同种异体骨加螺钉支撑治疗早期股骨头坏死

目的:探讨同种异体骨加螺钉支撑术治疗早期股骨头缺血性坏死的疗效。方法:采用同种异体骨加螺钉支撑术治疗Ⅰ～Ⅲ期股骨头缺血性坏死62例78髋,其中男40例,女22例。年龄22～61岁。术前疼痛时间2～24个月,平均11个月。所有患者于术前及术后15d,3个月和6个月行双髋关节功能、常规X线片、ECT、CT和MRI检查。结果:患者均获随访3～24个月,平均15个月。57例临床症状缓解明显,Harris评分从术前平均76分升至术后92.8分。57例X线片显示髋关节形态基本保持完好,无明显坏死进展。ECT、CT和MRI检查均见植骨成骨征象。有2例4髋于1年半后改行人工全髋关节置换术。另有3例5髋症状有所加重,但未行人工关节置换术。结论:同种异体骨加螺钉支撑术治疗早期股骨头缺血性坏死,手术损伤小,术后关节功能2～4周即可恢复或超过术前水平,临床症状改善。

The Effect of Allogeneic Bone and Screw Support on Osteone Crosis of the Femoral Head in Early Stage

Objective:To study the effect of allogeneic bone and screw support on osteone crosis of the femoral head in early stages. Methods:62 patients with necrosis of the femoral head(78 hips) were treated with allogeneic bone and screw support,indluding 40 males and 22 females.Necro sisw as classified as StagesⅠ～Ⅲaccording to ARCO classification system.Their ages ranged from22 to 61 years and pain duration was 2 to 24 months preoperatively(11 months on average).The regular examinations of joint function,X-ray,ECT,CT andMRI were conducted before surgerg and after 15 days,3 month s,and 6 monthsof surgery.Results:All patients were followed up for 3 to 24 months(15months on average).Symptoms 57 of the patients were relieved evidently.Harris hip score from 76 points preoperatively to 92.8 points.The X-ray films 58 of the patients showed that the geography of the hip joint kept intact with no deterioration.Osteogenesis was observed by regular examinations.Two cases(4 hips,10.25%)w ere revised by to tal h ip rep lacement,and 3 cases(5 hips,10.25%) without THR worsened postoperarively.Conclusions:The method is less traumatic than common procedures.The joint function can be recovered with in 2～4 weeks.Clinical symptom sare greatly improved.