自体红骨髓组织工程复合物治疗早期股骨头缺血性坏死_医学论文.docVIP

自体红骨髓组织工程复合物治疗早期股骨头缺血性坏死_医学论文 自体红骨髓组织工程复合物治疗早期股骨头缺血性坏死_医学论文 作者：杨新明 石蔚 杜雅坤 孟宪勇 阴彦林 李化光 【摘要】 目的：探讨自体红骨髓组织工程复合物治疗早期股骨头缺血性坏死的临床应用疗效。方法：本组9例，男性8例，女性1例双侧股骨头坏死2例，右单侧股骨头坏死5例，左单侧股骨头坏死2例；术前均行X线摄片、CT、MRI 检查，ARCO分期：Ⅰ期4髋，Ⅱ期7髋；C型臂X线透视下行股骨头坏死区和囊性变区定位、髓芯减压,关节镜监视下，刮除坏死骨送病理；植入由自体红骨髓与含BMP的骨诱导活性材料复合成的非细胞型组织工程骨，并用空心钛钉支撑股骨头软骨下骨质。结果：术后主要观察患者跛行、疼痛、关节功能和影像学表现较术前改善率，本组9例均获得随访,随访时间12～24个月,平均18个月。术前术后采用12分法评分系统评定:优:6髋；良:4髋；可:1髋；差:0髋，优良率为90.9%。结论：自体红骨髓组织工程复合物植入结合临床应用髓芯减压、空心钛钉支撑，在减轻疼痛、改善股骨头内循环、促进骨修复、防止或延缓股骨头塌陷有极好的作用，为临床治疗成人ARCOⅠ期、Ⅱ期股骨头缺血性坏死一种有效的新方法。 【关键词】 股骨头缺血性坏死；骨髓；骨形成蛋白；骨移植 【ABSTRACT】 Objective:To investigate the fundamental theory for the clinical effect of autologous red bone marrow tissue complex combined with bouche decompression and implanting hollow titanium screws for treating ANFH.Methods:9 patients including 8 male and 1 female were included in this study.2 patients suffered from both side of ANFH,5 were righe side and 2 were left side.X-ray,CT and MRI were performed before the surgery.4 hips were classified as ARCO stage 1,7 hips were stage 2.All the patients were treated as follows:the area of NFH and cystis degeneration were detected and bouche decompression was done through X-ray with C-arm,and the necrotic bone was cleared for the pathologic diagnosis under the monitoring of arthroscopy.And then the non-cell based tissue engineering bone,which was the complex of autologous red bone marrow and osteoinductice absorbing material containing BMP,was transplanted into the body.Finally,the hollow titanium screws were used to pedestal the sclerotin.Results:Pain,joint function,image findings of post-operation were compared with that of preoperation.All the patients were followed up for an averaged 18 months(12 months to 24 months).12 scores were used to estimate the clinical rescult:6 excellent,4 good,1 acceptable and 0 bad.Those who were categorized as excellent and good accounted for 90.9%.Conclusion:Autologous red bone marrow tissue complex combined with bouche decompression and imp