The Core Decompression,autologous Iliac Bone Graft,Fibular Fixation Combined With Traditional Chinese Medicine In The Treatment Of Osteonecrosis Of The Femoral Head During Peri-Collapse Period

Background: long term effect of simple hip preserving surgery for femoral head necrosis is not ideal.At present,hip preserving surgery combined with traditional Chinese medicine has achieved good results.Objective: To explore the clinical effect of core decompression,autologous iliac bone graft,Fibular fixation combined with Shanjia Huoxue Bushen Recipe in the treatment of osteonecrosis of the femoral head during Peri-Collapse Period.Methods: From March 2010 to September 2015,24 patients(28 hips)with osteonecrosis of the femoral head during Peri-Collapse Period were treated with core decompression,autologous iliac bone graft and Fibular fixation. After operation,All the patients were combined Shanjia Huoxue Bushen Recipe and followed-up for more than 1 year.The clinical evaluation was based on the Harris scores.The imaging evaluation was based on ARCO stage and JIC classification.The Kaplan-meier survival curve Analysis of femoral head survival.Results: The average follow-up was 26.95 months.The Harris score was increased from the mean(72.96±12.59)to the last follow-up(82.03±11.60).with The femoral head collapsed> 4mm as the end point,The total survival rate of femoral head was 78.57%.According to the preoperative frog type ARCO stage(according to the necrosis range),ARCO stage(according to the degree of collapse)stratification,JIC classification,femoral head collapsed> 4mm as the end point of Kaplan-meier Survival curve analysis shows that There were the differences of IIB,IIC,IIIA and IIIB in ARCO stage was statistically significant(according to the necrosis range) (P<0.05),and the difference of type A and B between ARCO staging(in the degree of collapse)was statistically significant(P<0.05),And no significant differences in the differences of B,C1 and C2 between the JIC classification(P>0.05).Conclusion: The core decompression,autologous iliac bone graft,Fibular fixation combined with Shanjia Huoxue Bushen Recipe can be used to treat osteonecrosis of the femoral head during Peri-Collapse Period,which can promote the repair of femoral head necrosis,and The recent clinical curative effect is exact,more suitable for IIB,IIC and III in ARCO stage when femoral head collapsed < 2mm of osteonecrosis of the femoral head patients.