Observation On The Clinical Curative Effect Of Rotational Osteotomy Combined With Oral Application Of Shuang He Tang(SHT) In The Treatment Of ARCO Phase Ⅲ Osteonecrosis Of The Femoral Head

Objective:Observe the short-term clinical efficacy of rotational osteotomy combined with oral application of Shuang He Tang（双合汤,SHT）in the treatment of ARCO phaseⅢ osteonecrosis of the femoral head in young and middle-aged patients to provide corresponding practical experience for better application of rotational osteotomy clinically.Methods:Twenty young and middle-aged patients（20 hips）with ARCO phase III ONFH who were treated in Jiangsu Province Hospital of TCM from September 2017 to September 2018 were selected and analyzed in this study.According to the method of random number table,they were randomly divided into 2 groups,10 cases（10 hips）in experimental group,10 cases（10 hips）in control group.The experimental group was treated with rotational osteotomy combined with oral application of SHT after operation,while the control group was treated with rotational osteotomy only.The data of VAS pain score,Harris hip joint function score,the highly selective angiography of medial femoral circumflex artery,pelvic anterior and posterior position film and pelvic frog position film of patients who were treated before and after 6 months were observed.Besides,SPSS 1 8.0 software was used for statistical analysis and comparison.Results:After 6 months,the postoperative effective rate of the experimental group is statistically higher than the control group.Postoperative VAS pain score decreased significantly in both groups and the degree of decrease is more significant in experimental group than control group.（experimental group:preoperative VAS pain score 4.23±1.1 7,postoperative VAS pain score 2.31±1.15,control group:preoperative VAS pain score 4.21±1.14,postoperative VAS pain score 2₄5±1.04,P<0.05）.Postoperative Harris hip function scale increased significantly in both groups according to the follow-up.And the degree of increase is more significant in experimental group than control group.（experimental group:preoperative VAS pain score 68.87±5.66,postoperative VAS pain score 88.23±3.76,control group:preoperative VAS pain score 68.06±5.23,postoperative VAS pain score 84.15±3.15,P<0.05）.Preoperative highly selective angiography of medial femoral circumflex artery in both groups showed that the blood vessel was not blocked.And postoperative angiography showed that the blood vessel of 9 hips in the experimental group developed,meanwhile,the blood vessel of 7 hips in the control group developed.Moreover,postoperative radiographic findings in both groups were better than preoperative radiographic findings.（P<0.05）.And the degree of improvement is more significant in experimental group than control group.（P<0.05）.Conclusion:Concerning the treatment of ARCO phaseⅢ osteonecrosis of the femoral head in young and middle-aged patients,the combination of rotational osteotomy and oral application of Shuang He Tang（双合汤,SHT）postoperatively is better than only rotational osteotomy.The combination can better relieve pain of patients,improve their hip function,and improve blood supply of femoral head,curative effect of radiographic findings and their quality of life.