早期股骨头缺血性坏死治疗：髓芯减压并钽棒优于并植骨

背景：单纯髓芯减压并植骨治疗早期股骨头缺血性坏死对软骨下骨支撑不够，增加了骨折及塌陷的风险。钽棒的置入不仅可以提供很好的生物学支撑，也会增加坏死区域的再血管化，从而达到修复股骨头坏死的作用。目的：比较髓芯减压并植骨、髓芯减压并钽棒置入治疗早期股骨头缺血性坏死的临床效果。方法：纳入髓芯减压并植骨治疗ARCOⅠ/Ⅱ期股骨头缺血性坏死患者24例28髋，髓芯减压并钽棒置入治疗ARCOⅠ/Ⅱ期股骨头缺血性坏死患者25例29髋。随访24个月，观察治疗前后Harris评分变化及临床疗效。结果与结论：所有患者均获得随访。治疗后6个月，髓芯减压并植骨组患者Harris评分较治疗前平均提高了4.93分；髓芯减压并钽棒置入组患者Harris评分较治疗前平均提高了6.89分，差异有显著性意义(P < 0.05)。治疗后12个月，2组患者Harris评分均有治疗前显著提高，髓芯减压并植骨组患者Harris评分低于髓芯减压并钽棒置入组(P < 0.05)。髓芯减压并钽棒置入组总的治疗优良率为83%，优于髓芯减压并植骨组的75%。治疗后24个月髓芯减压并钽棒置入组X射线评分显著高于髓芯减压并植骨组(P < 0.05)。提示与髓芯减压并植骨相比，髓芯减压并钽棒置入能够更有效地防止股骨头塌陷，改善关节功能及延缓股骨头坏死进程。 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程全文链接：

Treatment of early avascular necrosis of femoral head: core decompression with tantalum rod implantation is better than core decompression with bone implantation

BACKGROUND: Core decompression with bone implantation in treatment of early avascular necrosis of femoral head may provide insufficient support for subchondral bone and increase the risk of fracture and collapse. Tantalum rod implantation can not only provide good biological support, but also promote the revascularization at necrotic regions, thus repairing the necrosis of femoral head.