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唑来膦酸与富自体骨髓干细胞植入治疗股骨头坏死

Zoledronic Acid and Enriched Autologous Bone Marrow Stem Cell Implantation for Femoral Head Osteonecrosis.

作者信息

Li Xuedong, Tian Huiling, Zhang Jingyi, Dou Bangxian

机构信息

Zhengzhou Orthopaedic Hospital, Longhai Middle Road 58, Zhengzhou, 450000 Henan China.

Hainan University, Haikou, 570228 Hainan China.

出版信息

Indian J Orthop. 2024 Jun 3;58(8):1064-1069. doi: 10.1007/s43465-024-01188-2. eCollection 2024 Aug.

DOI:10.1007/s43465-024-01188-2
PMID:39087050
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11286889/
Abstract

PURPOSE

This study evaluated the clinical results of zoledronic acid in the treatment of early osteonecrosis of the femoral head (ONFH).

MATERIALS AND METHODS

Study retrospectively analyzed 60 patients with zoledronic acid with bone marrow stem cell (BMSC) implantation (The study group) and 64 patients with BMSC implantation (The control group). The primary evaluation index included VAS, HHS, collapsed rate, and total hip replacement arthroplasty (THA) conversion rate.

RESULTS

The study group had a lower VAS (1.12 ± 0.22 vs 1.44 ± 0.32) and higher HHS (75.07 ± 3.66 vs 68.78 ± 2.24) compared to the control group in 6 months after surgery ( < 0.05). In the study group, 12 hips (20%) collapsed, and 7 of 60 hips (11.67%) required THA surgery at the last follow-up. However, 25 hips (38.8%) collapsed in the control group, and 19 hips (29.69%) required THA surgery. The study group had a lower collapsed rate ( = 0.029) and THA conversion rate ( = 0.016) in survival analysis.

CONCLUSION

Zoledronic acid and BMSC implantation in the treatment of early ONFH is safe and effective, reduces pain shortens recovery time, and reduces collapsed rate and THA conversion rate in ONFH patients.

摘要

目的

本研究评估唑来膦酸治疗早期股骨头坏死（ONFH）的临床效果。

材料与方法

本研究回顾性分析了60例接受唑来膦酸联合骨髓干细胞（BMSC）植入的患者（研究组）和64例接受BMSC植入的患者（对照组）。主要评估指标包括视觉模拟评分（VAS）、髋关节 Harris 评分（HHS）、塌陷率和全髋关节置换术（THA）转换率。

结果

术后6个月，研究组的VAS评分低于对照组（1.12±0.22 vs 1.44±0.32），HHS评分高于对照组（75.07±3.66 vs 68.78±2.24）（P<0.05）。在研究组中，12髋（20%）出现塌陷，60髋中有7髋（11.67%）在末次随访时需要进行THA手术。然而，对照组中有25髋（38.8%）出现塌陷，19髋（29.69%）需要进行THA手术。生存分析显示，研究组的塌陷率（P=0.029）和THA转换率（P=0.016）较低。

结论

唑来膦酸联合BMSC植入治疗早期ONFH安全有效，可减轻疼痛、缩短恢复时间，并降低ONFH患者的塌陷率和THA转换率。

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