Ⅲ Options Were Bone Necrosis Tantalum Rods, Bone Graft Combined Treatment Of Traditional Chinese Medicine Clinical Research

Objective:To seek theoretical support for foundation of individualized treatment and to further improve the curative effect on esteonecrosis of femoral head by observing the outcome of combined therapeutic plan consists of core decompression, bone graft, tantalum rod implantation and TCM agents administration.Method:Cases meet following criteria were included:diagnosed as oseonecrosis of femoral head and classified as3a by ARCO; hospitalized in Wang Jing Hospital between January of2010and May of2011; treated by combined therapy of core decompression, bone graft, implantation and TCM agents administration or without tantalum rod implantation. Then, cases were paired according to related rules. These who accepted core depression, bone graft, tantalum rod implantation and TCM administration were assigned in experiment group; Cases merely treated by methods above without tantalum implantation were in control group. The Chinese Medicine decoction was chosen according to specific syndrome pattern. One hip of each patient was included and for patients with osteonecrosis of both hips, the side of more serious condition was chosen. Case report forms were filled and imaging data were collected to carry out the follow-up analysis. Harris hip score, SF-36table and collapse ratio of femoral head were adopted as indexes to evaluate the effects.Results:The treatment group and control group cases a total of62patients, the longest follow-up25months, the shortest10months, an average of16.2months. After treatment, the overall Harris score for85.2±13.13. According to the Harris score evaluation standard, clinical cure in23cases, clinical cure rate was37.1%, effective30cases,the effective rate was48.39%,9cases failed,no efficiency14.52%.All cases image stabilization50patients, steady80.65%, aggravating rate was19.35%.The treatment group and contrast between way after treatment Harris score contrast:treatment group Harris score of88.45±9.20, among them, the clinical cure in14cases, clinical cure rate was42.42%, effective in16, The effective rate was48.48%, invalid in3, no efficiency9.09%. The control group was81.22±16.04Harris assessment, among them, the clinical cure11cases, clinical cure rate was37.93%, effective in12cases, the effective rate was41.37%, invalid in6,20.69%. After the treatment group Harris efficient compared with the control, a statistically significant difference(P<0.05),the treatment group therapy Harris score compared with the control, there was no statistically significant difference(P>0.05). The treatment group Harris rose by an average of19.74±18.39points, the control group Harris rose by an average of9.03±7.41points, the treatment group was better than control Harris scores improve(P<0.05). The treatment group in33cases, imaging stable28cases, stable rate is84.85%, aggravating5cases, aggravating rate is15.15%.The control group in29cases, stable in22cases,stable rate is75.86%, aggravating in7cases, aggravating rate was24.14%, the treatment group and control group have significant statistical differences. Two groups of cases have13cases, had developed osteoporosis performance, accounting for20.97%of all62cases. During treatment group Harris score for80.27±14.84, one year after treatment group Harris score of88.45±9.20, in treatment group and a year later after treatment Harris score was significant difference(P<0.05).The control group during treatment Harris score for81.74±14.30, and the control group one year after treatment Harris score of81.22±16.04, and the control group6months after treatment with treatment in a Harris score is no significant difference(P<0.05).Conclusion:1.Even the femoral head started to collapse, the joint-reserving therapies is still of necessity and favorable curative effect.2.Combined therapy of tantalum rod implantation and bone graft receives better outcome than bone graft alone.3. In this study, favorable curative effect may result from TCM administration in the whole course.4. Image data should not be the only criteria for curative effect evaluation of ONFH, instead, it should be applied with perception of the patient and its related forms for more detailed and accurate assessment.