Hopson C N, Siverhus S W
Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Ohio 45267-0212.
J Bone Joint Surg Am. 1988 Aug;70(7):1048-51.
Since 1977, we have performed twenty-one core decompressions in seventeen patients who had stage-I or II ischemic necrosis of the femoral head. The diagnosis was confirmed histologically in all but one patient. After a mean length of follow-up of thirty-nine months, healing was evident in eight hips (40 per cent) but not in the other twelve. All twelve hips required additional surgical treatment; the average length of time before the additional treatment was required was 9.2 months. The results of two intraoperative diagnostic tests (intramedullary pressure and saline stress tests) did not correlate with the results of biopsy. A perioperative fracture through the site of the decompression occurred in one of the twenty-one hips. Given the relatively poor long-term results and the considerable morbidity that was associated with core decompression, this treatment cannot be recommended.
自1977年以来，我们对17例患有I期或II期股骨头缺血性坏死的患者进行了21次髓芯减压术。除1例患者外，所有患者的诊断均经组织学证实。平均随访39个月后，8个股骨头（40%）出现明显愈合，其余12个股骨头未愈合。所有12个股骨头均需要额外的手术治疗；需要额外治疗前的平均时间为9.2个月。两项术中诊断测试（髓内压力和盐水应激试验）的结果与活检结果不相关。21个股骨头中有1个在减压部位发生了围手术期骨折。鉴于长期效果相对较差以及与髓芯减压相关的相当高的发病率，不推荐这种治疗方法。
