Clinical Efficacy And Fea Of ONFH (ARCOⅢ) Use Of The Greater Trochanter Bone With Vascular Combined Bone Graft

ObjectiveCurrently, there are many of the treatments for middle-aged patients of Osteonecrosis of the femoral head (ONFH). How to repair the necrosis as much as possible, defer the joint replacement, reconstruction of good biomechanical support, becomes the difficult. Around the "hip reservation" concept, the current treatment is variously, among it, which is a important method with the microsurgical technique in the treatment of ONFH from the use of the greater trochanter bone flap with vascular pedicle bone graft for the middle-aged patients. But, because of the THA, and interests of the medical market, this treatment is used less and less. It is necessary to evaluate the surgery through the research of clinical efficacy and FEA, in order to investigate the clinical efficacy of this technique and the mechanical properties of femoral head repairing.MethodsThe research randomly selected20cases to follow up from the patients for treatment of the surgery of the greater trochanter bone with vascular combined bone graft from2006to2010, and used Harris’&Charnley’hip score to evaluate the postoperative hip function, and then statistical analysis the resu] ts. The second, the research chooses a patient from the20cases randomly, and through the FEA evaluate the biomechanical properties of both hips to compare the mechanical balance.ResultsThe clinical efficacy research found that the symptoms and pain is significantly improved through the Harris’&Charnley’hip score assess for24hips of20cases. FEA found that femoral head repaired well, and the stress distribution of both femoral head reaches mechanical equilibrium. The stress distribution of the femoral neck conform the body’s normal mechanical properties. There is a normal mechanical property in that part of the greater trochanter which was cut, this step in the surgery is safe. Meanwhile,the research successfully established a three-dimensional finite element model of the greater trochanter postoperative data for the further research like that long term mechanical observation, assess or improvement of the surgery, operative design, surgery simulation, and so on.ConclusionThe surgery of greater trochanter bone with vascular combined bone graft could retain the femoral head to defer the joint replacement, recover the normal function, reconstruct a good biomechanical support, and even be cured to avoid the arthroplasty. It is a most effective therapy for middle-aged patients of ONFH ARCOIII.