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[1]張宏軍,劉又文,范克杰,等.微創(chuàng)減壓植骨聯(lián)合自體骨髓干細(xì)胞移植治療股骨頭壞死[J].中醫(yī)正骨,2013,25(03):56-58.
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微創(chuàng)減壓植骨聯(lián)合自體骨髓干細(xì)胞移植治療股骨頭壞死()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期數(shù):
2013年03期
頁碼:
56-58
欄目:
股骨頭壞死
出版日期:
2013-03-20

文章信息/Info

作者:
張宏軍劉又文范克杰梁國輝
河南省洛陽正骨醫(yī)院,河南 洛陽 471002
關(guān)鍵詞:
股骨頭壞死 干細(xì)胞移植 骨髓干細(xì)胞 骨移植
摘要:
目的:探討微創(chuàng)減壓植骨聯(lián)合自體骨髓干細(xì)胞移植治療股骨頭壞死的臨床療效。方法:采用微創(chuàng)病灶清除、打壓植骨聯(lián)合自體骨髓干細(xì)胞移植治療股骨頭壞死患者67例(85髖),男44例(53髖),女23例(32髖)。年齡18~50歲,中位數(shù)38歲。激素性24例,酒精性29例,外傷性9例,特發(fā)性5例。按照ARCO骨壞死分期標(biāo)準(zhǔn),ⅠC期5髖,ⅡA期19髖,ⅡB期25髖,ⅡC期22髖,ⅢA期9髖,ⅢB期3髖,ⅢC期2髖。術(shù)后隨訪觀察患髖關(guān)節(jié)功能及ARCO骨壞死分期。結(jié)果:①一般情況。本組患者手術(shù)時間30~70 min,中位數(shù)50 min; 切口長度6~10 cm,中位數(shù)8 cm; 術(shù)中出血量80~150 mL,中位數(shù)100 mL。所有患者的手術(shù)切口均甲級愈合,未發(fā)生感染及其他并發(fā)癥。65例(82髖)獲得12個月以上隨訪,失訪的2例(3髖)患者失訪前未發(fā)現(xiàn)髖關(guān)節(jié)功能異常,影像學(xué)檢查示病變無進(jìn)展。②Harris髖關(guān)節(jié)功能評分。術(shù)后12個月隨訪時患者的患髖疼痛、功能、活動范圍評分及總分[(41.12±3.35)分,(43.42±5.63)分,(4.32±3.78)分,(86.42±9.74)分]均高于術(shù)前[(19.52±3.21)分,(34.87±5.23)分,(3.65±1.35)分,(62.21±7.71)分],差異有統(tǒng)計學(xué)意義(t=42.157,P=0.000; t=11.956,P=0.000; t=1.511,P=0.004; t=17.648,P=0.000)。③X線評價。術(shù)前ARCO分期為ⅡC期的2例(2髖)患者、ⅢA期1例(1髖)患者、ⅢB期1例(2髖)患者及ⅢC期2例(2髖)患者術(shù)后12個月X線片示植骨區(qū)股骨頭密度不均,有囊性變,18個月后發(fā)展為Ⅳ期,其中5例(6髖)行全髖關(guān)節(jié)置換,1例(1髖)未行髖關(guān)節(jié)置換術(shù),扶拐行走; 3例(5髖)由ⅡB期進(jìn)展為ⅢA期,未行髖關(guān)節(jié)置換術(shù)。其余56例(70髖)術(shù)后12個月X線片示股骨頭外形完整,無塌陷,病變區(qū)無密度不均和囊性變,壞死骨全部或大部被新生骨替代。結(jié)論:微創(chuàng)減壓植骨聯(lián)合自體骨髓干細(xì)胞移植治療股骨頭壞死近期療效確切、創(chuàng)傷小,比較適用于ARCOⅡ期股骨頭壞死患者的治療。

參考文獻(xiàn)/References:

[1] Kim YH,Kim JS,Park JW,et al.Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head:a concise follow-up,at an average of seventeen years,of a previous report[J].J Bone Joint Surg Am,2011,93(19):1806-1810.
[2] 張宏軍,高書圖,胡永成,等.髓芯減壓聯(lián)合自體骨髓干細(xì)胞移植治療股骨頭壞死的早期臨床觀察[J].中華骨科雜志,2010,30(1):48-52.
[3] Mont MA,Marulanda GA,Seyler TM,et al.Core decompression and nonvascularized bone grafting for the treatment of early stage osteonecrosis of the femoral head[J].Instr Course Lect,2007,56:213-220.
[4] Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty.An end-result study using a new method of result evaluation[J].J Bone Joint Surg Am,1969,51(4):737-755.
[5] Wei BF,Ge XH.Treatment of osteonecrosis of the femoral head with core decompression and bone grafting[J].Hip Int,2011,21(2):206-210.
[6] Gangji V,Rooze M,De Maertelaer V,et al.Inefficacy of the cementation of femoral head collapse in glucocorticoid-induced osteonecrosis[J].Int Orthop,2009,33(3):639-642.
[7] Herrera-Soto JA,Charles TP.Core decompression for juvenile osteonecrosis[J].Orthop Clin North Am,2011,42(3):429-436.
[8] Rosenwasser MP,Garino JP,Kiernan HA,et al.Long term followup of thorough debridement and cancellous bone grafting of the femoral head for avascular necrosis[J].Clin Orthop Relat Res,1994,(306):17-27.
[9] Hernigou P,Beaujean F,Lambotte JC.Decrease in the mesenchymal stem-cell pool in the proximal femur in corticosteroid-induced osteonecrosis[J].J Bone Joint Surg Br,1999,81(2):349-355.
[10] 王廷華,李力燕,Mcdonald JW.干細(xì)胞理論與技術(shù)[M].2版.北京:科學(xué)出版社,2009:56-61.
[11] Kocher AA,Schuster MD,Bonaros N,et al.Myocardial homing and neovascularization by human bone marrow angioblasts is regulated by IL-8/Gro CXC chemokines[J].J Mol Cell Cardiol,2006,40(4):455-464.
[12] Kinnaird T,Stabile E,Burnett MS,et al.Bone-marrow-derived cells for enhancing collateral development:mechanisms,animal data,and initial clinical experiences[J].Circ Res,2004,95(4):354-363.
[13] Kawate K,Yajima H,Ohgushi H,et al.Tissue-engineered approach for the treatment of steroid-induced osteonecrosis of the femoral head:transplantation of autologous mesenchymal stem cells cultured with beta-tricalcium phosphate ceramics and free vascularized fibula[J].Artif Organs,2006,30(12):960-962.
[14] Gangji V,Hauzeur JP,Matos C,et al.Treatment of osteonecrosis of the femoral head with implantation of autologous bone-marrow cells.A pilot study[J].J Bone Joint Surg Am,2004,86-A(6):1153-1160.
[15] Gangji V,Hauzeur JP.Treatment of osteonecrosis of the femoral head with implantation of autologous bone-marrow cells.Surgical technique[J].J Bone Joint Surg Am,2005,87( Suppl 1):106-112.

備注/Memo

備注/Memo:
基金項目:河南省科技廳攻關(guān)項目(09yy0068)
更新日期/Last Update: 2013-03-20