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多功能微创器械辅助下的髓芯减压术治疗早期股骨头坏死

Core decompression assisted by multi-functional minimally invasive instruments for the treatment of early osteonecrosis of the femoral head.

作者信息

Yuan Daizhu, Wu Zhanyu, Zhou Yuhu, Teng Jianxiang, Chen Qiuhan, Ye Chuan

机构信息

Department of Orthopaedics and Sport Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, China.

Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, 550004, China.

出版信息

Sci Rep. 2025 Feb 19;15(1):6113. doi: 10.1038/s41598-025-90551-w.

Abstract

Core decompression is a common method for treating early osteonecrosis of the femoral head (ONFH). However, the surgical procedure is cumbersome due to the lack of appropriate surgical instruments. This study aims to modify surgical instruments to improve surgery efficiency. A total of 28 patients with early ONFH treated with the core decompression were enrolled. 13 cases were treated with new instruments and the other 15 cases were treated with the traditional methods. The convenience of the new instruments was evaluated by comparing evaluation indicators. The multi-functional instruments reduced the number of fluoroscopy, shorted the operation time, improved the delivery efficiency, reduced the intraoperative blood loss, and reduced the surgical incision compared with the traditional method (p < 0.05). The new instruments removed the healthy bone of the femoral head and neck for reuse, the overall hospitalization cost was lower, and patient satisfaction was higher (p < 0.05). In the postoperative follow-up, the VAS was lower and Harris score was higher compared with the traditional group (p < 0.05). The multi-functional instruments can achieve the advantages of accurate positioning of the necrotic area, removed and reused healthy bone, effective expanded decompression, and efficient implant delivery, which is the effective instrument for the early ONFH.

摘要

髓芯减压是治疗早期股骨头坏死(ONFH)的常用方法。然而,由于缺乏合适的手术器械,手术操作繁琐。本研究旨在改进手术器械以提高手术效率。共纳入28例接受髓芯减压治疗的早期ONFH患者。13例采用新器械治疗,另外15例采用传统方法治疗。通过比较评估指标来评价新器械的便利性。与传统方法相比,多功能器械减少了透视次数,缩短了手术时间,提高了置钉效率,减少了术中出血量,缩小了手术切口(p < 0.05)。新器械取出股骨头和颈的健康骨以供再利用,总体住院费用较低,患者满意度较高(p < 0.05)。术后随访中,与传统组相比,视觉模拟评分(VAS)较低,Harris评分较高(p < 0.05)。多功能器械可实现坏死区域准确定位、健康骨取出及再利用、有效扩大减压和高效植入物置入等优点,是治疗早期ONFH的有效器械。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab3/11839915/6849a26bb78d/41598_2025_90551_Figa_HTML.jpg

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