The Analysis Of The Stem Cells With Vascular Pedicle Iliac And Tantalum Implant In Treating Osteonecrosis Of The Femoral Head For26Patients(32Hips)

Objective:To study the treatment of stem cells with vascular pedicle joint ilium disc transplant tantalum rod implant for the osteonecrosis of the femoral head.Methods:26cases (32hips) with osteonecrosis of the femoral head treated in the Zhongshan Hospital from January2010to January2011. including13female cases and13male cases:Age from18to55years old, average age is36.5years old.8cases occurred in the left hip,12cases in the right hip.and6cases occurred in the both hips.32cases in total. Exclusion criteria:younger than18years old or older than55years of age:other Hip diseases:Long-term application of the sebaceous glands hormone and can’t discontinue the drug.patients with muscle weakness:psychological and mental disorders can not cooperate with treatment:patients with cerebrovascular and other serious diseases are not suitable for surgery.Identifying the position and circumsciption of Osteonecrosis.and the blood supply of femural head by the examination of X-ray,CT,MRI, angiography of both hips. A total of32joints. including14cases of the left hip.10cases of right.8cases bilateral. According to the ARCO stages:7cases in Ⅱbstage.8cases in Ⅱc stage.8cases in Ⅲa stage.and9cases Ⅲb stage. Average follow-up for16monthes (13-26monthes).13patients were caused by use of Glucocorticoids.10patients caused by alcholism,2patients by trauma and5for unknown causes. All the patients were treated by stem cells transplantation.combined with vascular pedicle iliac flap transplant to increase blood supply of femural head.and recover the shape of femural head by tantalum rod. Analyze the clinical effects of the surgery by Harris hip score. Three-dimensional gait analysis was done for comparison between10days preoperative and at the6h,12th month postoperative, and observe the differences of gait.Results:None of26cases(32hips) need total hip replacement postoperatively until16th month postoperative.29hips of32hips in X-ray films indicate is no increase of the necrosis area and the femural head collapse.90.6%of all. The average Harris score is(63.86=6.08) preoperative.and (89.8±4.43) for the latest follow-up. Compared with preoperative. the gait analysis shows that step width, cadence.and frequency were improved.the gait would gradually go normal as time passed.Conclusion:the Stem cells combined with vascular pedicle iliac and tantalum implant is a effective treatment in the later stage of osteonecrosis of femural head in younger patients.