Observation Of The Cellular Marrow Core Decompression And The Decompression Grafting Bone For Treatment Of The Non-traumatic Osteonecrosis Of The Femoral Head(NONFH) At Ficat Ⅱ In Recently Clinical Curative Effect

[Objective] the traumatic femoral head necrosis (NONFH) clinically increased year by year, and younger, middle for the treatment of avascular necrosis of the current clinical methods is more, and each have advantages and disadvantages, this topic is based on my department are commonly used to treat Ficat Ⅱ avascular necrosis of the research of two methods, discusses two kinds of mechanism and feasibility of the treatment, evaluation of two kinds of therapy in the treatment of Ficat Ⅱ options were the clinical value of bone necrosis, seek a kind of for Ficat Ⅱ for clinical effective treatment options were bone necrosis.[Method] this topic all data are from chengdu university of traditional Chinese medicine hospital in March 2013 to June 2014, orthopedic inpatient admitted to the hospital for treatment, stage for Ficat Ⅱ of 50 patients with traumatic femoral head necrosis (NONFH); Take random grouping, it can be divided into group A (porous pulp core decompression group) 25 cases (25 hips); Group B (crackdown on graft group) 25 cases (25 hips). Two groups of patients in hospital were given routine blood, liver and kidney function, blood coagulation function, electrocardiogram, chest X-ray, pelvic plain radiographs, and limb arteriovenous colour to exceed check, and Harris hip score; After the completion of routine preoperative preparation for group A perforated pulp core decompression treatment; Group B line down for the treatment of bone graft. Arrange blood routine and biochemical examination postoperatively, and since the second day postoperatively to patients in both groups were recorded with oral faeries bone remains capsule to continue treatment for (December). Group A with complete data of 25 cases (25 hips), group B in the process of follow-up,1 case of patients in postoperative hip pain after six months, the final total hip replacement,24 cases (24 hips) with complete information.Observation indexes:1. General information:age, gender, weight, etiology, course; 2. Safety indexes, routine blood, liver, kidney function, electrolyte, such as heart and lung function, limb vascular colour to exceed examination; 3. The curative effect evaluation indexes:operation time, intraoperative bleeding, postoperative 1,3,6,9 and 12 months hospital outpatient care, follow-up, by the same doctor for patients with Harris hip score; And pelvic plain radiographs taken by not participate in the study of five orthopaedics and imaging experts assess.[Results] this topic has A complete research materials in 49 cases, in which A group of 25 cases (25 hips), excluding 0 cases,25 cases (25 hips) complete follow-up; B group of 24 cases (24 hips); Two groups of baseline distribution is good, grouping equilibrium, comparable (P> 0.05). At follow-up of 1,3,6,9 and 12 months, within two way contrast Harris hip score has improved significantly, improve hip pain and mobility significantly (P< 0.05); Contrast between two groups of Harris hip group, after 1 months follow-up after surgery (P>0.05, no statistical significance, shows two groups in postoperative 1 month the effect of the treatment to relieve symptoms, postoperative 3,6,9 and 12 months after the crackdown for alleviating clinical symptoms manifest the advantages of using bone graft (P<0.05); Imaging to compare postoperative also no significant change (P>0.05), the excellent to the imaging performance of control on obvious bone graft group (P<0.05).[Conclusion] 1. Porous pulp core decompression, suppress bone graft surgery for hip pain relieve Ficat phase II NONFH, improve joint function, both have the effect, and effect is exactly;2. The suppression of bone graft surgery to relieve joint pain and improve joint function curative effect is superior to pure pulp porous core decompression group;3. Depress because of using bone graft surgery to remove necrotic tissue and bone graft to support of femoral head weight bearing area, to delay for a long time of the collapse of the femoral head, and the relief of symptoms fully significantly in the porous pulp core decompression group, for clinical Ficat patients with stage II NONFH advice on treatment using bone graft.4. The suppression of bone graft surgery operating time is long, the bleeding is more porous pulp core decompression, and this is the research covers 20 to 60 patients, for more than 60 patients, when treating Ficat phase II NONFH porous pulp line core decompression can be considered.