摘要
目的观察金属骨小梁(AVN)钽棒和异体腓骨支撑在青壮年非创伤性早期股骨头坏死(ONFH)患者保髋术中的应用效果,探讨保髋治疗方法。方法将73例(80髋)青壮年非创伤性早期ONFH患者随机分为钽棒组36例(40髋)和腓骨组37例(40髋),两组均行保髋手术,术中分别采用AVN钽棒植入和异体腓骨移植进行股骨头支撑。记录两组治疗前及治疗后6、12、24、36、48个月髋关节功能评分(Harris评分)、视觉模拟评分(VAS)及病情分期(X线检查);两组治疗后48个月,评价疗效并计算病情好转率,记录两组需行全髋关节置换术(THA)的例数并计算保髋率。结果与治疗前比较,两组治疗后Harris评分均升高,P均<0.01;治疗后24、48个月,钽棒组Harris评分均高于腓骨组,P均<0.01。与治疗前比较,两组治疗后VAS均降低,P均<0.01;治疗后6、36、48个月钽棒组VAS均低于腓骨组,P均<0.01。随着保髋术后随访时间的延长,X线检查显示两组病情均有进展。钽棒组有6髋、腓骨组有7髋行THA,两组病情好转率及保髋率比较,P均>0.05。结论青壮年非创伤性早期ONFH患者保髋手术中应用AVN钽棒植入与异体腓骨移植支撑股骨头的效果均较好;与异体腓骨移植比较,AVN钽棒植入能更好地改善患者的髋关节功能,并减轻疼痛。
Objective To investigate the application results of AVN tantalum rod and allograft fibula in young adults with early non-traumatic osteonecrosis of femoral head ( ONFH) during hip-preserving surgery , and to explore the methods for hip-preserving treatment .Methods Seventy-three young patients (80 hips) with early non-traumatic ONFH were ran-domly divided into the tantalum rod group (36 cases, 40 hips) and fibula group (37 cases, 40 hips).The two groups re-ceived hip-preserving surgery , AVN tantalum rod implant and allogeneic fibula transplantation were respectively used to support the femoral head.Harris score, visual analogue scale (VAS) and X-ray staging in the two groups were recorded before treatment and 6, 12, 24, 36 and 48 months after treatment .The efficacy was evaluated and improvement rate was calculated after 48-month treatment in the two groups .The number of cases who needed total hip arthroplasty ( THA) in the two groups was recorded and the successful rate of hip-preserving was calculated .Results Harris scores were higher after treatment in the two groups as compared with those before treatment (all P<0.01).Harris scores of the tantalum rod group were higher than those of the fibula group after 24 and 48 months of treatment (all P<0.01).VAS was decreased in two groups after treatment as compared with that before treatment (all P<0.01).VAS in the tantalum rod group was lower than that of the fibula group after 6, 36 and 48 months of treatment (all P<0.01).As time went on, the progress of femo-ral head was observed under X-ray in two groups after the treatment .Six cases of the tantalum rod group and 7 cases of the fibula group received THA , but no significant differences were found in the improvement rate and the retention rate between the two groups (all P>0.05).Conclusion The effects of AVN tantalum rod and allograft fibula in treatment of young a-dults with early non-traumatic ONFH during hip-preserving surgery are good .Compared with allograft fibula , AVN tantalum rod implant can impro
出处
《山东医药》
CAS
北大核心
2015年第48期5-8,共4页
Shandong Medical Journal
基金
国家自然科学基金资助项目(81473704)
关键词
股骨头坏死
非创伤性
钽棒
异体腓骨
保髋方法
femur head necrosis,non-traumatic osteonecrosis
tantalum rod
allogeneic fibula
hip-preserving surgery
young adults
