Comparison Of The Short Effect Of Quadratus Femorismuscle Pedicled Bone Graft And Core Decompression With Bone Graft In Treatment Of Ficat Ⅱ Osteonecrosis

Objective:To compare the short term follow-up result of quadratus femoris muscle pedicle bone graft method and core decompression with bone graft method in treatment of Ficat II stage osteonecrosis of femoral head, Wecompare the surgical information that include blood loss and operation time, assess the clinical and radiologic result, then evaluate the survival rate of femoral head, finally, conclude which surgical technique is the better.Methods:Treated 37 cases of Ficat II with the two operations, then analyzed and followed-up. The cases selection criteria:quadratus femoris muscle peicled bone graft group incude nontraumatic 17 cases(19 hips), male 14 cases, female 3 cases, mean aged 42.35 (18-61), drinker 7 cases, glucocorticoid user 4 cases, without obvious cause 6 cases, who all underwent this operation during the period 2009.8-2013.10; Core decompression with bone graft group incude nontraumatic 20 cases(22 hips), male 15 cases,female 5 cases, mean aged 41.4(18-55), drinker 8 cases, glucocorticoid user 4 cases, drinker and glucocorticoid user at the same time 1 cases, without obvious cause 8 cases, who all underwent this operation during the period 2010.3-2013.3. We collected the surgical information, blood loss and operation time. Also we evaluated the clinical effect with Harris score system before and after operation, and radiological effect were assessed according to changes of X-rayimaging result.We setted the collapse of femoral head as termination, then used Kaplan-Meier methodto conduct the hip surgical analysis.Result:The duration of followed up was 12 to 62months(mean 34.5 months). Age, duration of follow up and preoperative Harris scores showed no significant difference between the two groups (P>0.05).The surgical time, blood loss of core decompression with bone graft was obviously less than quadratus femoris muscle pedicle bone graft group (P<0.05). The postoperative Harris scores of two groups showed no statistic difference(P>0.05), but were obviously increased than the preoperative data respectively (P<0.05). Kplan-Meier survivorship curve showed that the survival rate in the two groups were 84%(16/19), 77%(17/22)respectively,and had no statistic difference(P>0.05)Conclusion:In the treatment of ONFH(Ficat Ⅱ period), there is certain clinical short effect in the two operations. Although clinical result、X-ray imaging evaluation and survival rate show no statistical difference in the short-term results of both surgical techniques,the shorter surgical time and less blood make core decompression with bone graft a better choice.