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纸质出版:2013
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张琦,王雨,王爱民.钽棒植入治疗早期股骨头坏死短期临床疗效观察[J].陆军军医大学学报(原第三军医大学学报),2013,35(10):1027-1029.
Zhang Qi,Wang Yu,Wang Aimin.Short-term efficacy of porous tantalum implantation in treatment of early femoral head necrosis[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(10):1027-1029.
目的 探讨钽棒植入治疗早期股骨头坏死临床疗效。 方法 2008年4月至2012年6月我科采用钽棒植入治疗早期股骨头坏死26例31髋,包括男性21例25髋,女性5例6髋,其中单侧21例,双侧5例,年龄(43.8±10.7)岁,体质指数为(23.5±3.0)。病因:激素性11例14髋,酒精性10例12髋,特发性5例5髋。Harris评分为(65.2±20.7)分:优4髋、良4髋、中5髋、差18髋;根据Steinberg分期:ⅠC期3髋、ⅡB期3髋、ⅡC期25髋。 结果 术后随访7~57(29.4±14.8)个月,26例31髋全部获得随访。以最后一次随访结果作为评定依据,Harris评分为(86.6±13.9)分:优17髋、良7髋、中3髋、差4髋,优良率为77.4%,与术前比较差异有显著性(
P
0.05);根据Steinberg分期:ⅠC期3髋、ⅡB期4髋、ⅡC期15髋、ⅢC期2髋、ⅣB期1髋、ⅣC期6髋,29.0%(9/31)影像学进展为Steinberg Ⅲ期或以上;无手术并发症发生。 结论 钽棒植入治疗早期股骨头坏死可显著改善髋关节功能,延缓病情进展,短期疗效良好。
Objective To discuss the efficacy of porous tantalum implantation in treatment of early femoral head necrosis. Methods From April 2008 to June 2012
twenty-six patients with 31 hips of early femoral head necrosis were treated with porous tantalum implantation. Five patients suffered from bilateral hip involvement. The mean age was 43.8 years and the mean body mass index was 23.5. Eleven patients (14 hips) suffered from osteonecrosis as a result of corticosteroid therapy
and ten patients (12 hips) had alcohol-induced osteonecrosis. For five patients
(five hips)
no etiological factor could be detected. According to Harris hip score
four hips were assessed as excellent
four as good
five as moderate and eighteen as poor
and the average score was 65.2±20.7. According to Steinberg stages
three hips were identified as stage ⅠC
three as ⅡB and 25 as ⅡC. Results All patients were followed up with an average duration of 29.4±14.8 months. The final evaluation was made according to the last follow-up data. According to Harris hip score
seventeen hips were assessed as excellent
seven as good
three as fair and four as poor. The excellent to good rate was 77.4% and the average score was 86.6±13.9 with a statistical difference (
P
0.05). According to Steinberg stages
three hips were identified as stage ⅠC
four as ⅡB
fifteen as ⅡC
two as ⅢC
one as ⅣB and six as ⅣC. The radiographic progression rate to Steinberg ⅢA or more advanced was 29.0%. No serious adverse reaction occurred during this period. Conclusion Porous tantalum implantation in treatment of early femoral head necrosis can improve the joint function and delay the disease with good short-term efficacy.
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