髓芯减压联合自体浓缩骨髓有核细胞移植治疗早期股骨头坏死

目的：观察髓芯减压联合自体浓缩骨髓有核细胞移植治疗早期股骨头坏死（ONFH）的临床疗效。方法回顾性分析该院收治的早期ONFH患者56例（82髋），将患者分为观察组（30例，44髋）和对照组（26例，38髋），观察组采用骨髓间充质干细胞移植联合髓芯减压治疗，对照组采用单纯髓芯减压治疗。通过比较两组患者术前和术后3、6、18个月髋关节Harris髋关节评分及术后18个月影像学变化、坏死面积百分比改变程度等，了解两种治疗方法的临床疗效。结果观察组Harris髋关节评分升高至（88．24±5．53）分，优良率达84．09％；对照组升高至（75．84±4．20）分，优良率为71．05％；MRI坏死面积：观察组逐渐减少到（13．86±4．27）％，对照组降至（19．53±5．29）％，两组比较差异有统计学意义（P＜0．05）。术后两组Harris髋关节评分和影像学变化均较术前有所改善（P＜0．05）。结论髓芯减压联合自体浓缩骨髓有核细胞移植治疗早期ONFH的临床疗效明显优于单纯髓芯减压。

Core decompression combined with autologous concentrated bone marrow cell transplantation for treatment of early osteonecrosis of femoral head

Objective To observe the clinical outcome of core decompression combined with autologous concentrated bone mar‐row cell transplantation for treatment of early osteonecrosis of femoral head .Methods Forty six patients (82 hips) included in this retrospective analysis were divided into observation group (30 cases ,44 hips) and the control group (26 cases ,38 hips) .The obser‐vation group were treated by autologous BMMSCs transplantation joint core decompression treatment while control group treated only with core decompression .The therapeutic effect of 2 methods of treatment were summarized by comparing the 2 groups after 3 ,6 ,18 months postoperative with Harris hip score and the imaging changes and necrosis area percentage change degree at 18 months postoperatively .Results The Harris scores of the observation group after operation increased significantly (88 .24 ± 5 .53) score] ,the excellent and good rate was 84 .09% ;the Harris scores of the control group after operation increased significantly (75 .48 ± 4 .20)% ] ,the excellent and good rate was 71 .05% ;MRI necrosis area of the observation group after operation reduced gradually(13 .86 ± 4 .27)% ] and the MRI necrosis area of the control group after operation reduced gradually (19 .53 ± 5 .29)% ] .There was significant difference between them (P<0 .05) .Harris scores and the imaging changes and necrosis area per‐centage change degree of both group had been improved after the operation (P<0 .05) .Conclusion The core decompression com‐bined with autologous concentrated bone marrow cell transplantation for treatment of early osteonecrosis clinical efficacy might be better than core decompression .