高位头颈开窗植骨术与异体腓骨支撑术治疗早期股骨头坏死的疗效对比研究

doi:10.3969/j.issn.1006-6233.2021.04.011

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Abstract Objective: To compare the curative effect of debridement of high head and neck fenestration and bone grafting with core decompression and allograft fibula support in the treatment of ARCO stage II femoral head necrosis.Methods: 60 patients (68 hips) with osteonecrosis of femoral head in our hospital from January 2015 to June 2019 were retrospectively analyzed. Among them, 24 cases (26 hips) were treated with high head and neck fenestration, debridement and bone grafting (group A), 36 cases (42 hips) were treated with core decompression and allograft fibula support (group B). Harris score and VAS score were used to evaluate the clinical effect after operation. The morphological changes of the femoral head could be observed by reexamination of X-ray film, and the clinical effect of hip preservation was evaluated. Results: Patients in both groups were followed up. Patients in group A were followed up for 12~40 months with an average of (26.2±1.7) months; patients in group B were followed up for 12 to 38 months with an average of (25.4±1.2) months. In group A, 4 patients failed to preserve hips, and the success rate of hip preservation was 84.6%; in group B, 12 hips failed to preserve hips, and the success rate of hip preservation was 71.4%. At the last follow-up of the two groups of patients with successful hip preservation, Harris score: group A (93.23±2.19) points, group B (85.46±2.32) points, the scores of the two groups were higher than those before surgery, and the difference was statistically significant (t=27.652, P<0.05; t=25.527, P<0.05); VAS score: group A (1.21±0.54) points, group B (2.43±0.60) points, the scores of the two groups were lower than those before surgery, the difference was statistically significant (t =16.743, P<0.05; t=17.514, P<0.05); the difference in scores between the groups was statistically significant (P<0.05). Conclusion: For the treatment of early avascular necrosis of the femoral head, the clinical effect of high head and neck fenestration debridement and bone grafting is better than core decompression and allograft fibula support, which can improve the symptoms of hip joint.

Key words： Osteonecrosis of the femoral head Fenestration at high level Fibula support

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.04.011 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I4/575

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