Treatment Of Early Osteonecrosis Of The Femoral Head With Debridement, Bone Grafting And Bone Marrow Mesenchymal Stem Cells Implantation

Objective:To study the clinical effect of debridement, bone grafting combined with autologous bone marrow mononuclear cells transplantation for the treatment of early avascular necrosis of the femoral head.Methods:Total 33 hips in 23 patients with femoral head necrosis aged from 18 and 55 (34.6 on average) and treated by debridement, bone grafting combined with autologous bone marrow mononuclear cells were eorolled from department of joint and turner surgey, the First affiliated hospital of an hui medical university. there were 5 steroid-induced cases (7 hips),4 alcohol-induced cases (5 hips),16 idiopathic cases (21 hips). According to the system of the Association Research Circulation Osseous (ARCO),8 hips were classified as stage ⅡA,15 hips as stage ⅡB,9 as stage ⅡC,1 as stage ⅢA. We evaluated the clinical effect thorough the Harris score、VAS score and the volume of the necrotic femoral headResults:All the 25 patients (33hips) were followed up for 12-18 months (15 on average). The pain and the range of motion also improved, The Harris scores of patients after operation increased significantly (85.6±7.8) compared with that before operation 55.2±6.5, The VAS score decreased significantly from 6.81±1.19 to 2.38±3.3, The volume of the necrotic femoral head decreased significantly from 13.38±5.1cm3 to 7.23±3.3 cm3, respectively, showing significant difference. There were 15 hips of excellent,11 of good,4 of fair and 3 of poor. Three poor hips were subjected to total hip arthroplasty at last.Conclusion: These findings indicate that debridement, bone grafting combined with transplantation of autologous bone marrow mesenchymal stem cells is an effective method to treat early osteonecrosis of the femoral head, but the long-term effect need to be observed further.