Clinical Results Of Two Pedicle Bones Grafting Combined With Chinese Medicine And Medical Therapy For Osteonecrosis Of The Femoral Head

Objective:Based on clinical cases were analyzed retrospectively, observe curative effect after the vascularized greater trochanter bone graft, which is used as a treatment of the osteonecrosis of the femoral head (ONFH). And it usually combined with free iliac crest flap and impaction bone grafting. This method is discussed in alleviating pain symptoms, improve microcirculation, promote restoration and prevent collapse of clinical application value in different ARCO stages. Compare to the surgical methods of the same type, discover the superiority of this surgery, and for the treat merit of ONFH of the exploration of an effective surgical method, and the evidence of chosen.Methods:1. from 2003 to 2009,50 hips in 46 patients, who were diagnosed ONFH in the First Hospital Affiliated to Guangzhou University of Chinese Medicine, were gathered. No surgery patients, such as contraindications to native acetabulum lesions, the operation area without skin lesions, tolerated anesthesia, etc. lateral femoral circumflex artery without significant variation and vascular patency.2. All patients, who have underwent the vascularized greater trochanter combined free iliac flap and impaction bone grafting, and Chinese medical and medicine was use as adjuvant therapy after the operation, were adopted the preoperative and postoperative follow-up evaluation criteria of clinical curative effect by Harris score, preoperative X-ray analysis and postoperative symptoms, signs and X-ray films.Results:Harris reference criteria that include joint pain, the ability to walk, life ability, joint deformities and activity ability score, The mean Harris score was 65.42±10.85 before the operation; it was 88.32±8.96 improved, and the cases in ARCOⅡ,Ⅲstages showing marked improvement. Radiological resuls were good or fair in 88.0% of all case, and 6 cases were reported become deteriorated or failure, but no one collapsed more than 4mm, and most of them were only a little deteriorated than before, which were in less than 2mm collapse of the head. No THA was taken in the follow-up, and all of the clinical results after the operation shown significantly improving.Conclusion:the vascularized greater trochanter bone graft combined free iliac flap and impaction bone grafting, shows effective and reliable. And with vascular implantation, blood supply was reconstructed to the femoral head. And femoral head is opened a windows to remove the necrosis bones. It can reduce the pressure inside the bones, and improve the clinical symptoms such as pain and claudication. With bone support and osteoinduction, the creeping substitution for new bone, curative effect is distinct advantages for youth, for the avascular necrosis ARCOⅡ,Ⅲstage patients, it provides a more effective treatment methods.