| Background and Objective:Hip joint is one of the most important joint within the human body,the femoral head is an important part of the hip joint and it affects the motion of the hip joint directly.Osteonecrosis of the femoral head?ONFH?is one of common refractory diseases in orthopedics.Trauma?abnormal blood function?a lot of alcoholism?long-term large-scale use of hormones easily lead ONFH.The early discovery and accurate diagnosis of ONFH is very meaningful for the good effect of the patient.Otherwise,the femoral head of 80%patients will be collapsed within 1 to 4years with the loss of function of the hip joint and high disability,they had to undergo total hip arthroplasty[1-2].Core compression with thick passage has been the effective method to treat early ONFH and prevent collapse of the femoral head because of its advantages such as simpler operation,less trauma and economy.We made a long follow-up visit to learn long-term effects of core decompression with thick passage combined osteoinduction active material on early ONFH in order to grasp the indications of the core compression with thick passage and guide clinical treatment.Research methods:From October 2004 to October 2007,40 patients with 50 hips in ARCO I stage were treated with core decompression with thick passage combined osteoinduction active material in the first affiliated hospital of Zhengzhou university,including 28males and 12 females with an average age of 28.3?20-40?years old.According to the etiology classification:the hormonal ONFH in 10 patients with 12 hips,alcoholic ONFH was in 24 patients with 30 hips,hormonal and alcoholic ONFH was in 6patients with 8 hips.Staging with ARCO staging criteria,21?15?14 hips were in stage I-A,I-B and I-C?necrotic area was less than 40%of the total area of the femoral head?,separately.40 hips on the left and 10 hips on the right..All patients were treated by core decompression with thick passage combined osteoinduction active material.Evaluation criteria for the efficacy of adult ONFH[3]is used to evaluate the clinical and image effect of patients.We use SPSS 17.0 to analyze the information.Result:The pain of the hips were disappeared in all patients after the operation,the function of hip joint activity was significantly improved,without the complications about injury of vascular and nerve as well as infection.The Patients were followed up for an average of 10.5 years?10 to 12 years?at the last time after the operation.There were the excellent in 40 hips,good in 7 hips,fair in 3 hips,poor in 0 hip,the total rate of excellent and good was 94.0%.During the I-A stage,18 hips were excellent,2 hips were good,1 hip was fair,0 hip was poor.During the I-B stage,12 hips were excellent,2 hips were good,1 hip was fair,0 hip was poor.During the I-C stage,10hips were excellent,3 hips were good,1 hip was fair,0 hip was poor.The excellent and good rate was 95.2%,93.3%and 92.9%in stage I-A,I-B and I-C respectively.There was no statistically significant difference between excellent and good rates in each stage,I-A,I-B and I-C,P>0.05.Conclusions:1.The long-term effects of the core decompression with thick passage combined osteoinduction active material to treat the osteonecrosis of the femoral head in ARCO I-A?I-B?I-C?necrotic area was less than 40%of the total area of the femoral head?stage are excellent and good.2.Core decompression with thick passage combined osteoinduction active material to treat the osteonecrosis of the femoral head is especially suitable for young patients. |
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