Advanced Core Decompression Combined With Allograft Bone For The Treatment Of Early Stage ONFH:Initial Clinical Experience And Results Of Short Term Follow Up

Objective: To discuss the early curative effect of Advanced core decompression combined with Allograft bone in the treatment of early stage ONFHMethods: A total of 56 patients(92hips)with early stage ONFH(osteonecrosis of the femoral heads)were treated from June 2015 to October 2015.Their age ranged from 23 to 50 years(median 35).Unilateral femoral head necrosis occurred in 20 hips,and bilateral femoral head necrosis occurred in 72 hips.According to the standard of ACRO staging,9 hips were in stage?(?a5 hips,?b3hips,?c 1 hips),83 hips were in stage?(?a 3 hips,?b 47 hips,? c33hips).SURGICAL TECHNIQUE:After decompression using 9mm diameter cannalated drill bit,use the X-Ream expandable reamer into the drilling channel to debride the dead bone as much as possible.Finally the core and the surgically created bone defect were backfilled using allograft bone.After surgery,patients use crutches to walk without bearing any weight for 3 month,after which they were allowed to resume full activities gradually.The curative effect was analyzed according to VAS score?Harris hip score?X-Ray?CT and MRI before and after surgery.Results: All the involved 56 patients(92 hips)were followed up for 10-26 months postoperatively.42 of them obtained excellent and good results,showing the pain disappearance and free activities.The rate of excellent and good was 75%.The Harris Hip Score increased prominently from preoperative mean 72.5 points to postoperative mean 85.2,with significant difference(P<0.05).The VAS score decreased proniminently from preoperative mean 6.33 points to postoperative mean 2.73Conclusion: Experiment findings indicate that advanced core decom-pression combined with Allograft bone has good curative effect in the treatment of early stage ONFH in the short term,and further studies are needed to observe the long term curative effect.