Clinical Study Of Percutaneous Cement Injection In The Treatment Of Steroid - Induced Femoral Head Necrosis In Rabbits And The Etiology Of Femoral Head Necrosis

[Objective] Establish the rabbit animal model of glucocorticoid induced avascular necrosis of femoral head, to the injection of PMMA bone cement, morphology, the imageology and biomechanics, serological, pathological observation and comparison, and for the treatment of avascular necrosis of the femoral head and provide a theoretical basis.[Methods] Select32rabbits, randomly divided into3group and control group, with8rats in each group, animal model induced by a hormonal ischemic necrosis of femoral head, the successful model rabbits were randomly select4on the femoral head bone cement injection and fed for4weeks, respectively, in the experimental group, model group, control group rabbits. Morphology, imaging, observation and biomechanical serological, pathological and comparison.[Results] In the control group, rabbits were anorexia, abnormal gait, weight loss; imaging revealed a bone structure is not clear and the collapse of the femoral head changed; serological hints hyperlipidemia; histopathology indicated the number of empty lacuna increased, large accumulation of fat cells fusion, trabecular bone atrophy, thinning, the number of osteoblasts was significantly reduced, hematopoietic tissue the biomechanical strength decreased almost disappeared. The experimental group each have improved.[Conclusions] A large dose of hormone and endotoxin induced avascular necrosis of the femoral head, the animal model was successfully replicated; Animal model of osteonecrosis in morphology, imaging, serology, pathology and biomechanics were changed; Necrosis of femoral bone cement injection after treatment, the changes have improved. [Objective] To explore the different etiology of avascular necrosis of the femoral head and the difference of clinical feature.[Methods]264patients with osteonecrosis of the femoral head in2009March to2014February were treated patients (454hips) were studied, comparison of different etiology of avascular necrosis of the femoral head accounted for the difference ratio and clinical manifestations.[Results] In the steroid group,130cases of femoral head necrosis (238hips), male72cases, female58cases, average age was37.58years,16cases were misdiagnosed; In the alcohol group,84cases of femoral head necrosis (151hips), male83cases, female1patients, the average age was46.45years,18cases were misdiagnosed; In the trauma group,24cases of femoral head necrosis (24hips), male11cases, female13cases, average age was43.74years,0cases were misdiagnosed; In the idiopathic group,8cases of femoral head necrosis (12hips), male3cases, female5cases, average age was40.24years,2cases were misdiagnosed; In the group of unknown cause,18cases of femoral head necrosis (29hips), male9cases, female9cases, average age was45.36years,3cases were misdiagnosed.[Conclusions] Steroid hormone is still the main reason for the avascular necrosis, onset age is relatively young, the misdiagnosis rate is relatively low.