Research Of Optimization In Collapse Prognostication For Non-traumatic Osteonecrosis Of The Femoral Head And Of Evaluation For Chinese Medicine Treatment

Objective:Five different methods,which were based on imaging data,for non-traumatic osteonecrosis of the femoral head(NONFH) collapse prognostication,were applied to predict related cases.Then analysis of comparing the predictive results respectively to optimize a more accurate and practical way to better serve the clinical norms,and then predict the cases used Chinese medicine treatment with the optimized way,to evaluate the effect of Chinese medicine treatment of non-traumatic osteonecrosis of the femoral head.Methods:Looking back at the imaging and clinical data of the NONFH patients treated in WangJing hospital of China Academy of Traditional Chinese Medicine,divide the cases fulfilled the included standards into a optimization group and a Chinese Medicine group.The cases of the optimization group hadn't been treated systematically,but the cases of Chinese Medicine group accepted a Chinese medicine treatment system after hospitalization.To begin with,type or measure the X-ray data of cases with X-ray-based methods Ohzono typing law, Kerboul law and Sugano area percentage of necrosis law,and the MRI data of cases with MRI-based ones Laffirgue law and Sugano typing law in the optimization group.Secondly, forecast the result of each prediction method according to its collapse criteria and typing or measuring result,then to make a comparative analysis of the result predicted with the actual collapse situation respectively,to have the most accurate method optimized.At last,to predict the cases of the Chinese Medicine group,and make a comparative analysis of the results predicted with the actual collapse situation,evaluate the efficacy of Chinese medicine treatment for NONFH. Results:In the optimization group of 75 hips,33 hips collapsed actually,the collapse rate is 44%. The forecasting the results of Ohzono typing law,Kerboul law,Sugano area percentage of necrosis law,Laffirgue law and Sugano typing law are as follows:the predictable collapse are 49 hips,51 hips,36 hips,64 hips and 61 hips respectively,the collapse rate was 65.3%,68%, 48%,85.3%,81.3%respectively,there only is the forecast result of Sugano area percentage of necrosis law which approach the actual collapse situation,while the percentage of the other results are much more than that of the actual collapse situation.The five forecasting results of methods with the actual collapse situation in comparison,through the Chi-square test,χ~2 values were 6.887,8.766,0.242,28.039 and 22.34 respectively,the predicted results of four methods have P＜0.01 except for Sugano necrosis area percentage law of P=0.623＞0.05,this explain that the comparison of the predicted results of Sugano necrosis area percentage law with the actual collapse was not significant,the difference was not significant,suggesting that the method is more accurate;the comparison of forecasted results of remaining Methods with the actual collapse situation was significant,they differ significantly,suggesting that the accuracy of these four methods is low.In the five methods,the accuracy of Sugano area percentage of necrosis law is of the maximum in predicting NONFH collapse.In the Chinese Medicine group of 21 hips,5 hips collapsed actually,the collapse rate is 23.8%.To predict the cases of the Chinese Medicine group with Sugano area percentage of necrosis law which was proved the most accurate,the predicted result turn out that 12 hips collapsed,the collapse rate was 57.1%.The result was greatly different from the actual collapse situation.Comparing the predicted result with the actual collapse situation,through the Chi-square test,the results turned out thatχ~2=4.842,P=0.623＜0.05,had a statistical significant difference,suggesting that the effect of Chinese medicine treatment for NONFH is evident,the collapse percentage of the femoral head can be cut down obviously.Conclusion:1 Sugano area percentage of necrosis law is of the high accuracy in non-traumatic osteonecrosis of the femoral head collapse prognostication and simple operated,and it has a certain clinical value for spreading.2 Chinese medicine treatment for non-traumatic osteonecrosis of the femoral head can reduce the incidence of collapse of the femoral head.