Comparison Of Early Clinical Effect Between Bone Grafting Through Femoral Neck And Bone Grafting Through A Femoral Neck Window At High Location In Treatment Of Early Non-traumatic Femoral Head Necrosis

ObjectiveTo comparison of early clinical effect between bone grafting through femoral neck and bone grafting through a femoral neck window at high location in treatment of early non-traumatic femoral head.MethodsFrom Januaty 2009 to December 2013,90 patients(100 hips)diagnosed as early osteonecrosis of femoral head(stage ?B-?A according to the classification system of ARCO)were selected in this study.46 cases were male and 44 cases of female.The age was rang from 16 to 54,the average was 39.According to the classification system of ARCO,ARCO?B was 10 hips,ARCO?C was 31 hips,ARCO?A was 59 hips.Those patients were randomly assigned to group A and B,treated by the lightbult procedure and bone grafting through a femoral neck window at high location 50 hips respectively.Among of group A,ARCO?B was 7 hips,ARCO?C was 14 hips,ARCO?A was 29 hips respectively.Among of group B,ARCO?B was 3 hips,ARCO?C was 17 hips,ARCO?A was 30 hips respectively.All of the patients ware follow-up on a regular basis in outpatient department at postoperative 1,3,9,18 months respectively.The effectiveness was evaluated according to Harris Scoring system and excellent and good rate.Result1.All patients were followed up for 18 months,the difference of preoperative Harris score and the rate of excellent or good for all stages was no statistical significant(P>0.05)between A and B group.Between A and B groups ware comparable.The Harris score and the rate of excellent or good after surgery ware significant higer compared with those before suegery(P<0.05).2.Compared of the last postoperative scores showed that the Harris hip aggregate scores,range motion score,function score and pain score of patients in group B were all higher than that in group A,there was statistically significant difference(P<0.05)between the two group.The Harris hip aggregate score of group B with stage ARCO?C and ?A was higher than that in group A,the difference was statistical significant(P<0.05)between A group and B,The difference of The Harris hip aggregate score of ARCO ? B stage was no statistical significance(P>0.05)between A group and B.3.Compared of the rate of excellent or good,the rate of group B was significantly higher than that of group A(P<0.05).Among of group B in stage ARCO ?C and ?A,the rate of excellent or good was significantly higher than that of group A,the difference of the rate of excellent or good was statistically significant(P < 0.05).The rate of excellent or good of ARCO ? B stage,there was no statistically significant difference(P>0.05).4.Two groups of patients were not M type of femoral head necrosis.For type C,L1,L2 of femoral head necrosis,both of two kinds surgical treatments were obtain satisfactory clinical effect.But,for L3 type of femoral head necrosis,the rate of excellent or good of group B was significantly higher than that of group A(P<0.05).ConclusionThe two operation of the lightbult procedure and bone grafting through a femoral neck window at high location has obvious curative effect in treatment of early non-traumatic femoral head..For the patients of period of ARCO?B-?A and L3 type of ONFH,the bone grafting through a femoral neck window at high location was better than the lightbult procedure in curative effect.and it also could improve the prognosis of femoral head necrosis.