Abstract
Introduction Hip-salvage treatment in femoral head necrosis has a great social and economic importance.The number of hip joint replacements in young patients has been increasing. Purpose To evaluate the results of hip-preserving surgical interventions in the treatment of patients with non-traumatic femoral head necrosis. Materials and methods The study included 42 cases treated by minimally invasive core decompression of the femoral head and bone grafting, 22 cases of decompression and introduction of autologous bone marrow and mesenchymal stem cells into the core of necrosis, and six cases of using a titanium locking mesh implant. Results The follow-up time after surgery was up to 5 years. The survival rate of hip-reserving operations using cell technology to stimulate osteoregeneration were noticeably better than using bone grafting only in disease stages I, IIA, IIB, IIC. For femoral head osteonecrosis in stage IIIA, a titanium locking femoral head implant has been developed. It promotes regeneration and performs a supporting function. Conclusion The analysis of long-term results of these minimally invasive technologies has proven their efficacy and safety along with a low rate of complications.
Highlights
Hip-salvage treatment in femoral head necrosis has a great social and economic importance.The number of hip joint replacements in young patients has been increasing
To evaluate the results of hip-preserving surgical interventions in the treatment of patients with femoral head osteonecrosis of atraumatic genesis
Pain reduced from 60 ± 4.2 to 32 ± 3.4 visual analogue scale (VAS) points in 42 (60 %) cases that, as we opine, was related to the decrease in the intraosseous pressure in the necrotic core due to decompression and joint unloading
Summary
Hip-salvage treatment in femoral head necrosis has a great social and economic importance.The number of hip joint replacements in young patients has been increasing. For femoral head osteonecrosis in stage IIIA, a titanium locking femoral head implant has been developed. It promotes regeneration and performs a supporting function. Osteonecrosis of the femoral head (OFH) is a severe hip pathology that is characterized by progressive disease course resulting in failure of femoral head support, its destruction and secondary coxarthrosis [1]. As long as the disease mostly affects young population of working age and the number of total hip arthroplasties (THA) in patients with femoral head osteonectosis makes 7 % to 14.8 % of such interventions [4], the issues of its early diagnosis and treatment are of great social and economic importance. The numer of osteonecrotic cases might be around 900 cases
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