■血管坏死(AVN)是一种罕见的进行性退行性疾病,可导致骨骼和关节破坏。患者通常需要手术干预。股骨AVN是最常见的解剖位置。高压氧治疗(HBOT)已被证明对AVN有效。我们提供了从一个中心收集的30年数据,并将结果与其他已发布的数据进行了比较。
对自1989年以来在弗里曼特尔和菲奥娜斯坦利医院接受HBOT治疗的所有患者进行了回顾性图表回顾。主要结果是使用Steinberg评分的放射学外观,次要结果是主观改善,关节置换手术的必要性和并发症的发生率。
■自1989年以来,对14例患者(14个股骨头和7个股骨髁)的21个关节进行了HBOT治疗。两名患者被排除在外。在股骨头组中,14个关节中有9个(64%)在治疗后和6个月(最少)时磁共振成像(MRI)扫描稳定或改善;10个关节(71%)主观效果良好,三个关节需要手术干预,3例患者出现轻度听觉气压伤.在股骨髁组中,所有5个关节均有稳定或改善的治疗后MRI扫描(4个有明显的水肿和/或软骨稳定性改善),四个关节主观上报告了良好的结果,没有患者需要手术干预(随访>6个月).
■这项单中心回顾性研究观察到使用HBOT预防股骨AVN疾病进展,与其他已发表的研究相比。这增加了HBOT可能在股骨AVN的治疗中具有重要作用的证据。
UNASSIGNED: Avascular necrosis (AVN) is a rare progressive degenerative disease leading to bone and joint destruction. Patients often require surgical intervention. Femoral AVN is the most common anatomical location. Hyperbaric oxygen treatment (HBOT) has been shown to be effective in AVN. We present data collected from one centre over a 30-year period and compare the results with other published data.
UNASSIGNED: A retrospective chart review of all patients receiving HBOT for AVN at Fremantle and Fiona Stanley Hospitals since 1989 was performed. The primary outcome was radiological appearance using the Steinberg score, with secondary outcomes being subjective improvement, the need for joint replacement surgery and rates of complications.
UNASSIGNED: Twenty-one joints in 14 patients (14 femoral heads and seven femoral condyles) were treated with HBOT since 1989. Two patients were excluded. Within the femoral head group, nine of the 14 joints (64%) had stable or improved magnetic resonance imaging (MRI) scans post treatment and at six months (minimum); 10 joints (71%) had good outcomes subjectively, three joints required surgical intervention, and three patients developed mild aural barotrauma. Within the femoral condyle group, all five joints had stable or improved post-treatment MRI scans (four had visible improvement in oedema and/or chondral stability), four joints reported good outcomes subjectively, none of the patients required surgical intervention (follow-up > six months).
UNASSIGNED: This single centre retrospective study observed prevention of disease progression in femoral AVN with the use of HBOT, comparable to other published studies. This adds to the body of evidence that HBOT may have a significant role in the treatment of femoral AVN.