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股骨头坏死保髋手术治疗研究进展

  • 全坤 梅炯
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  • 1. 上海市同济医院
    2. 同济医院

收稿日期: 2016-08-29

  修回日期: 2016-09-01

  网络出版日期: 2017-02-17

基金资助

股骨头及髋周血供的三维数字化模型建立与临床应用研究

Research Progress On Hip-reserving Surgerys Of The Femoral Head

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Received date: 2016-08-29

  Revised date: 2016-09-01

  Online published: 2017-02-17

摘要

股骨头坏死(ONFH),也称为股骨头缺血性坏死,是由不同病因造成的一种病理状态,包括滥用激素、酗酒、创伤、血管损伤以及一些特发性疾病[1]。股骨头坏死造成了股骨头软骨下骨血供的减少,从而导致了成骨细胞的死亡及关节面的塌陷。股骨头一旦发生塌陷,大部分患者将不可避免的进行髋关节置换手术。但髋关节置换手术并不是每个患者的最佳选择,除了关节假体本身的因素外,部分患者的年龄与疾病特点可能会面临人工关节多次翻修的风险,因而股骨头坏死的保髋治疗更为一些学者所提倡。目前,股骨头坏死的保髋手术治疗主要包括截骨术、髓芯减压术、植骨术、钽棒置入术、干细胞治疗等,本文将从不同机制上对近年来常见的一些保髋手术做一综述。

本文引用格式

全坤 梅炯 . 股骨头坏死保髋手术治疗研究进展[J]. 外科研究与新技术(中英文), 2016 , 5(4) : 277 -280,286 . DOI: 10.3969/j.issn.2095-378X.2016.04.015

Abstract

Osteonecrosis of the femoral head (ONFH), also known as femoral head avascular necrosis, is a pathological state due to different etiologies, including steroid administration, alcohol abuse, traumatic events, vascular injury and idiopathic origins. ONFH reduces the blood supply of the subchondral bone of the femoral head, which results in osteocyte death and the collapse of the articular surface. Once the collapse happens, the majority of patients inevitably need total hip replacement. But hip replacement surgery is not the best choice for each patient. Expect for the joint prosthesis factors, the patient's age and disease characteristics may result in several renovations. So more and more scholars suggest that we would better reserve the femoral head. Currently, such surgerys include osteotomy, core decompression, bone graft surgery, tantalum rods surgery, stem cell therapy, etc. The aim of the present review is to summarize the hip-reserving surgerys for ONFH by different mechanisms from a new perspective.

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