[1]张蕾蕾 梁大伟 陈献韬△ 王庆丰 路坦 张颖刘立云 刘又文 孙永强 鲁亚杰 卢建熙.生物陶瓷骨混合自体髂骨微创治疗早中期股骨头坏死[J].中国中医骨伤科杂志,2021,29(06):21-25.
　ZHANG Leilei LIANG Dawei CHEN Xiantao WANG Qingfeng LU TanZHANG Yin LIU Liyun LIU Youwen SUN Yongqiang LU Yajie LU Jianxi.Minimally Invasive Treatment of Femoral Head Necrosis in Early andMiddle Stage with Bioceramic Bone and Autogenous Iliac Bone[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(06):21-25.
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生物陶瓷骨混合自体髂骨微创治疗早中期股骨头坏死()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年06期
页码:
21-25
栏目:
临床研究
出版日期:
2021-06-15

文章信息/Info

Title:
Minimally Invasive Treatment of Femoral Head Necrosis in Early andMiddle Stage with Bioceramic Bone and Autogenous Iliac Bone
文章编号:
1005-0205(2021)06-0021-05
作者:
张蕾蕾1 梁大伟1 陈献韬1△ 王庆丰1 路坦2 张颖1刘立云1 刘又文1 孙永强1 鲁亚杰3 卢建熙4
1河南省洛阳正骨医院(河南省骨科医院)(河南 洛阳,471000)2新乡医学院第一附属医院3中国人民解放军空军军医大学第一附属医院骨科4上海贝奥路生物材料有限公司
Author(s):
ZHANG Leilei1 LIANG Dawei1 CHEN Xiantao1△ WANG Qingfeng1 LU Tan2ZHANG Yin1 LIU Liyun1 LIU Youwen1 SUN Yongqiang1 LU Yajie3 LU Jianxi4
1Henan Luoyang Orthopaedic-Traumatological Hospital, Luoyang 471000, Henan China; 2First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453100, Henan China; 3First Affiliated Hospital of PLA Air Force Military Medical University,Xi’an 710032,China; 4Shanghai Beiaolu Biomaterial Limited Liability Company, Shanghai 200000, China.
关键词:
股骨头坏死;  打压植骨;  生物陶瓷;  减压术;  骨移植
Keywords:
osteonecrosis of femoral head;  bone graft;  bioceramics;  decompression;  bone transplantation
分类号:
R681.8
文献标志码:
A
摘要:
目的:观察采用生物陶瓷骨混合自体髂骨骨粒微创治疗ARCOⅡ、Ⅲ期股骨头坏死的临床疗效及安全性,丰富股骨头坏死保头治疗体系。方法:将2016年6月至2017年12月股骨头坏死患者40例(42髋),分为生物陶瓷骨组(对照组)和生物陶瓷骨混合自体髂骨组(治疗组),对照组行微创粗通道减压病灶清除生物陶瓷骨植骨术,治疗组行微创粗通道减压病灶清除生物陶瓷骨混合自体髂骨骨粒植骨术。记录两组手术时间,术中出血量,治疗前、术后6个月、术后12个月及末次随访Harris评分,采用X线片评价术后股骨头形态及植骨情况。结果:两组随访21～42个月,平均随访时间(26.34±3.52)个月。对照组在手术时间、术中出血量方面优于治疗组,差异有统计学意义(P<0.05),两组患者术后均无静脉血栓、感染等并发症。与术前相比,两组患者术后12个月Harris评分均明显提高,差异有统计学意义(P<0.05),且术后12个月治疗组Harris评分、末次随访影像学评价结果均优于对照组,差异有统计学意义(P<0.05)。结论:采用生物陶瓷骨混合自体髂骨骨粒微创治疗ARCOⅡ、Ⅲ期股骨头坏死,中短期临床疗效优于对照组,虽然该手术方式手术时间长、出血量略多,但不影响康复时间,后期X线结果更优,可以作为治疗早中期股骨头坏死的推荐方法。
Abstract:
To explore the clinical efficacy and safety of bioceramic bone combined with autogenous iliac bone granule combined in the treatment of ARCO stage Ⅱand Ⅲ avascular necrosis of the femoral head, and to enrich the treatment system of avascular necrosis of the femoral head.Methods:40 patients(42 hips)with osteonecrosis of the femoral head from June 2016 to December 2017 were divided into bioceramic bone group(control group)and bioceramic bone mixed with autogenous iliac bone group(treatment group). In the control group, bioceramic bone graft was used to remove the focus of micro invasive coarse channel decompression. While in the treatment group, bioceramic bone mixed with autogenous iliac bone graft was used to remove the focus of micro invasive coarse channel decompression. The operation time, intraoperative hemorrhage, Harris score before and after treatment were observed. The morphology of femoral head and bone graft were evaluated by X-ray.Results:The two groups were followed up for 21 to 42 months with an average follow-up time of(26.34±3.52)months. The control group was better than the treatment group in terms of operation time and intraoperative bleeding, the difference was statistically significant. There were no postoperative complication such as venous thrombosis and infection in both groups. Compared with the preoperative, the Harris scores of the two groups were significantly improved 12 months after operation, the difference was statistically significant, and the Harris scores of the treatment group and the imaging evaluation results of the last follow-up 12 months after operation were better than those in the control group, the difference was statistically significant.Conclusion:Bioceramic bone combined with autogenous iliac bone granule combined is better than the control group in the treatment of ARCO Ⅱ and Ⅲ stage of avascular necrosis of the femoral head. Although the operation time is long and the amount of bleeding is a little more, it does not affect the recovery time, and the later X-ray results are better. It can be used as a promotion method in the treatment of early and middle stage of avascular necrosis of the femoral head.

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备注/Memo

备注/Memo:
基金项目:2016年洛阳市科技计划医疗卫生项目(1603004A-8)2017年河南省中医药科学研究专项课题(2017ZY2032)
△通信作者 E-mail:luoyangzhenggu@163.com
更新日期/Last Update: 2021-06-15