Bozkurt Murat, Veizi Enejd, Fırat Neslihan, Şahin Ali
Department of Orthopedics and Traumatology, Ankara Acıbadem Hospital, Ankara, Turkey.
Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
Arthrosc Tech. 2024 Jun 21;13(11):103093. doi: 10.1016/j.eats.2024.103093. eCollection 2024 Nov.
Osteonecrosis of the femoral head can lead to end-stage osteoarthritis when left untreated. The incidence has been on the rise since the onset of the COVID-19 pandemic. Core decompression of the femoral head is usually the first line of surgical treatment when conservative options fail. Additional biologic support (e.g., bone marrow aspiration concentrates, mesenchymal stem cell derivatives, adipose-derived stromal vascular fraction) has been shown to augment the effects of core decompression alone, but the nature and amount of this additional support is still a topic for debate. This technique describes a surgical approach featuring debridement through retro-drilling, core decompression, and biologic augmentation with stromal vascular fraction and bone marrow aspiration concentrate on the early stages of osteonecrosis of the femoral head.
股骨头坏死若不治疗可导致终末期骨关节炎。自新冠疫情爆发以来，其发病率一直在上升。当保守治疗无效时，股骨头髓芯减压术通常是外科治疗的首选。额外的生物支持（如骨髓抽吸浓缩物、间充质干细胞衍生物、脂肪来源的基质血管成分）已被证明可增强单纯髓芯减压的效果，但这种额外支持的性质和数量仍是一个有争议的话题。本技术描述了一种手术方法，其特点是在股骨头坏死早期通过逆行钻孔进行清创、髓芯减压，并使用基质血管成分和骨髓抽吸浓缩物进行生物增强。
