| 岳元辉 龚庆国 周刚 向可 税国俊 龚万举 卢静 王卫国.关节镜治疗髋关节疾病的临床研究[J].,2016,16(18):3540-3543 |
| 关节镜治疗髋关节疾病的临床研究 |
| Clinical Study on Arthroscopic Treatment of Hip Joint Disease |
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| DOI： |
| 中文关键词: 髋关节 髋关节镜 股骨头坏死 吻合血管游离腓骨移植 |
| 英文关键词: Hip Hip arthroscopy Avascular necrosis of the femoral head Free vascularized fibular grafting |
| 基金项目:四川省教育厅青年基金项目(11ZB238) |
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| 中文摘要: |
| 目的：研究髋关节镜治疗髋关节疾病的方法、疗效及适应证，探讨髋关节镜在髋关节疾病中的临床价值。方法：研究对象为
86例有明显髋关节疼痛的患者，包括股骨头坏死（osteonecrosis, ON）（43%）、盂唇损伤（20%）、退行性关节病变（degenerative joint
disease，DJD）（10%）、股骨头骨骺缺血性坏死（Legg-Calve'-Perthes, LCP）（10%）、髋关节游离体（10%）、髋关节疼痛（100%）、机械性
损伤（78%）、运动损伤（56%）。对患者采用仰卧位进行髋关节镜检查，使用牵引床，300 或700，前外侧入口。观察不同疾病在治疗
后的预后结果。结果：所有患者均无并发症，平均随访时间30 个月，有60%的患者疼痛症状得到缓解。盂唇（91%，P<0.003）或LCP
（89%，P<0.05）患者疗效较好，而ON 和DJD 患者疼痛症状缓解较差，改善率仅为40%和44%。在吻合血管游离腓骨移植
（free-vascularized fibular graft，FVEG）的患者中有34%在随访期间得到改善（P=0.003）。其中18 名患者（21%）进行了全髋关节置
换术。结论：髋关节镜手术对于游离体、盂唇损伤、局灶性软骨病变、晚期LCP 后遗症患者有良好的治疗效果；对股骨头坏死的治
疗效果不佳。 |
| 英文摘要: |
| Objective:To study the method and curative effect of hip arthroscopy treatment on hip joint disease indications, as
well as clinical value of arthroscopy in hip joint disease.Methods:The objects were 86 cases of patients who have obvious hip pain,
including osteonecrosis of the femoral head (43%), labrum injury (20%), degenerative joint disease (DJD) (10%), Legg-Calve' -Perthes
(LCP) (10%), loose body (10%), Pain (100%), mechanical injury (78%), sports injury (56%). The patients were detected by hip
arthroscopy in a supine position. The traction bed was applied, 300 or 700, with an anterior lateral entrance. Observe the results of
different diseases after treatment.Results:All patients had no complications. The mean follow-up time was 30 months. In a total, 60%of
the patients had their pain symptoms relieved. Labrum (91%, P<0.003) or LCP (89%, P<0.05) patients had better effect, while ON and
DJD patients had relatively poor effect, for only 40% and 44% of them improved. As for patients with free vascularized fibular grafting
(free-vascularized fibular graft FVEG), 34%of themwere improved during the follow-up period (P=0.003). 18 patients (21%) received
total hip replacement.Conclusion:The hip arthroscopy operation had good therapeutic effect for patients with loose body, labrum injury,
focal cartilage lesions, or late sequela of LCP, but has no effect on the femoral head necrosis. |
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