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装载自体骨的灯笼形螺钉治疗股骨头坏死

Lantern-shaped screw loaded with autologous bone for treating osteonecrosis of the femoral head.

作者信息

Lin Dasheng, Wang Lei, Yu Zhaoliang, Luo Deqing, Zhang Xigui, Lian Kejian

机构信息

Orthopaedic Center of People's Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, 363000, China.

Department of Surgery, Experimental Surgery and Regenerative Medicine, Ludwig-Maximilians-University (LMU), 80336, Munich, Germany.

出版信息

BMC Musculoskelet Disord. 2018 Sep 5;19(1):318. doi: 10.1186/s12891-018-2243-z.

DOI:10.1186/s12891-018-2243-z
PMID:30185196
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6123930/
Abstract

BACKGROUND

Treatment for osteonecrosis of the femoral head (ONFH) in young individuals remains controversial. We developed a lantern-shaped screw, which was designed to provide mechanical support for the femoral head to prevent its collapse, for the treatment of ONFH. The purpose of this study was to investigate the efficacy and safety of the lantern-shaped screw loaded with autologous bone for the treatment of pre-collapse stages of ONFH.

METHODS

Thirty-two patients were randomly divided into two groups: the lantern-shaped screw group (core decompression and lantern-shaped screw loaded with autogenous bone) and the control group (core decompression and autogenous bone graft). During 36 months follow-up after surgery, treatment results in patients were assessed by X-ray and computed tomography (CT) scanning as well as functional recovery Harris hip score (HHS).

RESULTS

Successful clinical results were achieved in 15 of 16 hips (94%) in the lantern-shaped screw group compared with 10 of 16 hips (63%) in the control group (p = 0.0325). Successful radiological results were achieved in 14 of 16 hips (88%) in the lantern-shaped screw group compared with 8 of 16 hips (50%) in the control group (P = 0.0221).

CONCLUSION

The lantern-shaped screw loaded with autologous bone for the treatment of pre-collapse stages of ONFH is effective and results in preventing progression of ONFH and reducing the risk of femoral head collapse.

TRIAL REGISTRATION

The trial registration number: ChiCTR-TRC-13004078 (retrospectively registered at 2013-11-28).

摘要

背景

年轻患者股骨头坏死（ONFH）的治疗仍存在争议。我们研发了一种灯笼形螺钉，旨在为股骨头提供机械支撑以防止其塌陷，用于治疗ONFH。本研究的目的是探讨加载自体骨的灯笼形螺钉治疗ONFH塌陷前期的疗效和安全性。

方法

32例患者随机分为两组：灯笼形螺钉组（髓芯减压并植入加载自体骨的灯笼形螺钉）和对照组（髓芯减压并植入自体骨）。术后36个月随访期间，通过X线和计算机断层扫描（CT）以及功能恢复Harris髋关节评分（HHS）评估患者的治疗结果。

结果

灯笼形螺钉组16髋中有15髋（94%）取得了成功的临床结果，而对照组16髋中有10髋（63%）取得成功（p = 0.0325）。灯笼形螺钉组16髋中有14髋（88%）取得了成功的影像学结果，而对照组16髋中有8髋（50%）取得成功（P = 0.0221）。

结论

加载自体骨的灯笼形螺钉治疗ONFH塌陷前期有效，可防止ONFH进展并降低股骨头塌陷风险。

试验注册

试验注册号：ChiCTR-TRC-13004078（于2013年11月28日追溯注册）。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/373317addf9b/12891_2018_2243_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/785385ea4828/12891_2018_2243_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/f9bcd0d84b93/12891_2018_2243_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/c393373c2c10/12891_2018_2243_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/373317addf9b/12891_2018_2243_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/785385ea4828/12891_2018_2243_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/f9bcd0d84b93/12891_2018_2243_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/c393373c2c10/12891_2018_2243_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf8/6123930/373317addf9b/12891_2018_2243_Fig4_HTML.jpg

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