Descompresión cérvico-cefálica en la necrosis aséptica de la cabeza femoral
Keywords:
Descompresión cérvico-cefálica, necrosis aséptica de la cabeza femoralAbstract
La necrosis aséptica de la cabeza femoral que reconoce variadas etiologías provoca el deterioro del cartílago hialino y la coxoartrosis. Mostramos los resultados de la descompresión quirúrgica cérvico-cefálica femoral por perforaciones con barrenos de hasta 9 mm de grosor. El acto operatorio se realizó en 33 caderas de 24 pacientes con edades entre 31 y 67, años de ellos 11 mujeres y 13 hombres, que fueron operados entre los años 1995-2000. Según la severidad de la afección los pacientes fueron clasificados de acuerdo a Ficat (J.Bone Joint Surg. Br., 1985) en :Estadío 0 = 2, Estadío I = 2 Estadío II = 6 Estadío III = 14 Estadío IV = 7 Estadío V = 2 De los Estadíos III., IV, V, 15 pacientes recibieron tratamiento con Oxigenación Hiperbárica (20 sesiones) en el post-operatorio inmediato. Luego de 3,5 años de seguimiento promedio, 25 caderas se mantuvieron asintomáticas, mientras que 8 se deterioraron y fue necesario colocarle Prótesis Total de Cadera, para un 75 % de buenos resultados con la descompresión. Concluimos que: Este proceder, que realizamos por Cirugía Ambulatoria, posterga, y en un alto porcentaje evita la Artroplastia Total, siempre que no existan cambios quísticos o hundimiento de la cabeza femoral.Downloads
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