多孔金属钽棒治疗早期股骨头坏死的近期疗效观察

目的探讨多孔金属钽棒治疗早期股骨头坏死（ONFH）的临床效果。方法对应用多孔钽棒治疗的15例早期ONFH患者临床资料进行回顾性研究。按照国际骨循环研究会（ARCO）分类的ONFH病变Ⅰ、Ⅱ期患者共15例（15髋）,术后3、6、12、24个月时随访。临床评价Harris评分、X线片病情及骨长入情况。结果 Harris评分术前与术后3、6、12、24个月比较差异均有统计学意义（P=0.000）。手术前、后X线片分期比较,术后12个月2例ⅡB期进展为ⅡC期,24个月2例ⅡC期进展为Ⅲ期,股骨头塌陷,需行全髋关节置换术。4例可见原有囊性变区内骨密度增高表现,1例在钽棒周围出现＂骨锚固征＂。结论多孔金属钽棒对ONFHⅠ期病变治疗改善率最佳,ⅡA、ⅡB期改善率次之,ⅡC期改善率最低,对Ⅰ、ⅡA、ⅡB期病变可有效防止股骨头塌陷。

The early clinical observation of treatment of osteonecrosis of the femoral head with porous metal tantalum rod

Objective To explore the effect of the porous metal tantalum rod in the treatment of the osteonecrosis the femoral head（ONFH）. Methods The clinical data of 15 patients with ONFH stage I , Ⅱ graded by the Interr tional Bone Cycle Research Council（ Association Research Circulation Osseous, ARCO）were studied retrospectivel Harris score,X-ray films and bone ingrowth condition were assessed at 3,6,12,24 months after operation respectk ly. Results There was significant differences between Harris scores at pre-operation and post-operation （ P = 0. 000 Assessed by X-ray,2 cases with stage ⅡB progressed to Ⅱ c at 12 months after operation and 2 cases withⅡ c Progressed to Ⅲ at 24 months. The later 2 patients＇ femoral head collapsed and needed to be treated with THA. Increas BMD performance in original cystic changes area had been seen in 4 patients and＂ bone anchorage levy＂ around tan1 lure bar occured in 1 patient. Conclusions The clinical effect of porous tantalum is best for patients with ONt stage I ~ The result is moderate for ONFH Ⅱ A and Ⅱ B and poor for ONFH Ⅱ c. Porous tantalum can effectively prevent femoral head collapse in patients with ONFH I , Ⅱ A and ⅡB .