股骨头坏死_____股骨头坏死；

钛合金支撑架结合自体骨和DBM治疗股骨头坏死

http://www.100md.com 《中国矫形外科杂志》 2006年第7期

股骨头坏死,,股骨头坏死；,外科手术；,支架(骨科)；,骨移植,1临床资料,2结果,3讨论,参考文献：

     摘要：[目的]探讨空心钛合金支架植入结合自体松质骨和脱钙骨基质(DBM)治疗成人股骨头坏死初步疗效。[方法]采用经大转子下通过股骨颈钻隧道至股骨头骨坏死区，将装有自体松质骨和DBM的空心钛合金支架经隧道置入骨坏死区直至软骨下骨约5 mm处，髓道远端用自体髂骨填塞。[结果]经临床应用13例。15个髋关节，随访14~36个月，并按成人股骨头缺血性坏死疗效百分评价法进行评价，优良率为933%。[结论]空心钛合金支架植入结合自体松质骨和DBM治疗成人股骨头坏死具有以下优点：(1)手术操作简单，不破坏患者股骨头本身的血液供应，创伤小。(2)将具有骨诱导活性的DBM直接放入骨坏死区，成骨作用强。(3)增加股骨头负重区软骨下骨的机械支撑，降低局部应力，有利于股骨头坏死的修复及重建。

    关键词：股骨头坏死；外科手术；支架(骨科)；骨移植

    Treatment of osteonecrosis of the femoral head with implantation of titanium alloy support frame,autologous bone and decalcified bone matrix∥MEI Rongcheng,YANG Shuhua,YANG Cao,et alDepartment of Orthopaedics,Union Hospital of Tongji Medical College of Huazhong Science and Technology University,Wuhan 430022

    Abstract：[Objective]To introduce a new method for the treatment of avascular necrosis of the femoral head[Method]We studied thirteen patients(fifteen hips)with stageⅠ,Ⅱ or Ⅲ osteonecrosis of the femoral headAccording to Ficat and Arlet Classification System,the hips were treated with modify core decompression and implantation of titanium alloy support frame,autologous bone and decalcified bone matrix[Result]All the patients were followed up for an average of 27 months(ranged,14~36 months)Preoperatively,2 hips were of Ficat Arlet stage Ⅰ,10 stage Ⅱ and 3 stage ⅢPostoperatively,twelve patients were pain free,one had mild painNo major complications occurred[Conclusion]It is one of the better alternatives that can prevent the necrosis femoral head from progressing to collapse and can promote revasculafization and new bone formation by direct mechanical supportThe technique is suitable for the treatment of avascular necrosis of femoral head of stage Ⅰ to Ⅲ ......

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