Chen Xiantao, Tan Xuyi, Gao Shutu, Zhang Xiaodong, Li Jianming, Liu Youwen
Department of Osteonecrosis of the Femeral Head, Luoyang Orthopedics Hospital of Henan Province, Luoyang, China.
Hunan University of TCM, Changsha, China.
Int Orthop. 2016 Jul;40(7):1417-25. doi: 10.1007/s00264-015-2921-5. Epub 2015 Jul 15.
This study summarises the clinical efficacy of sartorius muscle-pedicle bone graft in osteonecrosis of the femoral head.
A total of 58 patients, including 53 men (61 hips) and five women (6 hips) with osteonecrosis of the femoral head, underwent sartorius muscle-pedicle bone grafting. Association Research Circulation Osseous (ARCO) staging was performed.
The ARCO staging revealed 23 hips of stage I, 36 hips of stage II and eight hips of stage III. The average surgical duration was 65 minutes (range 45-90 minutes). A total of 55 (64 hips) of the 58 patients undergoing surgery were followed up, with a mean follow-up duration of 34.48 months (range, 24-48 months) and a median of 34 months. The outcome was excellent in 27, good in 24, normal in two, and poor in 11 hips, with a total good rating of 79.68 %. The Harris score of the hip joints in the last follow-up was significantly improved compared with pre-surgical scores (P < 0.01). Imaging results showed that 21 hips were improved, 31 hips were stabilized and 12 hips were aggravated (of which 9 hips underwent total hip replacement). The survival rate of femoral head was 81.25 %.
Sartorius muscle-pedicle bone graft significantly promotes repair of osteonecrosis of the femoral head, improves the Harris score of the hip joints, with good clinical efficacy. It effectively improves the survival rate of femoral head, delaying or preventing artificial hip replacement.
本研究总结缝匠肌蒂骨瓣移植治疗股骨头坏死的临床疗效。
共58例股骨头坏死患者接受缝匠肌蒂骨瓣移植,其中男性53例(61髋),女性5例(6髋)。进行了骨循环研究协会(ARCO)分期。
ARCO分期显示,I期23髋,II期36髋,III期8髋。平均手术时间为65分钟(范围45 - 90分钟)。58例接受手术的患者中,共55例(64髋)获得随访,平均随访时间为34.48个月(范围24 - 48个月),中位数为34个月。结果为优27髋,良24髋,正常2髋,差11髋,总优良率为79.68%。末次随访时髋关节Harris评分较术前显著改善(P < 0.01)。影像学结果显示,21髋改善,31髋稳定,12髋加重(其中9髋接受了全髋关节置换)。股骨头生存率为81.25%。
缝匠肌蒂骨瓣移植能显著促进股骨头坏死修复,提高髋关节Harris评分,临床疗效良好。能有效提高股骨头生存率,延缓或避免人工髋关节置换。