股骨头坏死是一种让人闻之色变的疾病，也被称为“不死的癌症”。对于股骨头坏死的患者来说，是不是只能进行人工髋关节置换呢？答案是否定的。长沙市第四医院骨科一病区（关节、骨病、运动医学科）近日就用微创手术为左侧股骨头坏死的肖先生进行了保髋手术治疗。
三年前，15岁的花季少女小美因确诊系统性红斑狼疮，需要服用激素类药物，服药一年后，她感觉到自己右侧髋关节处经常疼痛，已经影响了正常走路，在绍兴当地医院查双侧髋关节核磁共振后，确诊双侧股骨头无菌性坏死，因年龄较小，症状较轻微，所以小美采取了保守治疗。
股骨头坏死又称为股骨头缺血性坏死或股骨头无菌性坏死，指股骨头血供受损或中断，导致骨髓成分及骨细胞死亡及随后的组织修复，继而导致股骨头结构改变及塌陷，引起患者髋关节疼痛及功能障碍的疾病，是造成青壮年髋关节残疾的常见疾病之一。
【导读】股骨头坏死是一种常见的骨关节病，又称股骨头缺血性坏死。那么，什么样的人容易得股骨头坏死呢？它又分为几个阶段呢？哪个阶段比较严重呢？股骨头坏死通常分为创伤性股骨头坏死和非创伤性股骨头坏死，后者又称为股骨头无菌性坏死或股骨头缺血性坏死。
45岁曹某为餐饮业老板，为了生意时常需交际应酬，近期因髋部疼痛至诊所检查，透过X片检查无异状，但髋部仍疼痛不已，来院透过核磁共振检查，确诊为股骨头坏死，所幸初期发现，透过“股骨头髓芯减压术”治疗，才得以保留原生关节。
近日，中南大学湘雅医院骨科副主任高曙光副教授团队应用机器人辅助导航、髋关节镜技术和生物再生疗法，为一位股骨头坏死合并股骨髋臼撞击征的患者顺利保髋。此次手术是湘雅医院发挥医疗技术集成创新优势，满足临床和患者需求的又一突破。
极目新闻记者 陆缘通讯员 张春红 陈林 黎尚赟 熊帆12月12日，武汉江夏区第一人民医院（协和江南医院）院长田洪涛教授带领骨科关节外科团队，为一名股骨头坏死患者，实施该院首例SuperPATH髋关节置换微创手术，术后六小时患者就能下地行走，一周内可以康复出院。
Lyu J ， Ma T ， Huang X ， et al. Core decompression with β-tri-calcium phosphate grafts in combination with platelet-rich plasma for the treatment of avascular necrosis of femoral head. BMC Musculoskeletal Disorders， 2023， 24:1-8.
Conservativetreatments for aseptic osteonecrosis of the femoral head have their ancestor inthe core decompression of the femoral neck， recommended by Ficat. Due toinconsistent results， this treatment has been optimized by either vascularizedfibular grafting， or by injecting autologous stem cells into the necrotic zone.The French promoters have published long-term results， showing efficacy in theearly stages of the disease， where the femoral head has not yet lost itssphericity. Over the last 10years， comparative studies， sometimes randomized，opposing them to simple core decompression， have been published bynon-promoters， confirming the possibility of stabilization or even regressionof necrosis area. But these techniques are not easy to implement. Cell therapyrequires treatment of marrow samples by centrifugation to obtain a pellet witha high concentration of haematopoietic cells. The now proven long-term efficacyas well as the safety of this technique make it the method of choice fortreating young patients detected at the sub-radiological stage by MRI.Unfortunately， many are seen late with detached cephalic cartilage or collapsedfemoral head and have no other option than total hip arthroplasty. Thistechnique is very reliable. With alumina ceramics， results of more than 20yearsshow the absence of wear and osteolysis， although other complications such asinstability or periprosthetic fractures may occur in these young and activepatients.
通讯员 陈义强股骨头坏死，也称为股骨头缺血性坏死或股骨头无菌性坏死，是一种由于股骨头血供中断或受损，导致骨细胞及骨髓成分死亡及随后修复的病症。它会导致股骨头结构改变、塌陷，从而引发患者髋关节疼痛、关节功能障碍。股骨头坏死不仅影响患者的日常活动，还会导致患者生活质量的下降。
