如何把握股骨头坏死患者的保髋治疗时机.pdfVIP

. 82 . 中国骨与关节杂志 2016 年 2 月第 5 卷第 2 期 Chinese Journal of Bone and Joint, February 2016, Vol 5, No 2 . 述评 Editorial . 如何把握股骨头坏死患者的保髋治疗时机 何伟 DOI: 10.3969/j.issn.2095-252X.2016.02.002 中图分类号：R687.4 作者单位：510105 广州中医药大学第一附属医院骨科 Timing of hip preservation for patients with osteonecrosis of the femoral head HE Wei. Department of Orthopaedics, the first Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510105, PRC Abstract Hip pain and loss of function are the main complications of progressive collapse. It is known 【 】 that patients between the age of 30 and 50 are at the highest risk. It is significant to preserve joint on the pre-collapse stage of osteonecrosis of the femoral head ( ONFH ). The indications are: ( 1 ) the time to collapse ( pain ) is less than 6 months; ( 2 ) the degree of collapse is less than 4 mm; ( 3 ) the age is younger than 45 years old; ( 4 ) good hip function; ( 5 ) good compliance. No matter which kind of hip preserving surgery will be cholsen, all should obey the following principles: ( 1 ) fully eliminate the dead bone thus to ensure a good blood supply on the area of the grafted bone; ( 2 ) fullly combinating the impacted bone graft with the sustaining bone graft; ( 3 ) autologous bone grafting material is preferred; ( 4 ) as possible as small exposure and slight trauma; ( 5 ) do not increase the damage of the blood supply of the femoral head; ( 6 ) do not increase the difficulty of the second artificial joint replacement after its primary failure. The foundation of the hip preserving surgery, on one hand, lies on a comprehensive analysis of pathological stage of the disease by combinating the clinical symptoms such as pain with the imaging findings, for example, bone marrow and femoral head interior fracture; on the other hand, the detailed medical history,