Department of Microsurgery and Plastic Surgery, HyeSan Medical College, HyeSan, Korea.
Department of Microsurgery and Plastic Surgery, Pyongyang University of Medical Sciences, Pyongyang, Korea.
Int Orthop. 2021 Jan;45(1):95-99. doi: 10.1007/s00264-020-04863-9. Epub 2020 Nov 27.
To observe necrotic findings of the femoral head through the endoscopic examination when performing the decompression procedure widely used in the treatment of osteonecrosis of femoral head. To assess the efficacy of injection of bone marrow aspirated from the iliac crest and new vascularized bone graft into the core of femoral head based on the endoscopic findings.
The first stage of osteonecrosis of femoral head based on ARCO classification includes 23, second stage 36, and third stage eight femoral heads. Bone marrow transplantations have been performed in 49 hip joints and new vascularized bone grafts in 18 hip joints.
The endoscopic findings of osteonecrosis of femoral heads are varied, and they can be divided into five categories. The average time in core decompression and bone marrow injection was 15 minutes, and the average time of new pedicled bone grafts was 65 minutes (45-90 minutes). The efficacy of bone marrow injection was 93.88%, and the efficacy of vascularized bone graft was 94.44% when performed based on the endoscopic findings.
It is possible to increase the treatment efficacy of the osteonecrosis of the femoral head when appropriate additional treatments are applied based on endoscopic findings in the decompression procedures of pre-collapse osteonecrosis of the femoral head.
通过对广泛应用于股骨头坏死治疗的减压术进行内镜检查，观察股骨头的坏死情况。根据内镜检查结果，评估经髂嵴骨髓抽吸注射和新血管化骨移植到股骨头核心部位的疗效。
根据 ARCO 分类，将股骨头坏死的第一期包括 23 髋，第二期 36 髋，第三期 8 髋。对 49 髋进行了骨髓移植，对 18 髋进行了新带蒂骨移植。
股骨头坏死的内镜表现多种多样，可分为五类。核心减压和骨髓注射的平均时间为 15 分钟，新带蒂骨移植的平均时间为 65 分钟（45-90 分钟）。根据内镜检查结果，骨髓注射的疗效为 93.88%，血管化骨移植的疗效为 94.44%。
在股骨头未塌陷坏死减压术的基础上，根据内镜表现进行适当的附加治疗，有可能提高股骨头坏死的治疗效果。
