Clinical Study Of Dislocation Of Hip Joint Surgery With Cleaning Up The Necrotic Bone And Impaction Bone Grafting Combined With Local Injection Of PRP And Traditional Chinese Medicine For Treatment Of Femoral Head Necrosis

Purpose:To evaluate the efficacy and safety of surgical dislocation of hip joint surgery with cleaning up the necrotic bone and impaction bone grafting and the use of traditional Chinese medicine adjuvant therapy after hip surgeries for the postoperative functional recovery,and to provide new development direction and experience for the treatment of femoral head necrosis in hip preservation.Methods:This study selected patients with osteonecrosis of the femoral head(ARCO III A-IIIB)who were admitted to the Department of Orthopaedics and Traumatology of the Jiangsu Provincial Hospital from June 2013 to February 2017.A total of 18 patients(20 hips)aged 19-55 years with an average age of 40.3 years were enrolled.The treatment group was divided into observation group,including 8 males with 8 hips and 2 females with 2 hips.The control group included 6 males with 8 hips and 2 females with 2 hips.All the patients underwent surgical dislocation of hip joint surgery with cleaning up the necrotic bone and impaction bone grafting combined,intraoperativeuse of autologous PRP to promote blood supply.In the observation group,the patient's prescription of Bushen Huoxue Decoction was treated for 3 months,and the control group was not assisted with Chinese medicine.All cases were followed up for 11-25 months with an average of 18.3 months.Follow-up data were recorded and data were collected for analysis.Results:The Harris score of all patients after the last follow-up was significantly higher than those before surgery,with statistically significant differences(P<0.05).The preoperative Harris score was(55.90 ± 5.72)in the observation group,and the Harris score was(86.60 ± 8.19)in the last follow-up,the preoperative Harris score was(56.90 ± 5.67)in the control group,and the Harris score was(78.80 ± 7.76)in the last follow-up.The rate of excellent and good results in the observation group was 80.0%,of which 4 were excellent,4 were good,1 was general,and 1 was poor.The control group had 60.0%of excellent and excellent results,of which 1 was excellent and 5 were good,3 were general,1 was poor.During the follow-up period,2 patients underwent joint replacement surgery because of premature weight-bearing collapse of the femoral head.Conclusions:Hip Surgical dislocation of hip joint surgery with cleaning up the necrotic bone and impaction bone grafting has advantages over other hip-sparing surgeries in the treatment of which has less interference with the normal blood supply of the femoral head and complete clean up of the sequestrum,its short-term effect is good,and hip protection Postoperative adjuvant Chinese medicine has a catalytic effect on postoperative functional recovery.For the young and middle-aged,the treatment is currently one of the ideal,less dangerous methods to prevent or correct the collapse of the femoral head,delay or avoid artificial joint replacement time.