Core decompression in combination with nano-hydroxyapatite/polyamide 66 rod for the treatment of osteonecrosis of the femoral head
Core decompression in combination with nano-hydroxyapatite/polyamide 66 rod for the treatment of osteonecrosis of the femoral head
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DOI：
10.1007/s00402-013-1885-4
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发表时间：
2014-01-01
影响因子：
2.3
通讯作者：
Wang, Kunzheng
中科院分区：
文献类型：
--
作者：
Yang, Pei;Bian, Chuanbao;Wang, Kunzheng
为探讨髓芯减压联合纳米羟基磷灰石/聚酰胺66(n-HA/PA66)棒和多孔生物玻璃植骨治疗股骨头坏死(ONFH)的疗效。64例(84个髋关节)股骨头坏死患者分为两组，一组采用髓芯减压(CD)联合n-HA/PA66棒和多孔生物玻璃植骨；临床失败率(9/38，23.68%)明显低于对照组(24/46，52.17%)(p<；0.05)。两组术后Harris髋关节评分(HHS)均有显著提高(P<；0.05)。在Steinberg IIC和IIIA的HHS改善方面，两组有显著差异(分别为P<；0.05和P<；0.001)。两组术后视觉模拟评分(VAS)均较术前显著降低(P<；0.05)。其中IIB组、IIC组和IIIA组的VAS评分改善程度差异有统计学意义(分别为P<；0.05、P<；0.05和P<；0.01)。髓芯减压联合n-HA/PA66棒和生物玻璃植骨可显著减轻股骨头坏死患者的髋关节疼痛，改善髋关节功能，防止股骨头塌陷。由于这种方法的有效性似乎随着Steinberg分期的不同而不同，我们建议这种治疗方法可能适用于早到中期的ONFH患者。
The aim of this study was to investigate the effectiveness of core decompression in combination with a nano-hydroxyapatite/polyamide 66 (n-HA/PA66) rod and a porous bioglass bone graft for the treatment of osteonecrosis of the femoral head (ONFH).Sixty-four patients (84 hips) with ONFH were allocated to a program of either core decompression (CD) in combination with a n-HA/PA66 rod and a porous bioglass bone graft (treatment group) or CD with an autologous cancellous bone graft (control group). Clinical and radiographic retrospective follow-ups were performed on all patients with the prospectively collected data.The overall clinical failure rate in the treatment group (9/38, 23.68 %) was lower than that of the control group (24/46, 52.17 %) (p < 0.05). Harris hip scores (HHS) were significantly increased in both groups post-surgery (p < 0.05). There was a significant difference between the two groups on HHS improvement for Steinberg IIC and IIIA (p < 0.05 and p < 0.001, respectively). The visual analogue scale (VAS) was significantly decreased in both groups post-surgery (p < 0.05). Especially, significant difference in the VAS improvement was observed between the groups for IIB, IIC and IIIA (p < 0.05, p < 0.05 and p < 0.01, respectively).Core decompression combined with the implantation of a n-HA/PA66 rod and a bioglass bone graft can significantly decrease hip pain, improve hip function, and prevent the collapse of the femoral head in patients with ONFH. As the effectiveness of this approach appears to vary with Steinberg stage, we suggest that this treatment procedure may be suitable for patients with early to middle stage ONFH.