股骨头坏死“三部失效”塌陷机制假说与保存自身髋关节的新理念

摘要

BACKGROUND:Unsatisfactory clinical efficacy of hip-preserving treatment after osteonecrosis of the femoral head is unavoidable. OBJECTIVE:To reveal the col apse mechanism of osteonecrosis of the femoral head, and then point out the direction for improvement. METHODS:We put up with three-part failure col apse mechanism hypothesis of osteonecrosis of the femoral head for the first time according to a series of studies by our research team in recent 5 years, paral eling with preliminary verification from three aspects of biomechanics, pathology and clinical application. RESULTS AND CONCLUSION:New concept of maintaining stability and promoting repair for hip preservation and new surgical procedures aiming at the reconstruction of femoral head anterior lateral columns are wel presented, and good short-term effects have been achieved. These results show that the mid-long-term clinical curative effect and mechanism of action are worthy of further study.%背景：股骨头坏死的临床保髋疗效仍不尽如人意。目的：分析股骨头坏死塌陷的机制，指出其改进的方向。方法：根据作者所在团队近5年的系列研究，率先提出了股骨头坏死“三部失效”塌陷机制假说，并从生物力学、病理学和临床应用3方面进行验证。结果与结论：提出了维稳修复的保存自身髋关节新理念和旨在重建股骨头前外侧柱的保髋新术式，短期疗效优良，显示其中远期临床疗效和作用机制值得期待和深入研究。