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股骨头缺血性坏死的髓芯减压与多孔钽棒植入术与保守治疗的比较:一项至少18个月的随访研究。

Comparison of core decompression and porous tantalum rod implantation with conservative treatment for avascular necrosis of the femoral head: A minimum 18 month follow-up study.

作者信息

Fang Yuan, Ding Changrong, Wang Yingzhen, Zhang Haining

机构信息

Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China.

Department of Electrocardiogram, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China.

出版信息

Exp Ther Med. 2020 Jul;20(1):472-478. doi: 10.3892/etm.2020.8669. Epub 2020 Apr 21.

Abstract

Porous tantalum rod implantation is a novel surgical method that is used to treat avascular necrosis (AVN) of the femoral head (hip). In the present study, the results of core decompression and tantalum rod implantation were compared with non-surgical treatment for AVN, and the survivorship of the femoral head was evaluated. In total, 60 patients with AVN femoral head were recruited and analysed. Non-surgical treatment was selected by 30 patients (41 hips), 7 with a Ficat score of I and 23 with a score of II. Non-surgical treatment included celecoxib, and tetramethylypyrazine and a reduction in weight-bearing activities. Surgical treatment and porous tantalum rod implantation were selected by 30 patients (41 hips), 10 with a Ficat score of I and 20 with a score of II. After follow-up (average: 33.5 months), patients were evaluated by assessing post-operative complications, radiology, hip survivorship and Harris hip score. In the surgical group, pre-operative symptoms were significantly alleviated. No complications, including infection, delayed healing or fractures were reported. Final follow-up rates of femoral head survivorship were 4.9% in the non-surgical group and 36.7% in the surgical group. The Harris hip score was significantly improved following surgery when compared with non-surgical treatment (P<0.05). The results indicated that core decompression and porous tantalum rod implantation are beneficial short- and mid-term treatment methods for AVN of the femoral head.

摘要

多孔钽棒植入术是一种用于治疗股骨头(髋关节)缺血性坏死(AVN)的新型手术方法。在本研究中,将股骨头髓芯减压及钽棒植入术的结果与AVN的非手术治疗结果进行了比较,并评估了股骨头的生存率。总共纳入并分析了60例股骨头AVN患者。30例患者(41髋)选择非手术治疗,其中Ficat I期7例,II期23例。非手术治疗包括塞来昔布、川芎嗪以及减少负重活动。30例患者(41髋)选择手术治疗及多孔钽棒植入术,其中Ficat I期10例,II期20例。随访(平均33.5个月)后,通过评估术后并发症、影像学、髋关节生存率及Harris髋关节评分对患者进行评价。手术组术前症状明显缓解。未报告包括感染、愈合延迟或骨折在内的并发症。非手术组股骨头生存率的最终随访率为4.9%,手术组为36.7%。与非手术治疗相比,手术后Harris髋关节评分显著改善(P<0.05)。结果表明,股骨头髓芯减压及多孔钽棒植入术是治疗股骨头AVN的有益的短期和中期治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/426f/7271720/33eb49c75588/etm-20-01-0472-g00.jpg

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