Chinese Journal of Tissue Engineering Research ›› 2018, Vol. 22 ›› Issue (36): 5746-5752.doi: 10.3969/j.issn.2095-4344.0555

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Core decompression, autologous iliac bone graft, allogeneic fibular fixation combined with traditional Chinese medicine for treatment of peri-collapse stage osteonecrosis of the femoral head

Zeng Ping1, Lai Chongrong2, Li Jinyi1, Du Mindong1, He Kaiyi1, Sun Bin1, Huang Xiaohua1, Qin Gang1   

  1. (1Second Department of Orthopedics, Xianhu Branch of the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530200, Guangxi Zhuang Autonomous Region, China; 2Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China)
  • Received:2018-06-25 Online:2018-12-28 Published:2018-12-28
  • About author:Zeng Ping, MD, Chief physician, Second Department of Orthopedics, Xianhu Branch of the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530200, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81360551; State Administration of Traditional Chinese Medicine, No. JDZX2015272; the Traditional Chinese Medicine Administration of Science and Technology Project of Guangxi Zhuang Autonomous Region, No. GZMZ1206; the Medical and Health Research Project of Guangxi Zhuang Autonomous Region, No. 2011053

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Abstract:

BACKGROUND: Long-term effect of simple hip-preserving surgery for osteonecrosis of the femoral head (ONFH) is not ideal. The combination of hip-preserving surgery and traditional Chinese medicine has achieved satisfactory curative effectiveness.
OBJECTIVE: To explore the clinical effect of core decompression, autologous iliac bone graft, and allogeneic fibular fixation combined with Shanjia Huoxue Bushen Recipe in the treatment of peri-collapse stage ONFH.
METHODS: Twenty-four patients (28 hips) with peri-collapse stage ONFH were treated with core decompression, autologous iliac bone graft and allogeneic fibular fixation. After operation, all the patients received oral administration of Shanjia Huoxue Bushen Recipe for 9-12 months, and were 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 femoral head collapsed > 4 mm was the end point; the survival rate of femoral head was analyzed by Kaplan-meier survival curve.
RESULTS AND CONCLUSION: All patients were followed up for 12-78 months (26.95 months averagely). The Harris score at the last follow-up was significantly higher than that at baseline (P < 0.05), and the total survival rate of femoral head was 79%. There were significant differences in the survival rate of femoral head among IIB, IIC, IIIA, IIIB and IIIC in ARCO stage (according to the necrosis range) (100%, 100%, 100%, 67%, P < 0.05). There was significant difference in the survival rate of femoral head between A and B in ARCO classification (according to collapse degree). There was no significant difference in the survival rate of femoral head among B, C1 and C2 in JIC classification (100%, 81%, 100%, P > 0.05). To conclude, core decompression, autologous iliac bone graft, allogeneic fibular fixation combined with Shanjia Huoxue Bushen Recipe can be used to treat peri-collapse period ONFH, which can promote the repair of necrotic femoral head, short-term clinical effect is exact and more suitable for IIB, IIC and III in ARCO stage when femoral head collapsed < 2 mm in ONFH patients.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words:  Femur Head Necrosis, Decompression, Surgical, Drugs, Chinese Herbal, Bone Transplantation, Tissue Engineering

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