| 徐培力,邢晨阳,计钟凯,等.钻孔减压死骨刮除联合陶瓷棒植入治疗股骨头坏死的临床疗效评估.骨科,2026,17(3): 232-236. |
| 钻孔减压死骨刮除联合陶瓷棒植入治疗股骨头坏死的临床疗效评估 |
| Evaluation of the clinical efficacy of core decompression and necrotic bone curettage combined with ceramic rod implantation in treating osteonecrosis of the femoral head |
| 投稿时间：2025-11-04 |
| DOI：10.3969/j.issn.1674-8573.2026.03.006 |
| 中文关键词: 股骨头坏死 陶瓷棒植入 保髋治疗 治疗结果 |
| 英文关键词: Femur head necrosis Ceramic rod implantation Hip preservation treatment Treatment outcome |
| 基金项目: |
| 作者 | 单位 | E-mail | | 徐培力 | 南京医科大学第二附属医院骨科,南京 210011 | | | 邢晨阳 | 南京医科大学第二附属医院骨科,南京 210011 | | | 计钟凯 | 滨海县人民医院骨科,江苏盐城 224000 | | | 王笑天 | 南京医科大学第二附属医院骨科,南京 210011 | | | Urba Rafi | 南京医科大学第二附属医院骨科,南京 210011 | | | 闵美鹏 | 南京医科大学第二附属医院骨科,南京 210011 | | | 姚承 | 南京医科大学第二附属医院骨科,南京 210011 | | | 何斌 | 南京医科大学第二附属医院骨科,南京 210011 | | | 杨凯翔 | 南京医科大学第二附属医院骨科,南京 210011 | yangkx9003@163.com | | 范磊 | 南京医科大学第二附属医院骨科,南京 210011 | fanlei8839@126.com |
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| 中文摘要: |
| 目的 探讨经股骨颈钻孔减压死骨刮除联合人工陶瓷棒植入术治疗非创伤性股骨头坏死（osteonecrosis of the femoral head，ONFH）的中短期临床疗效。方法 回顾性分析2021年10月至2023年12月于南京医科大学第二附属医院诊断为非创伤性ONFH的32例（34髋）患者，年龄为（40.1±7.8）岁，男23例，女9例，国际骨循环研究会（Association Research Circulation Osseous，ARCO）分期为Ⅰ、Ⅱ、ⅢA期，均行经股骨颈钻孔减压死骨刮除联合人工陶瓷棒植入术治疗。所有患者均采用髋关节Harris评分（HHS）评估术前及术后髋关节功能，以髋关节功能优良率和X线影像学评估作为疗效评定指标。结果 32例随访（12.4±0.7）个月（12~14个月）。末次随访时HHS为（84.1±6.4）分，较术前的（79.3±6.1）分明显提高，差异有统计学意义（P＜0.05）；其中优2髋、良19髋、中13髋、差0髋；随访过程中无患者行全髋关节置换术。32髋（94.12%）无进展，进展2髋（5.88%）。结论 经股骨颈钻孔减压死骨刮除联合搭载人工陶瓷棒植入术治疗非创伤性ONFH的中短期疗效满意，可有效改善患者髋关节功能，缓解或消除患者髋部疼痛，从而为年轻非创伤性ONFH的患者行保髋治疗提供理论依据。 |
| 英文摘要: |
| Objective To evaluate the short- to medium-term clinical efficacy of core decompression and curettage of necrotic bone combined with artificial ceramic rod implantation in the treatment of non-traumatic osteonecrosis of the femoral head (ONFH). Methods A retrospective study was conducted on 32 patients (34 hips) diagnosed with non-traumatic ONFH at the Second Affiliated Hospital of Nanjing Medical University between October 2021 and December 2023. The cohort comprised 23 males and 9 females, with a mean age of 40.1±7.8 years. According to the Association Research Circulation Osseous (ARCO) classification, the involved hips were graded as stage Ⅰ, Ⅱ, or ⅢA. All patients underwent core decompression via the femoral neck, necrotic bone curettage, and artificial ceramic rod implantation. Hip function was evaluated pre- and postoperatively using the Harris Hip Score (HHS). Clinical efficacy was assessed based on the excellent-to-good rate of hip function and radiographic evaluations. Results All patients were followed up for a mean of 12.4±0.7 months (range, 12-14 months). At the final follow-up, the mean HHS significantly improved from 79.3±6.1 preoperatively to 84.1±6.4 (P＜0.05). Functional outcomes were graded as excellent in 2 hips, good in 19, fair in 13, and poor in 0. No patient required total hip arthroplasty during the follow-up period. Radiographic evaluation showed no disease progression in 32 hips (94.12%), while 2 hips (5.88%) progressed. Conclusion Core decompression and curettage of necrotic bone combined with artificial ceramic rod implantation demonstrates satisfactory short- to medium-term efficacy in treating non-traumatic ONFH. This surgical technique effectively improves hip function and alleviates pain, providing a reliable joint-preserving treatment strategy for young patients with non-traumatic ONFH. |
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