| Objective:This study was designed to investigate the efficacy of Madopar treatment for early-mid non-traumatic ONFH.At the same time,it analyzes the epidemiological characteristics of it.Methods:Collected the dates of 529 cases(843hips)of non-traumatic osteonecrosis of the femoral head treated in the First Affiliated Hospital of Suzhou University Department from October 2002 to December 2015.372 males(586hips),157 females(257hips),230 patients had the history of taking hormone,175 cases of alcoholism,124 cases of unknown etiology.the method of frequency and constituent ratio was for statistical analysis.The etiologic composition of non-traumatic osteonecrosis of the femoral head was analyzed according to age and gender and the epidemiological characteristics of non-traumatic osteonecrosis of the femoral head.At the same time,we conducted a clinical follow-up study of 40 patients,40(63hips)patients were treated with Madopar.22 males(35 hips)and 18 females(28 hips),with average age of 43.50 ±8.50 years old.20 cases had history of taking hormone,16 cases of alcoholism,4 cases of unknown etiology.According to Ficat staging:Ⅰ 6 hips,Ⅱ a period of 39 hips,Ⅱb 11 hips,Ⅲa 7 hips.We inform patients with the relevant treatment risk,given patients with Madopar treatment,and asked patients to be regular outpatient review(every three months to review X-ray,every six months to review MRI),and from the patient imaging data and clinical symptoms of suffering from hip Ficat staging,necrosis index determination and hip function score.All patients with 40(63 hips)were followed up for more than 2 years.Data on patient-related necrosis index and hip function score were analyzed by SPSS22.0.The data were expressed as mean ± standard deviation.T test was used between the two groups.Results:1.The proportion of steroid-induced,alcoholic,unknown etiology of non-traumatic osteonecrosis of the femoral head was respectively 43.48%,33.08%,23.44%.The ratio of male to female was 2.37:1.The onset time of male was same with that of female,respectively 41.59± 12.32years old,41.51 ± 11.96years old.The proportion of steroid-induced non-traumatic osteonecrosis of the femoral head aged 15-34 years old about 2/3,alcoholic-induced non-traumatic osteonecrosis of the femoral head aged 35-54years old aboutl/2,Steroid-induced non-traumatic osteonecrosis of the femoral head always incurred in bilateral femoral heads,alcoholic always in unilateral femoral head.In different age groups,distribution of the etiology is different.2.Forty(63hips)patients were followed up integrally with 24-80 months.The hip function score increased(16.86 ± 1.53>15.59 ± 1.47)and Necrosis index reduced(65.41 ±24.29%<57.20±121.50%)after Madopar treatment,65.08%(45/63)femoral heads maintained the original form.the clinical improvement rate was 71.43%,the collapse rate was 28.47%,and Only 2 hips were treated with total hip arthroplasty.Conclusion:1.Steroid has become the first etiology of non-traumatic osteonecrosis of the femoral head,Alcoholic is the secondary etiology.the patients are mainly young.the incidence of male is higher than female.The proportion of male with alcoholic non-traumatic osteonecrosis of the femoral head is higher than that of female while the proportion of female with steroid-induced non-traumatic osteonecrosis of the femoral head is higher than that of male.Steroid-induced non-traumatic osteonecrosis of the femoral head always incurred in bilateral femoral heads.And alcoholic-induced is maybe in unilateral femoral head.2.Madopar could effectively interpose the process of early-mid non-traumatic ONFH.It can enhance self-repair in the area of necrosis of the femoral head,reduce the collapse rate of the femoral head,avoid or delay joint replacement surgery;In most of the mid-term femoral head necrosis(Ficat Ⅲa)after Madopar treatment,the shape of the femoral head did not continue to collapse,the hip function is good. |
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