The Clinical Observation Of Allo-fibula Implantation With Core Decompression And Bone Grafting Combined With Bu Shen Huo Xue Decoction In The Treatment Of Early Metaphase Femoral Head Necrosis

Objective Through clinical retrospective study,analysis the clinical effect of the allo-fibula implantation withcore decompression combined with Bu Shen Huo Xue Decoction on the patients with different etiology,age,staging or parting to provide clinical basis in the treatment of the osteonecrosis of the femoral head(ONFH).Methods The study selected cause-specific patients were diagnosed of ONFH inⅡB～ⅢB stage(According to the classifcation system of ARCO)from the jiont diseases of the Jiangsu Province Hospital of traditional Chinese medicine,According to the Harris score and radiographic stable rate after 6 months,1 year,2 years of follow-up,Comparring different groups to analysis the effects of different etiology,age,stage and fractal on the clinical efficacy of patients.Result The study selected etiology-clear 57 patients(68 hips)with femoral head necrosis,and followed up for 3 to 7 years.7 hips received total hip arthroplasty because of severe collapse and the success rate was 89.7%.The overall Harris hip score of the last postoperative follow-up was 81.75± 12.69 higher than the preoperation points(66.94±7.21),difference was statistically significant[t=-11.478,p=0.000).Comparision with the difference of Harris score and radiographic stable rate between alcohol group and hormone group:there is on significant difference[Harris score excellent rate:70.37%,73.17%(χ2=0.063;P=0.801);radiographic stable rate:66.67%,73.17%(χ2=0.647;P=0.421)].Comparision with the difference of Harris score and radiographic stable rate between different age groups:there is statistically significant[Harris score excellent rate:82.35%,61.76%(x2=3.579;P=0.059);radiographic stable rate:82.35%,58.82%(χ2=4.533;P=0.033)].Comparision with the difference of Harris score and radiographic stable rate between different stages:the prognosis of patients in ⅡB stage was better;the prognosis of patients in ⅢB stage was poor;there was no significant difference between the patients in ⅡC stage,and the patients in IIIA stage.Comparision with the difference of Harris score between between different classification:the prognosis of patients in type C and type L1 was better;the prognosis of patients in type L2 was poor.Conclusion The allo-fibula implantation withcore decompression combined with Bu Shen Huo Xue Decoction could effectively improve the joint function,delay and avoid the collapse of the femoral head,especially for young patients in ARCOII stage,ⅢA stage or type C,type L1.