Modified porous pulp core decompression in the treatment of early avascular necrosis of the femoral head: hip replacement rate in 5-year follow-up

doi:10.3969/j.issn.2095-4344.2014.53.001

Abstract

Abstract:

BACKGROUND: Femoral core decompression is a classical method for early femoral head necrosis that has been widely concerned. However, some scholars applied postoperative scores and other subjective data for analysis, which affected the reliability of experimental results.
OBJECTIVE: To verify clinical effect and imaging changes of core decompression in treatment of early avascular necrosis of the femoral head.
METHODS: Sixty-seven patients (99 hips) with osteonecrosis atⅠ-Ⅱgrade according to the staging criteria of the Association Research Circulation Osseuse were involved in this study. The involved patients were divided into two groups: treatment group (40 cases, 57 hips; receiving modified porous pulp core decompression treatment) and control group (27 cases, 42 hips; receiving drugs and comprehensive treatment). Harris scores were evaluated before treatment and at 1, 3 months after treatment. Patients were detected with pelvic plain film, hip CT in lateral projection, hip MRI and Harris hip score at postoperative 6 months.
RESULTS AND CONCLUSION: After 5 years of follow-up, 28 hips in the treatment group (57 hips) underwent hip replacement, accounted for 49%; and 29 hips in the control group (42 hips) underwent hip replacement, accounted for 69%, hip replacement rate of treatment group was obviously lower than that of control group. Hip core decompression significantly delayed the joint replacement time (P < 0.05). The hip replacement rate was postoperative 2-3 years in the control group and postoperative 3-4 years in the treatment group. In the treatment group, postoperative Harris scores and necrosis index were significantly better than that before treatment (P < 0.05). There was no correlation between preoperative Harris score and necrosis index (P > 0.05), and the correlation was still not found after core decompression surgery. Femoral head pulp core decompression can ease the pain symptoms, improve the walking ability and improve the limb function in treatment of early avascular necrosis of the femoral head, delay the time of total hip replacement, it is especially suitable for patients with ARCOⅠ-Ⅱosteonecrosis.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: avascular necrosis of the femoral head, femoral head, hip joint

CLC Number:

R318

Ren Zheng, Liu Xiu-xin, Shen Zhi-min. Modified porous pulp core decompression in the treatment of early avascular necrosis of the femoral head: hip replacement rate in 5-year follow-up[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(53): 8529-8535.

Figures/Tables 7

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