Drilling Decompression Combined With Bone Grafting From The Greater Trochanter And Femoral Head For The Treatment Of Early And Medium-term Non-traumatic Osteonecrosis Of Femoral Head

Objective:To observe the clinical curative effect of Drilling decompression combined with Bone Grafting from The greater trochanter and femoral head for the treatment of early stage of non-traumatic Osteonecrosis of the Femoral Head(NONFH), to explore the mechanism and feasibility of Drilling decompression combined with Bone Grafting from The greater trochanter and femoral head for treatment of early and medium-term stage of NONFH, to evaluate the clinical curative effect and treatment of the hip preserving treatment in young and middle-aged.Methods:Retrospective study of26patients diagnosed early or mid-term stage non-traumatic osteonecrosis of the femoral head (Ficat Ⅰ-Ⅲ) in the Department of outpatient and inpatient of our hospital from June2011to January2013. There were16males (18hips), female10cases (12hips), At the age of20-52years old, Average age of39.7years,1to27months from the onset to hospitalization time.Etiology:14cases (16hips) has a long history of drinking;8patients(10hips) with history of taking hormones;4cases (4hips) of unknown causes.26patients all have no explicit history of trauma.Clinical manifestations are hip joint pain, activity limitation. Physical examination:Tenderness in groin, Greater trochanter percussion pain, range of motion of the hip joint becomes smaller,"4" test is positive and so on. According to Ficat staging, there are4hips in Ficat1,17hips in Ficat II a,7hips in Ficat Ⅱ B,2hips in Ficat ⅢI.26cases of NONFH were divided into Drilling decompression combined with Bone Grafting from The greater trochanter and femoral head group (A):12cases (12hips), core decompression group(B group):14patients (18hips).26patients were taken anteroposterior pelvic X-ray preoperative and postoperative and evaluate the efficacy according to the International Harris hip score (HHS).Two groups were compared of the Harris hip score, X-ray Progress and postoperative pain, ability of the activity, living ability and radiographic progression results were statistically analyzed. Results:6-12months after the operation,26cases (30hips) were all followed up, there is no significant difference between two groups at the baseline level. Balanced grouping, suggesting that two groups were comparable. Comparison in both groups before and after the surgery, Harris hip function scores were statistically significant (P<0.05), indicating that the two groups both can ease the pain, improve the hip joint function and quality of life of patients. The comparison between two groups showed that Drilling decompression combined with Bone Grafting from The greater trochanter and femoral head was superior to core decompression surgery group, there was statistical significance.Conclusion:The short-term curative effect of Drilling decompression combined with Bone Grafting from The greater trochanter and femoral head in early and middle-stage of Non-traumatic Avascular Necrosis of the femoral head is satisfactory, and there is high application value of the hip preserving treatment for young and middle-aged early NONFH, which is worthy of promotion, but the long-term efficacy and imaging requires further observation.