Arthroscopy-assisted Minimally Invasive Surgery For Avascular Necrosis Of The Femoral Head

The avascular necrosis of the femoral head (ANFH)is a kind of frequent and refractoriness disease of orthopedics.The pathogenesis of ANFH was not clear and lack of unified treatment in current time.There are many means of early treatment of ANFH,but exist various problems, or trauma is too big, or poor efficacy, eventually leading to hip dysfunction or loss.There is no one surgical style can be satisfied wholly. The trend and orientation of surgical treatment on ANFH is minimally invasive method. The study showed that treatment methods of core decompression and hip arthroscope debridement treated cases with early ANFH, and have a contrast research with the traditional core decompression surgery.Objective To probe the therapeutic effect of ANFH with arthroscopic debridement of hip and core decompression.Methods From February 2005 to April 2009,23 cases(30 hips) with earlied ANFH treated with Kirschner wire drilling decomperssion.There were 19 males (24 hips),4 females (6 hips) .Aging from 22-62 years (mean 42 years); The etiological factor of ANFH were:alcohol 12cases (53.17%), hormone 5cases (26.09%), idiopathic 4 cases (15.04%), trauma 2 cases (8.70%).With case history 3-12months (mena 7.24 months). Preoperative stage of Ficat:0 stage 7 hips ,I stage 8 hips,II stage 15 hips; There were 11 patients (11 hips) by arthroscopic clean-up and core decompression surgery and the simple core decompression in 12 cases (12 hips) in the 23 cases, the general comparability. Results There are 23 cases acquired 3-20 months(means 12.1months) follow-up. Carries on the double hip joint X-ray, CT or MRI scan regularly and hip joint functional check to evaluation the femoral head's restores. With the Harris scores to judge the clinical result, scores≥80 was thinked clinical success; The imageology evaluation by stages according to the Ficat osteonecrosis no progressive was thinked clinical success. observation group and control group's Harris scores were (83.2±16.4)and(72.8±18.5)respectively in post-operatively, the clinical success ratio respectively is 81.82% (9/11), 58.33% (7/12), p <0.05. clinical manifestation showed that pain relieve,increased walk distance and progressed in gait. In 11 cases with arthroscopic debridement of hip and core decompression the therapeutic effect in 7 hips (accounts for 63.64%) were fineness (Hariss score>80);3 hips (accounts for 27.27%) were well (70