使用高压氧治疗股骨头和股骨髁的血管性坏死:一个中心 30 年来的经验。

IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Diving and hyperbaric medicine Pub Date : 2024-06-30 DOI:10.28920/dhm54.2.92-96
John Rb Currie, Ian C Gawthrope, Neil D Banham
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引用次数: 0

摘要

导言:血管性坏死(AVN)是一种罕见的渐进性退行性疾病,会导致骨和关节破坏。患者通常需要手术治疗。股骨头坏死是最常见的解剖位置。高压氧治疗(HBOT)已被证明对 AVN 有效。我们介绍了一个中心在 30 年间收集的数据,并将结果与其他已发表的数据进行了比较:方法:我们对弗里曼特尔医院和菲奥娜-斯坦利医院自 1989 年以来接受 HBOT 治疗的所有 AVN 患者进行了回顾性病历审查。主要结果是使用斯坦伯格评分的放射学外观,次要结果是主观改善、关节置换手术需求和并发症发生率:自 1989 年以来,共有 14 名患者的 21 个关节(14 个股骨头和 7 个股骨髁)接受了 HBOT 治疗。有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个月后(最短)的磁共振成像(MRI)扫描结果稳定或有所改善;10个关节(71%)主观疗效良好,3个关节需要手术治疗,3名患者出现轻度耳压创伤。在股骨髁组中,所有五个关节在治疗后的核磁共振扫描结果均稳定或有所改善(四个关节的水肿和/或软骨稳定性有明显改善),四个关节的主观疗效良好,没有一名患者需要手术治疗(随访时间超过六个月):这项单中心回顾性研究观察到,使用 HBOT 可预防股骨头坏死的疾病进展,这与其他已发表的研究结果不相上下。这为 HBOT 在股骨头坏死治疗中发挥重要作用提供了更多证据。
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The use of hyperbaric oxygen for avascular necrosis of the femoral head and femoral condyle: a single centre's experience over 30 years.

Introduction: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

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来源期刊
Diving and hyperbaric medicine
Diving and hyperbaric medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
1.70
自引率
22.20%
发文量
37
审稿时长
>12 weeks
期刊介绍: Diving and Hyperbaric Medicine (DHM) is the combined journal of the South Pacific Underwater Medicine Society (SPUMS) and the European Underwater and Baromedical Society (EUBS). It seeks to publish papers of high quality on all aspects of diving and hyperbaric medicine of interest to diving medical professionals, physicians of all specialties, scientists, members of the diving and hyperbaric industries, and divers. Manuscripts must be offered exclusively to Diving and Hyperbaric Medicine, unless clearly authenticated copyright exemption accompaniesthe manuscript. All manuscripts will be subject to peer review. Accepted contributions will also be subject to editing.
期刊最新文献
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