复合自体骨髓的骨诱导材料结合髓芯减压钛棒支撑修复Ⅱ期股骨头坏死

背景：虽然髓芯减压植骨能促进骨坏死区的重建，但单纯髓芯减压植骨存在一定的不足之处，不能彻底解决股骨头的重建问题。目的：探讨关节镜下Ⅱ期股骨头坏死实施髓芯减压植入复合自体骨髓的骨诱导材料结合钛棒支撑治疗的临床效果。方法：回顾性分析铜川市人民医院南院2011年2月至2013年2月收治的79例Ⅱ期股骨头坏死患者的临床资料，按照治疗方法分为对照组40例和观察组39例，分别实施常规髓芯减压植骨治疗和关节镜下髓芯减压植入复合自体骨髓的骨诱导材料结合钛棒支撑治疗。治疗后随访24个月，观察两组患者的屈髋活动度和髋关节功能Harris评分变化以及不良事件发生情况。结果与结论：入组的79例患者均顺利完成24个月的随访。经末次随访，观察组的屈髋活动度和髋关节功能Harris评分均显著高于对照组(P < 0.05)，且两组患者均未出现因手术材料排斥所导致的失败病例。表明对Ⅱ期股骨头坏死患者实施关节镜下髓芯减压植入复合自体骨髓的骨诱导材料结合钛棒支撑治可获得较好的修复效果，是一种安全有效的治疗方案。中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

Arthroscopic core decompression with autologous bone marrow induction material combined with titanium rod in the repair of stage II femoral head necrosis

BACKGROUND: Although core decompression can contribute to the reconstruction of necrotic bone, its single use appears to have some deficiencies and cannot completely realize the reconstruction of the femoral head.OBJECTIVE: To explore the effect of arthroscopic core decompression with autologous bone marrow induction material combined with titanium rod in the repair of stage II femoral head necrosisMETHODS:A retrospective analysis was performed on clinical data of 79 cases of stage II femoral head necrosis admitted at the South Branch of Tongchuan People’s Hospital from February 2011 to February 2013. According to the therapeutic methods, these cases were divided into control group (40 cases) and observation group (39 cases), and were given conventional core decompression and arthroscopic core decompression with autologous bone marrow induction material combined with titanium rod. Patients were followed up for 24 months, and the range of hip flexion and Harris scores on hip function and adverse events were observed and compared between two groups.RESULTS AND CONCLUSION:All the 79 patients successfully completed the 24-month follow-up. By the last follow-up, the range of hip flexion and Harris score were significantly higher in the observation group than the control group (P < 0.05). There was no failure case due to surgical material rejection. To sum up, arthroscopic core decompression with autologous bone marrow induction material combined with titanium rod is safe and effective for repair of stage II femoral head necrosis.