The Clinical Observation On Core Decompression Combined With Two Materials For Treatment Of Early-to Medium-Term Non-Traumatic Femoral Head Necrosis

Objective: To discuss the clinical efficacy of core decompression combined with beta tricalcium phosphate bioceramic rod and tantalum rod in the treatment of early-to medium-term non-traumatic osteonecrosis of the femoral head of two cases.Methods: From March 2011 to October 2016,Sixty-six cases of early-to medium-term non-traumatic femoral head necrosis patients were treated by core decompression combined with beta tricalcium phosphate bioceramic rod or tantalum rod and retrospectively analyzed in the joint surgery of Affiliated Hospital of Zunyi Medical College.According to the different operation methods,divided into core decompression combined with the implantation of beta tricalcium phosphate bioceramic rod in treatment of 36 cases as group A and core decompression combined with the implantation of tantalum rod in treatment of 30 patients recorded as group B.Among them,there were 29 males and 7 females in group A,they were from 20 to 67 years old,with an average age of 44 years old,and there were 24 males and 6 females in group B,they were from 18 to 64 years old,with an average age of 45 years old.The preoperative Association Research Circulation Osseous(ARCO)stage was divided into A group: I stage 13 cases,II stage 18 cases,III A stage 5 cases,B group: I stage 11 cases,II stage 14 cases,III A stage 5 cases.The operative time,intraoperative blood loss and postoperative hospitalization days were recorded.Postoperative follow-up was regularly followed.The preoperative and postoperative Harris scores of the two groups were observed,and the imaging findings were analyzed.Results: There was no significant difference in the time of operation,the amount of bleeding and the days of hospitalization in the two groups,and there was no statistical significance(P > 0.05).The two groups of Harris scores were significantly higher than those before the operation,with significant difference(P < 0.05).There was no significant difference in the Harris score between the two groups at 1 months after operation(P > 0.05).At 12 months and 18 months after operation,the Harris score in group A was significantly higher than that in group B(P < 0.05).At 18 months after operation,the rate of head preservation was 89%(32/36)in the group A,and the rate of head preservation was 67%(20/30)in the group B,the difference between the two groups was statistically significant(P < 0.05).Conclusion: Core decompression combined with beta tricalcium phosphate bioceramic rod or tantalum rod were effective in the treatment of early-to medium-term non-traumatic osteonecrosis of the femoral head in two different materials,and the core decompression combined with porous calcium phosphate bioceramics has more satisfactory early-term curative effect than tantalum rod,which is more conducive to the rehabilitation of patients.