PDF(Pubmed)
Abstract：
OBJECTIVE: Avascular necrosis of the femoral head is a disease usually seen in middle-aged individuals. Although many aetiological factors have been blamed, there are still aetiological factors that have not been fully elucidated. Although treatment options show a wide range, early and appropriate treatment is of great importance to preserve the hip joint. In our study, we compared the results of core decompression and core decompression combined with bone marrow mesenchymal stem cell implantation in patients with avascular necrosis of the femoral head.
METHODS: In this retrospective study, Steinberg stage 1-2 patients operated on for avascular necrosis of the femoral head between 2018 and 2023 were analysed. Separate groups were formed from patients who underwent isolated core decompression and core decompression + bone marrow mesenchymal stem cell implantation. Age, gender, Steinberg staging, aetiology of the disease, follow-up period, progression to hip arthroplasty, Vas scores, Harris hip scores (HHS), and complications were evaluated. Harris hip scores at preoperative and 2-year follow-up periods; VAS scores at preoperative, 3-month, 6-month, 1-year, and 2-year follow-up periods were analysed.
RESULTS: In the study, 44 patients were analysed. While 25 patients underwent core decompression only (group 1), 19 patients underwent core decompression and bone marrow mesenchymal stem cell implantation (group 2). The mean age of the patients in group 1 was 39.3 ± 6.5 years, and the mean age of the patients in group 2 was 38.4 ± 6.7 years. The mean follow-up was 31.85 ± 4.4 months in group 1 and 32.2 ± 4.1 months in group 2. Total hip arthroplasty was performed in 2 of the patients in group 1 (one of the patients underwent total hip arthroplasty at month 28 and the other at month 33).
CONCLUSIONS: The treatment of avascular necrosis of the femoral head varies according to various staging methods. Early diagnosis of the disease and correct treatment are very important for the patient\'s quality of life in the future. In our research, we found that patients who received both core decompression and stem cell implantation for early-stage avascular necrosis of the femoral head exhibited decreased pain at the 6-month, 1-year, and 2-year follow-up examinations. Additionally, their hip function improved at the 24-month mark according to the HHS evaluation.
METHODS: In this retrospective study, Steinberg stage 1-2 patients operated on for avascular necrosis of the femoral head between 2018 and 2023 were analysed. Separate groups were formed from patients who underwent isolated core decompression and core decompression + bone marrow mesenchymal stem cell implantation. Age, gender, Steinberg staging, aetiology of the disease, follow-up period, progression to hip arthroplasty, Vas scores, Harris hip scores (HHS), and complications were evaluated. Harris hip scores at preoperative and 2-year follow-up periods; VAS scores at preoperative, 3-month, 6-month, 1-year, and 2-year follow-up periods were analysed.
RESULTS: In the study, 44 patients were analysed. While 25 patients underwent core decompression only (group 1), 19 patients underwent core decompression and bone marrow mesenchymal stem cell implantation (group 2). The mean age of the patients in group 1 was 39.3 ± 6.5 years, and the mean age of the patients in group 2 was 38.4 ± 6.7 years. The mean follow-up was 31.85 ± 4.4 months in group 1 and 32.2 ± 4.1 months in group 2. Total hip arthroplasty was performed in 2 of the patients in group 1 (one of the patients underwent total hip arthroplasty at month 28 and the other at month 33).
CONCLUSIONS: The treatment of avascular necrosis of the femoral head varies according to various staging methods. Early diagnosis of the disease and correct treatment are very important for the patient\'s quality of life in the future. In our research, we found that patients who received both core decompression and stem cell implantation for early-stage avascular necrosis of the femoral head exhibited decreased pain at the 6-month, 1-year, and 2-year follow-up examinations. Additionally, their hip function improved at the 24-month mark according to the HHS evaluation.
摘要：
目的：股骨头缺血性坏死是一种常见于中年人的疾病。尽管许多病因被指责，仍然有病因因素尚未完全阐明。尽管治疗选择范围广泛，早期和适当的治疗对保留髋关节非常重要。在我们的研究中,我们比较了髓芯减压和髓芯减压联合骨髓间充质干细胞植入治疗股骨头缺血性坏死的结果。
方法：在这项回顾性研究中，分析了2018年至2023年接受股骨头缺血性坏死手术的Steinberg1-2期患者。分别由接受孤立核减压和核减压+骨髓间充质干细胞植入的患者组成。年龄,性别,斯坦伯格分期，病因学的疾病，随访期,进展为髋关节置换术，Vas分数，哈里斯髋关节评分（HHS），并对并发症进行了评估。术前和2年随访期间Harris髋关节评分；术前VAS评分，3个月,6个月,1年,和2年的随访期进行了分析。
结果：在研究中，对44例患者进行了分析。而25例患者仅接受核心减压（第1组），19例患者行核心减压和骨髓间充质干细胞植入(第2组)。第1组患者的平均年龄为39.3±6.5岁,第2组患者的平均年龄为38.4±6.7岁。第1组的平均随访时间为31.85±4.4个月，第2组的平均随访时间为32.2±4.1个月。第1组中的2例患者进行了全髋关节置换术（其中一名患者在第28个月接受了全髋关节置换术，另一名在第33个月接受了全髋关节置换术）。
结论：股骨头缺血性坏死的治疗方法因分期方法而异。疾病的早期诊断和正确的治疗对患者今后的生活质量非常重要。在我们的研究中,我们发现接受髓芯减压和干细胞植入治疗早期股骨头缺血性坏死的患者在6个月时疼痛减轻，1年,和2年的随访检查。此外,根据HHS评估，他们的髋关节功能在24个月时有所改善。
方法：在这项回顾性研究中，分析了2018年至2023年接受股骨头缺血性坏死手术的Steinberg1-2期患者。分别由接受孤立核减压和核减压+骨髓间充质干细胞植入的患者组成。年龄,性别,斯坦伯格分期，病因学的疾病，随访期,进展为髋关节置换术，Vas分数，哈里斯髋关节评分（HHS），并对并发症进行了评估。术前和2年随访期间Harris髋关节评分；术前VAS评分，3个月,6个月,1年,和2年的随访期进行了分析。
结果：在研究中，对44例患者进行了分析。而25例患者仅接受核心减压（第1组），19例患者行核心减压和骨髓间充质干细胞植入(第2组)。第1组患者的平均年龄为39.3±6.5岁,第2组患者的平均年龄为38.4±6.7岁。第1组的平均随访时间为31.85±4.4个月，第2组的平均随访时间为32.2±4.1个月。第1组中的2例患者进行了全髋关节置换术（其中一名患者在第28个月接受了全髋关节置换术，另一名在第33个月接受了全髋关节置换术）。
结论：股骨头缺血性坏死的治疗方法因分期方法而异。疾病的早期诊断和正确的治疗对患者今后的生活质量非常重要。在我们的研究中,我们发现接受髓芯减压和干细胞植入治疗早期股骨头缺血性坏死的患者在6个月时疼痛减轻，1年,和2年的随访检查。此外,根据HHS评估，他们的髋关节功能在24个月时有所改善。
