期刊文献+

髓芯减压自体骨髓细胞移植与带血管蒂骨瓣转位治疗股骨头缺血坏死的比较 被引量:8

A Comparative Study on Treatment of Ischemic Necrosis of Femoral Head Using Decompression and Reconstituted Autologous Bone Marrow Cells Transplantation vs.Transplantation of Vascularized Bone Flap Grafting
下载PDF
导出
摘要 目的对比研究髓芯减压自体骨髓细胞移植与带血管蒂骨瓣转位两种方法治疗成人股骨头缺血性坏死的疗效。方法对48例(60髋)成人股骨头缺血性坏死(ARCO分期:Ⅰc~Ⅱc期)分别采用带血管蒂骨瓣转位和髓芯减压自体骨髓细胞移植治疗。髓芯减压自体骨髓细胞移植治疗23例(30髋),带血管蒂骨瓣转位治疗25例(30髋)。术后采用髋关节的Harris评分及影像学稳定情况评定疗效。结果髓芯减压自体骨髓细胞移植与带血管蒂骨瓣转位两组的手术时间和出血量,分别为40.2±16.5min、57.4±18.5min(P<0.05)和180.0±20.5ml、260.6±19.5ml(P<0.05)。术中、术后无严重并发症发生。所有患者获平均36.5个月随访,髓芯减压自体骨髓细胞移植与带血管蒂骨瓣转位两组的优良率为别为83.3%、90.0%(P>0.05);两组影像检查学分别显示24髋、25髋保持稳定(P>0.05)。结论髓芯减压自体骨髓细胞移植和带血管蒂骨瓣转位治疗成人早期股骨头缺血性坏死的优良率相近,但前者较后者出血少并且手术时间短,是一种安全、有效的治疗早期股骨头缺血坏死的微创治疗方法。 Objective To compare the results of the treatment of ischemie necrosis of the femoral head using the decompression and the reconstituted autologous bone marrow cells transplantation vs. the transplantation of the vascularized bone flap grafting. Methods Two surgical procedures were performed in 60 hips in 48 patients with the isehemie necrosis of the femoral head (ARCO stage Ⅰc-Ⅱ c). Thirty hips in 23 patients (group A) underwent the decompression and reconstituted autologous bone marrow cells transplantation and 30 hips in 25 patients (group B) received transplantation of vascularized bone flap grafting. The clinical outcomes of all patients were evalu - ated with Harris hip score and the radiologieal stability. Results The average blood loss was 80.0±20.5 ml and 260.6± 19.5 ml ( P 〈0.05) respectively and the operative time was 40.2± 16.5 min and 57.4 ± 18.5 min (P〈0.05) respectively in the two groups. No intraoperative or postoperative severe complications occurred. Forty - eight patients were followed up with an average period of 36.5 months. According to the standards of the mean Harris hip score, in group A and B, the excellent and good rate were 83.3 % and 90 % (P〉0.05) respectively, 24 hips were radiologieally stable in group A and 25 hips were radiologieally stable in group B (P 〉0.05). Conclusion The excellent and good rate of group A is similar to that of the group B with less blood loss and shorter operative time. As a new minimally invasive technique, the decompression and reconstituted autologous bone marrow cells transplantation is an effective and safe treatment for ischemie necrosis of femoral head at early stage.
出处 《中国骨与关节损伤杂志》 2007年第1期16-19,共4页 Chinese Journal of Bone and Joint Injury
关键词 股骨头缺血坏死 自体骨髓细胞 髓芯减压 带血管蒂骨移植 Ischemie necrosis of femoral head Autologous bone marrow cells Core Decompression Vaseularized bone flap grafting
  • 相关文献

参考文献8

  • 1Urbaniak JR, Coogan PG, Gunneson EB, et al. Treatment of osteonecrosis of the femoral head with free vaseularized fibular grafting.A long - term follow - up study of one hundred and three hips. J Bone Joint Surg (Am), 1995, 77:681
  • 2赵德伟,王卫明,王本杰,王铁男,芦健民,郭林,崔旭,于晓光.保留股骨头手术治疗股骨头缺血性坏死1005例临床分析[J].中华外科杂志,2005,43(16):1054-1057. 被引量:52
  • 3Zhao DW, Xu DC, Wang WM, et al. Iliac graft vascularization for femoral head osteonecrosis. Clin Orthop Relat Res, 2006, 442:171
  • 4Gangji V, Hauzeur JP, Matos C. Treatment of osteonecrosis of the femoral head with implantation of autologous bone - marrow cells.Apilot study. J Bone Joint Surg (Am), 2004, 86:1153
  • 5Hernigou P, Beaujean F. Treatment of osteonecrosis with autologous bone marrow grafting. Clin Orthop, 2002, 405:14
  • 6赵德伟,徐达传,王卫明.早期股骨头缺血性坏死的微创治疗[J].中国骨与关节损伤杂志,2005,20(10):670-672. 被引量:7
  • 7Steinberg ME, Bands RE, Parry S, et al. Does lesion size affect the outcome inavascular necrosis. Clin Orthop, 1999, 367:262
  • 8Steinberg ME. Recent advances in the management of osteo - necrosis of the hip. Introduction. Semin Orthro- plasty, 1998, 9:181

二级参考文献18

  • 1赵德伟,张晓明.带血管蒂大转子转移重建无菌性坏死股骨头第二次手术病理观察1例[J].骨与关节损伤杂志,1995,10(6):362-363. 被引量:11
  • 2Fuchs B, Knothe U, Hertel R, et al. Femoral osteotomy and iliac graft vascularization for femoral head osteonecrosis. Clin Orthop,2003, (412) :84-93.
  • 3Ficat RP, Arlet J. Functional investigation of bone under normal conditions. In : Hungerford DS, ed. Ischemia and necrosis of bone.Baltimore : Williams and Wilkins, 1980. 29-52.
  • 4Smith SW, Fehring TR, Griffin WI, et al. Core decompression of the osteonecrotic femoral head. J Bone Joint Surg (Am), 1995, 77:674-680.
  • 5Eisenschenk A, Lautenbach M, Schwedick G, et al. Treatment of femoral head necrosis with vascularized iliac crest transplants. Clin Orthop Relat Res, 2001, (386):100-105.
  • 6Jay R, Lieberman MD. Core decompression for osteonecrosis of the hip. Clin Orthop,2004, (418) :29-33.
  • 7Urbaniak JR, Harvey EJ. Revascularization of the femoral head in osteonecrasis. J Am Acad Orthop Surg, 1998, 6:44-54.
  • 8Yoo MG, Chung DW, Han CS. Free vascularized fibula grafting for the treatment of osteonecrosis of the femoral head. Clin Orthop Relat Res, 1992, (277):128-138.
  • 9Fairbank AC, Bhatia D, Jinnah RH, et al. Long- term results of core decompression for ischemic necrosis of the femoral head. J Bone Joint Surg (Br), 1995, 77:42
  • 10Arlet J, Ficat RP: Forage - biopsie de la tete femorale dans 1'osteonecrose primative. Observations histopathologiques portant sur huit foranes. Rev RhumEdFr, 1964, 31:257

共引文献57

同被引文献89

引证文献8

二级引证文献38

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部