CAJ | 학술논문

目的：探讨多孔钽棒置入联合髓芯减压治疗早期股骨头坏死( ONFH)的近期临床效果。方法：采用多孔钽棒置入联合髓芯减压治疗成人早期ONFH 11例11髋,其中ⅠB期1髋,ⅠC期1髋,ⅡA期2髋,ⅡB期6髋,ⅡC期1髋。术前Harris评分平均(53.8±9.7)分。随访时以Harris评分、影像学检查及股骨头生存率作为疗效评价指标。结果：手术时间30~50 min,出血量50~100 ml。术后随访12~21个月。术后Harris评分为(84.2±7.3)分,较治疗前明显提高(P<0.01)。1例伴有系统性疾病长期服用激素患者术后9个月发生了股骨头塌陷及关节间隙狭窄,其余病例股骨头外形完整,无股骨头变扁、塌陷或坏死加重。结论：多孔钽棒置入联合髓芯减压治疗成人早期ONFH能有效避免坏死区股骨头塌陷,近期疗效满意。
목적：탐토다공단봉치입연합수심감압치료조기고골두배사( ONFH)적근기림상효과。방법：채용다공단봉치입연합수심감압치료성인조기ONFH 11례11관,기중ⅠB기1관,ⅠC기1관,ⅡA기2관,ⅡB기6관,ⅡC기1관。술전Harris평분평균(53.8±9.7)분。수방시이Harris평분、영상학검사급고골두생존솔작위료효평개지표。결과：수술시간30~50 min,출혈량50~100 ml。술후수방12~21개월。술후Harris평분위(84.2±7.3)분,교치료전명현제고(P<0.01)。1례반유계통성질병장기복용격소환자술후9개월발생료고골두탑함급관절간극협착,기여병례고골두외형완정,무고골두변편、탑함혹배사가중。결론：다공단봉치입연합수심감압치료성인조기ONFH능유효피면배사구고골두탑함,근기료효만의。
Objective:To explore the short-term effects of porous tantalum implant combined with core decompression in the treatment of early osteonecrosis of the femoral head ( ONFH ) . Methods:The clinical data of 11 hips treated with porous tantalum implant combined with core decompression from 11 patients with early ONFH were retrospectively analyzed from March 2012 to January 2013, 11 hips included stage ⅠB in 1 hip,stageⅠC in 1 hip,stageⅡA in 2 hips,stageⅡB in 6 hips and stageⅡC in 1 hip. The average preoperative Harris score of all cases was(53. 8 ± 9. 7). The clinical effects in all cases were evaluated by the Harris score,imaging examination and femoral head survival rate. Results:The operative time and blood loss of all cases were from 30 to 50 min and from 50 to 100 ml,respectively. All cases were followed up for 12 to 21 months,the mean follow-up time was 15. 8 months. Compared with thepreoperativescore,thepostoperativemeanHarrisscore(84.2±7.3) inallcasessignificantlyincreased(P<0.01).Thecollapse of femoral head and joint space narrowing in 1 patient with systemic disease patients with long-term use of hormone was found by X-ray in 9 months after operation,complete femoral head and no flat collapse or aggravating necrosis of femoral head were verified in other patients. Conclusions:The effects of porous tantalum implant combined with core decompression in the treatment of adult early ONFH are good,which can avoid the collapse of ONFH.