Fundamental Research Of The Early Treatment Of Non-traumatic ONFH By Madopar

Objective Osteonecrosis of the femoral head(ONFH) has been recognized as a refractory disease. Most of the patients with ONFH have to accept the artificial joint replacement surgery. ONFH always occurr in young adults. Most of patients should experience once or more times artificial joint revision surgery in their lives, it is a serious economic and mental burden for the social and patients. Therefore, it is very important to look for a treatment having exact curative effect on early ONFH. Previous studies showed that there was good clinical effect of Madopar for treating ONFH. But there was strong subjectivity because the evaluation of therapeutic effect of the literatures are by various joint function score. There is lack of more objective evaluation index. In this paper, we performed fundamental research in order to provide more objective evidence of the treatment of ONFH by Madopar.Methods Test samples were the femoral head removed from patients who received hip replacement in the first affiliated hospital of soochow university from October 2013 to December 2014. The patients were divided into drug group, necrosis group and control group according to different pathogenesis. The femoral heads have been made uniform specimen. First of all, scaned samples with Micro-CT, obtained the 3D model of samples by reconstruction, calculated the morphology parameters of samples: the bone mineral density(BMD), trabecular volume fraction(BV/TV), trabecular thickness(Tb.Th), trabecular separation(Tb.Sp), trabecular number(Tb.N), trabecular bone pattern factor(Tb.Pf), structure model index(SMI). And then, performed compression experiment by material testing machine obtain the biomechanical parameters of samples: the strength-deformation curve, stress-strain curve, limit load, compressive strength, elastic modulus. At last, performed statistical analysis by SPSS for all the experimental data.Results 3D models: the trabecular structure of control group is complete, the shape is regular, the spacing is uniform, the thickness is moderate. The trabecula of necrosis group have more breaking off or even missing, the trabecula is desultorily, the spacing is wide, the thickness is thin. The trabecula of drug group having a small number of breaking off, the shape is irregular, the spacing is significantly narrow, the thickness increased significantly.Morphological parameters: the bone mineral density(BMD), bone volume fraction(BV/TV), trabecular thickness(Tb. Th) and trabecular number(Tb. N) of the samples in drug group are significantly higher than the samples of necrosis group(P < 0.05). The trabecular separation(Tb. Sp), trabecular bone pattern factor(Tb.Pf) and structure model index(SMI) of the samples in drug group are significantly lower than that in necrosis group(P < 0.05). There is no significant difference between control group and drug group about trabecular number(Tb. N)(P > 0.05).Mechanical parameters: The compressive strength and elastic modulus of the samples in necrosis group were significantly lower than that in drug group and control group(P < 0.05), and there is no statistical difference between drug group and the control group(P> 0.1).Conclusion The Madopar can promote the speed of osteogenesis of necrosis femoral head, speed up the restoration of necrotic area, improve the microstructure of the necrotic femoral head, improve the biomechanical performance of necrotic femoral head, delay or prevent the deformation and collapse of femoral head. In conclusion, there is a good effect of the treatment of early ONFH by Madopar.