lesions. Free vascularised fibular grafting has provided more consistently successful results than any other joint-preserving method. It supports the collapsing subchondral plate by primary callus formation, reduces intra-osseous pressure, removes and replaces the necrotic segment, and adds viable cortical bone graft plus fresh cancellous graft, which has osseoinductive and osseoconductive potential. Factors predisposing to success are the aetiology, stage and size of the lesion. Furthermore, it is a hip-salvaging procedure in early pre-collapse stages, and a time-buying one when the femoral head has collapsed.
股骨头坏死的治疗方法多样，从对症治疗到全髋关节置换不等。保守治疗仅对早期小病灶有效。带血管蒂游离腓骨移植术比其他任何保关节方法都能更持续地取得成功结果。它通过一期骨痂形成来支撑塌陷的软骨下骨板，降低骨内压，去除并替换坏死节段，还添加具有骨诱导和骨传导潜能的活性皮质骨移植块及新鲜松质骨移植块。影响手术成功的因素包括病因、病灶分期和大小。此外，该手术在股骨头早期未塌陷阶段可挽救髋关节，而在股骨头已塌陷时则可延缓病情发展。
