The Initial Clinical Effect Report Of The Minimally Invasive Bone Graft And Screw Inter-fixation Surgery Combined With Traditional Chinese Medicine Interference In Pain Of Pericollapse Stage Nontraumatic Osteonecrosis Of Femoral Head

Objective: 1. To evaluate the initial clinical effect report of the minimally invasive bone graft and screw inter-fixation surgery combined with traditional Chinese medicine interference in pain of pericollapse stage Nontraumatic Osteonecrosis of Femoral Head(NONFH),and to approach its possible mechanism of action. 2. To explore a new better therapy or scheme to deal with the pain of pericollapse stage NONFH.Materials and method: 77 in-patients(105 hips) in pericollapse stage of NONFH were selected from the third orthopaedics department of the first affiliated hospital of Guangzhou university of TCM during Fab 2004 to Jun 2005. The present series of in-patients was comprised of 64 male (85 hip)and 13 female (19 hip).Aged from 19 to 63 years old (average 41.3 years old) . They had accepted the treatment of the minimally invasive bone graft and screw inter-fixation surgery combined with traditional Chinese medicine (Tongluoshenggu capsule) . The follow-up time after operation ranged from 9 to 24 months(average 16.5 months). Patient were evaluated preoperatively according to the Association Research Circulation Osseous (ARCO) international classification system the clinical ache effect evaluation was evaluated by visional analoge system ( VAS score ) . The clinical evaluation and contrasting analysis was done preperatively and postoperatively about relative information of hip pain (pain position, classify, whether relieve or not, time of relieve, extent of relieve etc.) .The statistic results were test by spss 10.0 software.Results: The overall good-to-excellent rate of post-treatment is 78.1%, and effective rate is 94.3%.There is different between pre-treatment and post-treatment,and the latter is inferior to the former(P<0.05).It was proved that the pain is relieved after treatment.The overall good-to-excellent rate of inner one year grounp is 91.67%,and the overall good-to-excellentrate of out of one year grounp is 95.06%,which does not exist statistics difference between two proup (P>0.05).The good-to-excellent rate on stage: stagell, III were 87.27% and 68% respectively.The good-to-excellent rate of stage II compared to stage III result in P<0.05.The pain relieve time after treatment is from one month to two years(average 7.4 months).Conclusion: 1, The treatment for the nontraumatic avascular of the femoral head in pericollapse stage with the minimally invasive bone graft and screw inter-fixation surgery combined with traditional Chinese medicine (Tongluoshenggu capsule) is effective and feasible. 2^ This treatment for the pain of NONFH in pericollapse stage had a confirmable clinical effect and some advantage— minimally invasive surgery and safety of TCM. 3> The pain of NONFH is possibally concerned with instability inner femoral head. 4> The curative effect will be better,if the treatment was performed when the femoral head have not appeared collaps.