Therapeutic Effect Of Femoral Neck Decompression And Iliac Bone Grafting On Ischemic Femoral Head Necrosis

Objective: To observe the early effect of femoral neck decompression and iliac bone grafting for avascular necrosis of the femoral head.Methods:10 cases(11 hips)of avascular necrosis of the femoral head were treated with femoral neck decompression and iliac crest grafting.The patient’s hip Harris score and hip imaging data were obtained by follow-up.The hip joint Harris criteria were used to objectively evaluate hip pain,hip function and hip mobility at different time points,and Harris scores were obtained at different time points.According to hip X-ray,the femoral head necrosis area was observed.Fix the situation.A correlation analysis was performed between the patient’s basic condition and the Harris score to evaluate the impact of these factors on the Harris score.Results:In this group of 10 patients(11 hips),9 patients(10 hips)were followed up,and 1 patient(1 hip)was lost to follow-up.The reason for the loss of follow-up was the patient’s contact information.The patients were followed up for more than 12 months.In this study,2 patients had postoperative numbness and discomfort in the front and outer thighs of the affected limb.However,after the nutritional nerve treatment,the numbness symptoms improved significantly in the first half of the year.There was no femoral neck fracture or tibia block loss in this study.Complications such as venous thrombosis and wound infection.(1)Correlation analysis: Age,ARCO stage and Harris score were negatively correlated,and BMI was not correlated with Harris score.(2)Hip Harris score: the average Harris score before surgery was(67.80±6.00)points,and the Harris score was(68.10±6.40)points after surgery.The Harris score was slightly higher than that before surgery.The difference was not statistically significant(P=0.081),but hip pain was significantly reduced compared with preoperative,the difference was statistically significant(P=0.005),and hip function and hip mobility were improved compared with preoperative.Not obvious,the difference was not statistically significant(P>0.05).The average Harris score was(84.50±6.00)points in June,and the Harris score was significantly higher in June than in the preoperative period.The difference was statistically significant(P=0.005).The Harris score was higher after surgery in June.The increase was significant in March,and the difference was statistically significant(P=0.005).The average Harris score was(87.10±5.24)points in the postoperative period.The Harris score was significantly higher than that before surgery in the 12 months after surgery.The difference was statistically significant(P=0.005).The Harris score was lower in the 12 months after surgery.After the increase in March,the difference was statistically significant(P=0.005).The Harris score was higher in the postoperative month than in June,and the difference was statistically significant(P=0.043).(3)X-ray findings of the hip joint: Among the 9 patients(10 hips)after operation,1 patient(1 hip)showed obvious uneven density of the femoral head and enlarged cystic area at 6 months after operation.After the first 12 months,the stage III collapse occurred.The preoperative ARCO stage was stage IIc.The remaining 8 cases(9 hips)of the X-ray femoral head maintained a circular contour(or the collapse was improved),and the density of the lesion was more uniform than before.The sexual area is significantly reduced(or disappeared),the necrotic bone is replaced by new bone(or most of the replacement),and the osteogenesis of the femoral head is stronger.Conclusion:Femoral neck decompression and iliac bone grafting for the treatment of avascular necrosis of the femoral head has the advantages of less trauma,easy removal of the lesion,less interference with the blood supply to the femoral head,and satisfactory early clinical results.