He Bang-Jian, Li Ju, Lyu Yi, Tong Pei-Jian
Department of Orthopaedics, the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310005, Zhejiang, China;
Zhongguo Gu Shang. 2016 Dec 25;29(12):1119-1124. doi: 10.3969/j.issn.1003-0034.2016.12.011.
To compare clinical effects of core decompression with stem cell transplantation and tantalum rod implanting in treating stage II non-traumatic osteonecrosis of femoral head.
From March 2012 to September 2012, 45 patients(55 hips)with stage ARCO II non-traumatic osteonecrosis of femoral head were treated and divided into core decompression with stem cell transplantation group(group A) and tantalum rod implanting group(group B) according to number table. In group A, there were 23 cases(28 hips) , including 12 males and 11 females aged from 23 to 51 years old with an average of (36.87±9.52) years, the courses of disease ranged from 2 to 28 months with an average of (17.13±7.74) months, preoperative Harris score was for 35 to 70 with an average of(54.74±11.81), treated with core decompression with stem cell transplantation. In group B, there were 22 cases(27 hips), including 11 males and 11 females aged from 26 to 46 years old with an average of (35.59±7.39) years, the courses of disease ranged from 3 to 26 months with an average of(16.00±7.46) months, preoperative Harris score was for 35 to 76 with an average of (57.18±12.95), treated with core tantalum rod implanting. Operative time, blood loss, hospital stays, hospitalization expenses were observed and compared after treatment between two groups, the clinical effects were evaluated according to Harris criteria.
All patients were followed up from 6 to 12 months with an average of 10.8 months. There were significant difference in hospitalization expenses between two groups(<0.05), while there was no significant statistical difference in blood loss and hospital stay (>0.05). At the final following-up, Harris score in group A was(83.04±8.97), 6 cases obtained excellent results, 14 good, 2 good and 1 poor;while Harris score in group A was(84.41±9.94), and 9 cases obtained excellent results, 9 good, 3 good and 1 poor; there was no statistical meaning differences between two groups(>0.05).
Core decompression with stem cell transplantation and tantalum rod implanting could both improve function of hip joint, while core decompression with stem cell transplantation had advantages of shorter operation time, less cost, and higher potency ratio. It is suitable for stage ARCO II non-traumatic femoral head necrosis.
比较髓芯减压联合干细胞移植与钽棒植入治疗Ⅱ期非创伤性股骨头坏死的临床效果。
选取2012年3月至2012年9月收治的45例（55髋）ARCOⅡ期非创伤性股骨头坏死患者，按随机数字表法分为髓芯减压联合干细胞移植组（A组）和钽棒植入组（B组）。A组23例（28髋），男12例，女11例，年龄23～51岁，平均（36.87±9.52）岁，病程2～28个月，平均（17.13±7.74）个月，术前Harris评分为35～70分，平均（54.74±11.81）分，采用髓芯减压联合干细胞移植治疗；B组22例（27髋），男11例，女11例，年龄26～46岁，平均（35.59±7.39）岁，病程3～26个月，平均（16.00±7.46）个月，术前Harris评分为35～76分，平均（57.18±12.95）分，采用钽棒植入治疗。观察比较两组治疗后的手术时间、出血量、住院时间、住院费用，并根据Harris标准评估临床疗效。
所有患者均随访6～12个月，平均10.8个月。两组住院费用比较差异有统计学意义（<0.05），而出血量和住院时间比较差异无统计学意义（>0.05）。末次随访时，A组Harris评分为（83.04±8.97）分，优6例，良14例，可2例，差1例；B组Harris评分为（84.41±9.94）分，优9例，良9例，可3例，差1例；两组比较差异无统计学意义（>0.05）。
髓芯减压联合干细胞移植与钽棒植入均可改善髋关节功能，而髓芯减压联合干细胞移植具有手术时间短、费用低、有效率高的优点，适用于ARCOⅡ期非创伤性股骨头坏死。
