The Observation Of The Therapeutic Effect Of Gugutouhuaisiyu Capsule In Treating Nontraumatic Osteonecrosis Of Femoral Head Patients Received The Impaction Bone Grafting

Objective:To observe the latest clinical effects of gugutouhuaisiyu capsule for nontraumatic osteonecrosis of femoral head patients after the impaction bone grafting.Methods:A randomized controlled prospective study.60 cases of nontraumatic osteonecrosis of femoral head patients (ARCO stage Ⅱ) selected from Henan Luoyang Orthopedic Hospital from February 2013 to February 2014 were randomly divided into treatment group and control group with 30 cases in each group. Both groups first received the treatment of small incision bone impaction grafting after which the patients in treatment group take gugutouhuaisiyu capsules.Observe the changes of VAS and Harris scores, the radiographic appearance of the femoral head, the range of cystic change of femoral head and the joint space changes before and after 3,6,9,12 months of the operation and then carry out statistic analysis of these indicators of the two groups under the guide of SPSS 16.0 software.Results:Twenty-eight patients(38 hips) in treatment group and Twenty-seven patients (36 hips) in control group were followed up12 months.The statistical analysis of the data of the followed-up patients in the two groups including gender, age, duration, etiology, ARCO stage, necrosis other side, preoperative Harris hip score, VAS score suggests that the difference was of no statistical significance (P>0.05). That is to say two groups of cases are comparable. Postoperative blood loss, operative time was of no statistical significance (P>0.05). Compared with the preoperative Harris scores, Harris scores of the two groups obtained 3 months after the surgery increased markedly and the difference was of no statistical significance (P>0.05). Difference between Harris scores of the two groups obtained 6,9,12 months later was of statistical significance (P＜0.05). Difference between VAS scores of the two groups obtained 3 months later was of no statistical significance (P>0.05) while differences between VAS scores of the two groups obtained 6,9,12 months later were of statistical significance (P<0.05). The X-ray evaluation:In the treatment group,2 hips aggravated to femoral head as stage ⅡC after 12 months when there are uneven density and cystic change in femoral bone area,1 hip aggravated to femoral head as stage ⅢA with its collapse less than 2mm. The other 35 hips had no uneven density and cystic change and lnecrotic bone were substituted by new bone. the According to the X-ray Evaluation criteria,20 hips were improved,15 hips became stable, 3 hips became worse. In the control group,1 hip aggravated to femoral head as stage ⅡB,5 hips aggravated to femoral head as stage ⅡC after 12 months,3 hips aggravated to femoral head as stage IIIA. The other 27 hips had no uneven density and cystic change and lnecrotic bone were substituted by new bone. According to the X-ray Evaluation criteria 11 hips were improved,16 hips became stable,9 hips became worse. Difference of the two groups was of statistical significance (P<0.05).Conclusion:Taking gugutouhuaisiyu capsules after the impaction bone grafting can relieve the postoperative pain, improve joint function and promote the graft survival, and strengthen the efficacy of the impaction bone grafting surgery.