CAJ | 학술논문

目的：探讨髓芯减压联合钽金属棒植入治疗股骨头缺血坏死的远期疗效。方法回顾性分析2006年6月至2009年1月收治的18例(28髋)股骨头坏死患者的临床诊治资料，均采用髓芯减压联合钽金属棒治疗，平均年龄45.3岁；ARCO分期：Ⅰ期8髋，Ⅱ期20髋。根据Harris功能评分及髋关节MRI进行髋关节临床结果评估。结果18例患者均获得随访，平均随访时间70.2个月。18例(28髋)患者中10例(16髋)髋关节疼痛复发， Harris功能评分为(39.3±11.2)分。髋关节MRI：10例(16髋)患者出现钽金属棒周围均有水肿信号改变，其中9例(15髋)患者发生股骨头塌陷、1例(1髋)髋关节炎。10例(16髋)患者均行全髋关节置换手术治疗，股骨头生存率仅为42.9%，平均生存时间为(4.2±0.5)年。结论采用髓芯减压联合钽金属棒植入治疗早期股骨头坏死临床结果不理想且钽金属棒费用高，因此，不建议早期股骨头坏死行髓芯减压联合钽金属棒植入治疗。
목적：탐토수심감압연합단금속봉식입치료고골두결혈배사적원기료효。방법회고성분석2006년6월지2009년1월수치적18례(28관)고골두배사환자적림상진치자료，균채용수심감압연합단금속봉치료，평균년령45.3세；ARCO분기：Ⅰ기8관，Ⅱ기20관。근거Harris공능평분급관관절MRI진행관관절림상결과평고。결과18례환자균획득수방，평균수방시간70.2개월。18례(28관)환자중10례(16관)관관절동통복발， Harris공능평분위(39.3±11.2)분。관관절MRI：10례(16관)환자출현단금속봉주위균유수종신호개변，기중9례(15관)환자발생고골두탑함、1례(1관)관관절염。10례(16관)환자균행전관관절치환수술치료，고골두생존솔부위42.9%，평균생존시간위(4.2±0.5)년。결론채용수심감압연합단금속봉식입치료조기고골두배사림상결과불이상차단금속봉비용고，인차，불건의조기고골두배사행수심감압연합단금속봉식입치료。
Objective To investigate the long-term outcome of core decompression in combination with tan-talum tod implant in treatment of osteonecrosis of femoral head (ONFH). Methods Retrospective analysis of 18 ON-FH cases (28 hips) from the hospital (time limited from June 2006 to January 2009) was performed. The patients were treated with core decompression in combination with tantalum tod implant. Patients' average age was 45.3. According to ARCO staging, there were 8 stageⅠcases and 20 stageⅡ. The clinical outcomes were evaluated based on Harris score and hip joint MRI. Results All patients were followed up with the mean time of 70.2 months. In all 18 pa-tients, 10 patients (16 hips) complained hip pain, with a Harris score of (39.3±11.2). MRI showed edema signal chang-es around the tantalum tod, among which nine (15 hips) showed collapse of the femoral head and one (1 hip) with hip arthritis. The 10 patients were given total hip replacement surgery, with the survival rate of only 42.9%, and mean sur-vival time of (4.2±0.5) years. Conclusion The clinical outcome of core decompression in combination with tantalum tod implant in treatment of early stage ONFH is not ideal, and the cost is high. Thus, the treatment in this study is not recommend in early stage ONFH.