髓芯减压植骨与多孔钽棒植入修复非创伤性股骨头坏死

背景：髓芯减压植骨是临床上常用的一种方法，随着对股骨头生物力学研究的深入，多孔钽棒技术也越来越多的用于保髋手术，但这两种术式在临床上疗效比较报道较少。 目的：比较髓芯减压植骨与多孔钽棒植入治疗非创伤性股骨头缺血性坏死的临床疗效。 方法：选择36例(45髋)成人股骨头缺血坏死患者，其中15例(19髋)采用髓芯减压植骨治疗，21例(26髋)采用髓芯减压多孔钽棒植入治疗。 结果及结论：植入治疗均成功，随访3~12个月，两组手术时间、出血量、住院天数比较差异均无显著性意义，治疗后Harris评分较治疗前均有明显提高(P < 0.05)，治疗后12个月Harris评分，多孔钽棒植入高于植骨治疗(P < 0.05)，差异显著性意义。髓芯减压与多孔钽棒植入对早期成人股骨头坏死髋关节功能改善优于髓芯减压植骨，预防了关节软骨的逐渐塌陷。

Core decompression with bone graft and porous tantalum rod insertion for avascular necrosis of the femoral head

BACKGROUND:Core decompression with bone graft is a common method for avascular necrosis of the femoral head clinically. With the development of biomechanics research on the femoral head, porous tantalum rod insertion is more and more used for avascular necrosis of the femoral head. However, the comparative study between the two methods is rarely reported. OBJECTIVE:To contrast the clinical effect of core decompression with bone graft and porous tantalum rod insertion on avascular necrosis of the femoral head. METHODS:Totally 36 patients (45 hips) with avascular necrosis of the femoral head were selected, and 15 patients in them (19 hips) underwent core decompression with bone graft, while 21 patients (26 hips) underwent porous tantalum screw insertion. RESULTS AND CONCLUSION:All patients were succeeded in operation and followed up for 3-12 months. There was no significant difference between the two groups in intraoperative blood loss, surgical time and hospital days. Harris hip score was significantly increased postoperatively (P < 0.05). The average Harris hip score of porous tantalum rod insertion group was higher than that of core decompression with bone graft group. There was a significant difference between the two groups (P < 0.05). These findings suggest that compared with the core decompress with bone graft, porous tantalum rod insertion shows more satisfactory result in the joint function improvement following avascular necrosis of the femoral head at early stage, and prevents the continuous sinking of joint cartilage.