Abstract:

BACKGROUND: Core decompression can relieve the symptoms of early-stage femoral head necrosis effectively. This method is simple and feasible. Even if the long term result is not ideal, artificial total hip replacement can be performed with no influence.
OBJECTIVE: To explore the clinical effect of three methods based on core decompression in treating the early-stage femoral head necrosis.
METHODS: Forty-six cases (61 hips) with femoral head necrosis were included. There were 21 cases (29 hips) in phaseⅠ, 25 cases (32 hips) in phase Ⅱ based on Association Research Circulation Osseous classification. They were all treated with core decompression, of which 15 cases (23 hips) were only treated with core decompression (group A), 18 cases (25 hips) were treated with core decompression and autologous bone marrow mononuclear cells implantation after separation and collection of bone marrow mononuclear cells (group B), 13 cases (13 hips) were treated with core decompression plus porous tantalum rod insertion (group C).
RESULTS AND CONCLUSION: All the patients were followed-up for 12 months. The last follow-up Harris scores of three groups were higher than that of preoperation (P < 0.01). The Harris score of last follow-up in group B and group C was higher than that in the group A (P < 0.01), and there was no significant difference between group B and group C (P > 0.05). Postoperative X-ray image showed that 2 cases (3 hips) developed to femoral head collapse in group A, while 1 case (1 hip) in group B and 2 cases (2 hips) in group C developed to femoral head collapse. The three methods based on core decompression have positive effect in treating early stage femoral head necrosis. The effect of core decompression combined with autologous bone marrow mononuclear cells implantation or porous tantalum rod insertion was superior to simple core decompression.