[1]袁强,张颖△,林继红,等.股骨头坏死硬化带分型与骨髓水肿及疼痛程度的相关性分析[J].中国中医骨伤科杂志,2023,31(01):40-45.
　YUAN Qiang,ZHANG Ying,LIN Jihong,et al.Correlation Analysis of Sclerotic Band Type of Classification System with Bone Marrow Edema and Pain Grading[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(01):40-45.
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股骨头坏死硬化带分型与骨髓水肿及疼痛程度的相关性分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年01期
页码:
40-45
栏目:
临床研究
出版日期:
2023-01-15

文章信息/Info

Title:
Correlation Analysis of Sclerotic Band Type of Classification System with Bone Marrow Edema and Pain Grading
文章编号:
1005-0205(2023)01-0040-06
作者:
袁强1; 张颖1△; 林继红1; 张宁1; 董一平1; 李无阴1
1河南省洛阳正骨医院(河南省骨科医院)髋关节外五科(河南 洛阳,471000)
Author(s):
YUAN Qiang1; ZHANG Ying1△; LIN Jihong1; ZHANG Ning1; DONG Yiping1; LI Wuyin1
1Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital), Luoyang 471002, Henan China.
关键词:
股骨头坏死;  硬化带;  分型;  骨髓水肿;  疼痛
Keywords:
osteonecrosis of femoral head;  sclerotic band;  type of classification system;  bone marrow edema;  pain grading
分类号:
R681.8
文献标志码:
A
摘要:
目的:探究股骨头坏死硬化带分型与骨髓水肿分级及髋关节疼痛程度的相关性。方法:回顾性分析2016年3月至2021年4月确诊为股骨头坏死的病例资料,共126例195髋。运用硬化带分型方法将坏死股骨头分为三种类型,即稳定型、中度不稳定型及重度不稳定型,分析不同分型与髋关节疼痛程度及骨髓水肿分级之间的关系。结果:通过R×C列联表卡方检验,结果表明不同股骨头坏死患者各髋关节疼痛程度与骨髓水肿分级有相关性; 通过多个独立样本的非参数检验,表明各疼痛程度下骨髓水肿分级的平均秩次呈递增趋势,说明疼痛程度越高,骨髓水肿越严重; 不同股骨头坏死患者各硬化带分型与骨髓水肿分级、疼痛程度的差异均有相关性,通过多个独立样本的非参数检验,表明各硬化带分型下骨髓水肿分级及髋关节疼痛程度的平均秩次呈递增趋势,说明硬化带分型分级越高,骨髓水肿分级越高,髋关节疼痛越严重。结论:股骨头坏死硬化带分型与髋关节疼痛程度和骨髓水肿分级之间有相关性,硬化带分型分级越高,骨髓水肿分级越高,髋关节疼痛越严重。
Abstract:
Objective:To explore the correlation between the sclerotic band type of classification system and bone marrow edema and pain grading.Methods:The clinical data of 126 cases(195 hips)of femoral head necrosis from March 2016 to April 2021 were retrospectively analyzed. The average stability index of each affected hip was calculated by using the s sclerotic band type of classification system, and the femoral head necrosis was divided into three types according to the index: namely stable type, moderately unstable type, and severe unstable type. The relationship between different types of pain and bone marrow edema grade was analyzed.Results:R×C contingency table chi-square test results showed that there were significant differences in the grade of bone marrow edema and the degree of pain between different sclerotic band type of classification system. The nonparametric test results of multiple independent samples showed that the mean rank of bone marrow edema grade and hip joint pain degree under each sclerotic band type of classification system showed an increasing trend.Conclusion:There was a correlation between the sclerotic band type of classification system and the degree of hip pain and the grade of bone marrow edema.

参考文献/References:

[1] TAN B,LI W,ZENG P,et al.Epidemiological study based on China osteonecrosis of the femoral head database[J].Orthop Surg,2021,13(1):153-160.
[2] MA H Y,MA N,LIU Y F,et al.Core decompression with local administration of zoledronate and enriched bone marrow mononuclear cells for treatment of non-traumatic osteonecrosis of femoral head[J].Orthop Surg,2021,13(6):1843-1852.
[3] 夏天卫,魏伟,张超,等.基于中日友好医院分型的股骨头坏死阶梯化保髋治疗经验总结[J].中国修复重建外科杂志,2020,34(1):10-15.
[4] FUKUSHIMA W,FUJIOKA M,KUBO T,et al.Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head[J].Clin Orthop Relat Res,2010,468(10):2715-2724.
[5] WANG J C,YANG L,WANG B J,et al.Study on correlation between bone marrow edema,stage of necrosis and area ratio of necrosis with the hip pain grading in nontraumatic osteonecrosis of the femoral head[J].Open Med(Wars),2015,10(1):440-444.
[6] 陈群群,周驰,何伟.骨髓水肿与股骨头坏死“带塌陷生存”相关性的X射线评估[J].中国组织工程研究,2019,30(20):3170-3175.
[7] ZHANG Y,LIU Y W,SUN R B,et al.“Sclerotic Band” type of classification system and measurement of necrotic area for osteonecrosis of the femoral head[J].Medicine(Baltimore),2020,99(36):e22106.
[8] 袁强,董一平,张宁,等.不同SBTOCS分型的股骨头坏死患者保髋治疗后股骨头塌陷、头臼匹配度、髋关节稳定度对比观察[J].山东医药,2022,62(15):61-64.
[9] 中华医学会骨科学分会关节外科学组.股骨头坏死临床诊疗规范[J].中国矫形外科杂志,2016,8(1):49-54.
[10] YOON B H,MONT M A,KOO K H,et al.The 2019 revised version of association research circulation osseous staging system of osteonecrosis of the femoral head[J].J Arthroplasty,2020,35(4):933-940.
[11] 陈超,尹阳,李娜,等.髋部骨髓水肿综合征的MRI诊断[J].分子影像学杂志,2017,40(1):27-29.
[12] 赵培荣,庄奇新,乔瑞华,等.股骨头缺血坏死骨髓水肿的MRI研究[J].实用放射学杂志,2006(7):835-837.
[13] JIN H,LI L,YU W,et al.The efficacy of acupuncture and moxibustion for early and middle-stage osteonecrosis of the femeral head:a systematic review and meta-analysis of randomized controlled trials[J].Medicine(Baltimore),2021,100(22):e26210.
[14] TASI S H L,TAI W C,FU T S,et al.Does surgical repair benefit pipkin type Ⅰ femoral head fractures?A systematic review and meta-analysis[J].Life(Basel),2022,12(1):71.
[15] MA J,HUA X Y,ZHENG M X,et al.Surface-based map plasticity of brain regions related to sensory motor and pain information processing after osteonecrosis of the femoral head[J].Neural Regen Res,2022,17(4):806-811.
[16] CASTRO F P,BARRACK R L.Core decompression and conservative treatment for avascular necrosis of the femoral head:a meta-analysis[J].Am J Orthop(Belle Mead NJ),2000,29(3):187-194.
[17] 刘丙立,赵刚,王雪,等.早中期股骨头坏死疼痛与坏死面积及关节积液分级相关性分析[J].实用骨科杂志,2015,21(11):1001-1004.
[18] 何伟,曾勤,张庆文,等.非创伤性股骨头坏死骨髓水肿与疼痛分级及坏死分期相关性的研究[J].中国修复重建外科杂志,2008(3):299-302.
[19] 詹维强,尹宗生,陆鸣,等.非创伤性股骨头坏死骨髓水肿与ARCO分期及疼痛的相关性[J].中国组织工程研究,2015,19(46):7529-7533.
[20] TOTTY W G,MURPHY W A,GANZ W I,et al.Magnetic resonance imaging of the normal and ischemic femoral head[J].Am J Roentgenol,1984,143(6):1273-1280.
[21] GAO F,SUN W,LI Z,et al.Intractable bone marrow edema syndrome of the hip[J].Orthopedics,2015,38(4):e263-e270.
[22] KOO K H,AHN I O,KIM R,et al.Bone marrow edema and associated pain in early stage osteonecrosis of the femoral head:prospective study with serial MR images[J].Radiology,1999,213(3):715-722.
[23] CHAN W,LIU Y J,HUANG G S,et al.MRI of joint fluid in femoral head osteonecrosis[J].Skeletal Radiol,2002,31(11):624-630.
[24] MEIER R,KRAUS T M,SCHAEFFELER C,et al.Bone marrow oedema on MR imaging indicates ARCO stage 3 disease in patients with AVN of the femoral head[J].Eur Radiol,2014,24(9):2271-2278.
[25] HYNES J P,HUGHES N,CUNNINGHAM P,et al.Whole-body MRI of bone marrow:a review[J].J Magn Reson Imaging,2019,50(6):1687-1701.
[26] YANG J W,KOO K H,LEE M C,et al.Mechanics of femoral head osteonecrosis using three-dimensional finite element method[J].Arch Orthop Trauma Surg,2002,122(2):88-92.
[27] GAO F,HAN J,HE Z,et al.Radiological analysis of cystic lesion in osteonecrosis of the femoral head[J].Int Orthop,2018,42(7):1615-1621.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金面上项目(81774348,81874477)
河南省重点研发与推广专项(科技攻关)(212102310365)
河南省中医药科学研究专项课题(20-21ZY2247)
△通信作者 E-mail:hhxi2021@163.cm
更新日期/Last Update: 2023-01-10