Clinical observation of deliquesce strut with titanium web and cage containing bone grafting pedicled with femoral quadratus to treat non-traumatic osteonecrosis of the femoral head

Abstract

objective To investigate the clinical outcome for the treatment of nontraumatic os-teonecrosis of the femoral head (ONFH) by a technique of deliquesce strut with titanium web and cage con-taining bone grafting pedicled with femoral quadratus.Methods Sixteen adult patients (20 hips) suffered from non-traumatic ONFH underwent the surgery of the deliquesce strut with titanium web and cage contain-ing bone grafting pedicled with femoral quadratus from January 2008 to June 2009.The mean age was 30.4 years (21-46).The steroid-induced ONFH was in 2 patients (4 hips),alcohol-induced ONFH in 14 patients (16 hips).According to Association Research Circulation Osseous (ARCO) classification,4,14 and 2 hips were in stage ⅡB,ⅡC and ⅢA.respectively.The results were followed and evaluated by the method of hundred percent score.Results The mean operation time was 155 minutes.The mean blood loss was 420 ml.All the wounds healed uneventfully.Anticoagulation medicine was not routinely used,and no deep vein thrombus (DVT) occurred.All patients were followed for an average time of 12.1 months (range,3 to 15 months).Weight-bearing was permitted 4 months postoperatively.Pain disappeared or significantly improved in all hips with hip function improved greatly.Bong-grafting healing was noted 3 to 4 months postoperatively.The normal height of the femoral head was maintained in 18 hips.Collapse occurred in 2 hips.There were resuits of excellent in 16 hips and better in 4 hips in this group.Conclusion For non-traumatic ONFH in stage ARCO ⅡC or ⅢA,satisfactory clinical outcome can be achieved by the new technique in the short-term period,the long-term clinical outcome has yet to be observed. Key words: Femur head necrosis; Transplantation; autologous; Treatment outcome