髓芯减压联合骨形成蛋白活性诱导棒植入术治疗早期股骨头坏死的效果

doi:10.3969/j.issn.1006-5725.2024.09.017

Abstract

Abstract:

Objective To investigate the effect of core decompression combined with bone-morphogenetic proteins （BMP） activity inducing rod implantation in the treatment of early-stage femoral head necrosis. Methods Retrospective analysis of 116 patients with early-stage femoral head necrosis from June 2018 to June 2022 were divided into core decompression combined with BMP activity inducing rod group （BMP group） and allograft bone group. Sixty cases in the BMP group were treated with core decompression combined with implantation of BMP-activated induced rods， and 56 cases in the allograft group were treated with core decompression combined with bone grafting of the allograft bone by punching and compression.The differences in hip Harris scores and visual analogue scores （VAS） of pain between the two groups at preoperative， 6 months postoperative and 1 year postoperative， and the patient treatment response and femoral head survival rate at 1 year postoperative were compared. Results All patients were followed-up， and the difference between the preoperative VAS score and Harris score of the two groups was not statistically significant （P > 0.05）， and the VAS score and Harris score of the two groups were significantly improved at 6 months and 1 year after operation， and the BMP group was better than the allograft bone group， with significant difference（P < 0.05）. At 1 year after surgery， the Harris hip score excellence rate of the BMP group was higher than that of the allograft bone group， and the difference was statistically significant （P < 0.05）； the femoral head survival rate of the BMP group was higher than that of the allograft bone group， and the difference was statistically significant （P < 0.05）. Conclusions Core decompression combined with BMP activity induced rod implantation was effective in the treatment of early femoral head necrosis， which accelerated the induction of new bone formation， improved the quality of new bone， provided biomechanical support for the femoral head， and effectively avoided femoral head collapse. Moreover， it has good biocompatibility and couldbe degraded and absorbed in the body， which is worthy of clinical promotion.

Key words: early osteonecrosis of the femoral head, core decompression, calcium phosphate cement, recombinant human bone morphogenetic protein-2, BMP activity induced rod

CLC Number:

R687.4

Liming ZHENG,Feng WEN,Wei WANG,Zhiwen. ZHANG. Core decompression combined with BMP activity inducing rod implantation for early femoral head necrosis[J]. The Journal of Practical Medicine, 2024, 40(9): 1280-1285.

Figures/Tables 6

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References 26

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组别	例数（髋）	Harris评分			VAS评分
组别	例数（髋）	术前	术后6个月	术后1年	术前	术后6个月	术后1年
BMP组	60（74）	58.43 ± 5.98	76.27 ± 3.58^?	85.95 ± 4.69^?	4.02 ± 0.70	2.78 ± 0.58^?	1.72 ± 0.88^?
同种异体骨组	56（69）	57.80 ± 3.68	73.02 ± 2.88^?	79.61 ± 5.24^?	4.13 ± 0.60	3.18 ± 0.39^?	2.22 ± 0.97^?
t值		0.678	5.357	6.881	-0.888	-4.262	-2.894
P值		0.493	< 0.001	< 0.001	0.376	< 0.001	0.005

组别	例数	优	良	可	差	优良率（%）
BMP组	60	32	24	3	1	93.33
同种异体骨组	56	24	20	8	4	78.57
χ²值						5.308
P值						0.021

组别	例数（髋）	塌陷髋数	存活髋数
BMP组	60（74）	1（1.35） 5（7.25）	73（98.65）
同种异体骨组	56（69）	1（1.35） 5（7.25）	64（92.75）
χ²值			4.837
P值			0.028

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Core decompression combined with BMP activity inducing rod implantation for early femoral head necrosis

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