Middle-term Effects Of Marrow Core Decompression With Thick Passage And Bone Grafting With Osteoinduction Active Material On Early Osteonecrosis Of Femoral Head

Background and PurposeOsteonecrosis of femoral head is a common orthopedic disease, early detection and treatment is very important. A timely surgical intervention to drop intramedullary pressure is very meaningful for the head protection. This could not only relieve the patients from pain symptoms, but also help maintain the anatomical morphology of femoral head, and prevent collapse of the femoral head, help reduce disability caused by the illness, finally help improve the quality life of the patients. Core-decompression surgery is widely used in the clinical treatment of early osteonecrosis of femoral head. The operation is a simple way to gain a relatively good effect, during short-term follow-ups. However at home and abroad there were few researchers and scholars that have done the mid-term efficacy of surgical follow-up studies. The purpose of our study is to analyze the middle-term effects of marrow core compression with thick passage on early osteonecrosis of femoral head(ONFH), based on follow-up of the patients recovered this kind of surgery,MethodsWe studied a total of46adult patients with56hips which suffered from the early stage ONFH and underwent the surgery of marrow core decompression with thick passage. There were32male cases,14female cases, the mean age was32.6(20～53) years old. According to the etiology classification:30patients with36hips were the alcohol-induced ONFH,11patients with13hips were sterorid-induced ONFH in,5patients with7hips were steroid and alcohol-induced ONFH. According to association research circulation osseous (ARCO) classifying,26,13,8,9hips were in stage Ⅰ-A,Ⅰ-B, Ⅰ-C,and Ⅱ-A, respectively. There were43hips in left side and13hips in the right side.ResultsThe pain of the hips in all patients was relieved or disappeared after the operation. The period of postoperative follow-up studied from (5-7.3)years, with an average of6.1years. The results showed44hips got excellent effect and7hips got good effect. Of them, all hips in stage Ⅰ-A(26hips) were excellent, and so did all hips in Ⅰ-B(13hips).There were2excellent hips,3good hips,2fair hips and1poor hips in stage Ⅰ-C. In the Ⅱ-A stage there were3hips occured in excellent stage,4hips in good,2hips in fair and0hips in poor. The rate of excellent and good results was100%(26/26),100%(13/13),62.5%(5/8),77.8%(7/9) in stage Ⅰ-A,Ⅰ-B,Ⅰ-C,Ⅱ-A. The total rate of excellent and good results was91.1%, The total efficiency percentage was98.2%,The best results occured in the stage Ⅰ-A and stage Ⅰ-B. The X-ray films showed obviously in this excellent hips, there was bone pillar shadow formed in the thick passage day by day, the femoral head was not collapsed. The1poor hip in stage Ⅰ-C, the necrotic area was up to60%, the femoral head collapsed in five yearsConclusionsThe middle-term effects of marrow core compression with thick passage bone grafting with osteoinduction active material are satisfactory，specially in ARCO Ⅰ-A, Ⅰ-B stage patients.