Hernigou P, Bachir D, Galacteros F
Henri Mondor Hospital, Créteil, France.
J Bone Joint Surg Br. 1993 Nov;75(6):875-80. doi: 10.1302/0301-620X.75B6.8245075.
In ten patients with sickle-cell disease, we used a new technique of cement injection for the treatment of 16 painful hips with a radiographic crescent line or flattening of the articular surface due to avascular necrosis. The necrotic bone and overlying cartilage are elevated by the injection to restore the sphericity of the femoral head. Five days after the operation, full weight-bearing was allowed with the help of crutches for three weeks. The time in hospital averaged eight days; the average blood loss was 100 ml. There was early pain relief and postoperative radiographs showed improvement in the shape of the femoral head. At a mean follow-up of 5 years (3 to 7), 14 of the 16 hips were still improved although some gave slight pain. Only two hips had required revision to total hip arthroplasty, at one year and two years respectively. The increasing longevity of patients with sickle-cell disease means that avascular necrosis will be an increasing problem. Total hip replacement has a poor prognosis because of the risks of infection, high blood loss, and early loosening. Cement injection does not have these problems and allows for earlier, more conservative surgery.
在10例镰状细胞病患者中，我们采用一种新型骨水泥注射技术治疗了16例因缺血性坏死出现X线新月征或关节面塌陷的疼痛性髋关节。通过注射使坏死骨和覆盖其上的软骨抬高，以恢复股骨头的球形。术后5天，借助拐杖允许完全负重3周。平均住院时间为8天；平均失血量为100毫升。早期疼痛缓解，术后X线片显示股骨头形状改善。平均随访5年（3至7年），16个髋关节中有14个仍有改善，尽管有些有轻微疼痛。仅2个髋关节分别在1年和2年时需要翻修为全髋关节置换术。镰状细胞病患者寿命延长意味着缺血性坏死将成为一个日益严重的问题。由于感染、失血过多和早期松动的风险，全髋关节置换术预后较差。骨水泥注射没有这些问题，且允许进行更早、更保守的手术。
