记忆合金网球治疗成人股骨头缺血性坏死

目的 探讨用超弹性镍钛合金记忆金属网球治疗早、中期股骨头缺血性坏死(ostconecrosis of the femoralhead,ONFH)的中期随访效果. 方法 1996年7月-1998年1月,采用超弹性镍钛合金记忆金属网球植入术治疗54例(75髋)股骨头缺血性坏死患者并随访观察.其中5例失访,3例分别因心肌梗死、肾脏衰竭及胃癌死亡而被排除.男32例,女14例;年龄21～61岁,平均39岁.按Ficat分期,Ⅱ期29髋,Ⅲ期36髋.术前Harris评分(58.20±13.82)分. 结果 46例(65髋)获随访86～125个月,平均8年8个月.术后Harris评分为(80.78±18.77)分,与术前比较差异有统计学意义(P＜0.01);其中优29髋,良21髋,可2髋,差13髋,优良率76.9%.8髋金属网球破裂,行人工全髋关节置换术.影像学评估Ⅰ级16髋(24.6%),Ⅱ级34髋(52.3%),Ⅲ级15髋(23.1%). 结论 超弹性镍钛合金记忆金属网球植入是治疗早、中期ONFH的方法之一,但其最终能否治愈ONFH,金属网球是否会继续破裂仍有待长期随访观察.

CAGE IMPLANTATION FOR THE TREATMENT OF OSTEONECROSIS OF THE FEMOPAL HEAD

OBJECTIVE: To explore the midterm efficacy of superelastic cage implantation for the treatment of osteonecrosis of femoral head (ONFH). METHODS: From July 1996 to January 1998, 54 patients (75 hips) of ONFH were treated with superelastic cage and followed up. Among 54 patients, 5 patients were lost to follow up and 3 patients were dead of myocardial infarction, renal failure and gastric cancer, respectively. Forty-six patients completed follow up including 32 males and 14 females, aged from 21 to 61 with an average of 39 years old. Twenty-nine hips were classified as Ficat Stage II and 36 as Stage II. Harris score was 58.20 +/- 13.82. All patients were evaluated both clinically and radiographically. RESULTS: Postoperatively, forty-six patients (65 hips) were followed up for 86 to 125 months with an average of 8 years and 8 months. Harris score was 80.78 +/- 18.77. Twenty-nine hips were rated excellent, 21 good, 2 fair and 13 poor. A total of 76.9% of overall clinical results were rated as good or excellent. Eight hips (12.3%) with the cage broken were turned to total hip replacement. Radiographic evaluation: 16 hips (24.6%) rated as grade I , 34 (52.3%) grade II and 15 (23.1%) grade III. CONCLUSION: Superelastic cage implantation is one of alternative treatments for ONFH at early and midterm stages. However, long-term follow-up is needed to know whether it is able to cure ONFH and whether cages will be broken as time passes by.