中文摘要：

背景：腓骨支撑以及钽棒置入是治疗早期股骨头坏死常见的方法,可有效延缓甚至逆转股骨头坏死进展,但二者术后股骨头力学支撑与疗效对比需要进一步探讨。目的：比较腓骨支撑、钽棒置入修复早期股骨头坏死的临床效果。方法：ARCOⅠ期、Ⅱ期股骨头坏死患者共58例81髋,按治疗方案分为2组,其中腓骨支撑组30例41髋采用腓骨支撑术治疗,钽棒置入组28例40髋采用钽棒置入术治疗。2组术后均获得2年以上随访,比较治疗前、后髋关节Harris评分,分别以股骨头塌陷和股骨头塌陷〉4 mm为观察截点,比较不同ARCO分期2组股骨头生存率。结果与结论：（1）2组术后Harris评分均较术前明显提高,差异有显著性意义（P〈0.05）;（2）以术后股骨头塌陷为观察截点的Kaplan-Meier生存曲线比较显示,髋关节总生存率腓骨支撑组为83%,钽棒置入组为65%;经log-rank（Mantel-Cox）检验,2组ⅡC期髋关节生存率差异有显著性意义（P=0.043 1）;（3）以术后股骨头塌陷〉4 mm为股骨头生存终点Kaplan-Meier生存曲线比较显示,髋关节总生存率腓骨支撑组为95%,钽棒置入组为83%;经log-rank（Mantel-Cox）检验,2组ⅡC期髋关节生存率差异有显著性意义（P=0.041 8）;（4）综上,腓骨支撑术、钽棒置入术治疗早期股骨头坏死均可有效改善髋关节功能;ARCOⅡC期患者腓骨支撑治疗的髋关节生存率优于钽棒置入。

英文摘要：

BACKGROUND： Fibular fixation and tantalum rod implantation are two commonly used methods for the treatment of early osteonecrosis of the femoral head （ONFH）, both of which can effectively delay or even reverse the progress of ONFH. However, further comparative evaluation on their mechanical properties and therapeutic efficacy is required. OBJECTIVE： To compare the clinical efficacy of fibular fixation and tantalum rod implantation on ONFH at early stage. METHODS： Fifty-eight patients （81 hips） suffered from ONFH with ARCO stage 1 and stage 2, and underwent fibular fixation （30 cases, 41 hips） or tantalum rod implantation （28 cases, 40 hips）. Postoperatively, both groups were followed up for over 2 years. The Harris scores of the hip were compared between two groups before and after treatment. With femoral head collapse and the collapse distance 〉 4 mm as observation points, the survival rate of the femoral head was compared between two groups. RESULTS AND CONCLUSION： The postoperative Harris scores of the two groups were significantly improved than before （P 〈 0.05）. With the appearance of femoral head collapse as the observation point, the Kaplan-Meier survival curve showed that the overall survival rate of the hip was 83% in the fibular fixation group and 65% in the tantalum rod implantation group. After examined by log-rank （Mantel-Cox）, there was a significant difference in the survival rate of the hip at Stage IIC between two groups （P=0.043 1）. With 〉 4 mm collapse as the observation point, the Kaplan-Meier survival curve showed that overall survival rate of the hip was 95% in the fibular fixation group and 83% in the tantalum rod implantation group. After examined by log-rank （Mantel-Cox）, there was a significant difference in the survival rate of the hip at Stage IIC between two groups （P=0.041 8）. To conclude, both fibular fixation and tantalum rods implantation applied to ONFH at early stage can effectively improve the hip function, and the survival rate