The clinical study of therapy for early-stage femoral head necrosis with technique of rotary cutting pressure-relief, bone grafting, and tantalum rod supporting

Abstract

Objective To investigate new methods of osteonecrosis of femoral head (ONFH) with retrospective analysis of the clinical cases with technique of rotary cutting pressure-relief, impacted graft, and tantalum rod supporting treatment of early-stage femoral head necrosis. Methods From June 2010 to June 2014, 32 cases (38 hips, 23 males and 9 females) with ONFH were treated with technique of rotary cutting pressure-relief, impacted graft, and tantalum rod supporting, with the mean age of 24~52 (36.2±3.8) years old. According to the Association Research Circulation Osseous (ARCO) classification, there were 11 hips on ⅡA stage, 12 hips ⅡB, 8 hips ⅡC, 7 hips ⅢA. The averaged Harris score of all cases was 65~81 (72.5±5.8) points. All cases were cured with minimally invasive technique, rotary cutter pressure-relief in femoral head, thoroughly remove sequestrum and implant allogeneic bone. Postoperative patients laid in bed for 1 month, after 1 month hold crutch gradually began to functional training. Postoperative 1 month, X ray film was reviewed every 3 months. According to the clinical symptoms, imaging findings, Harris scoring system was graded to evaluate the effectiveness. Results All the cases were followed up for average of 12~32 (20.2 ±2.6) months, 31 hips Kept hips succeed, hips pain; lame line symptoms were reduced or disappeared; x-ray showed femoral head necrosis area formed new bone, Harris scoring was upgraded to 75~95 (87.7±6.4) points; and seven hips failed with operation of total hip arthroplasty. The overall good rate was promoted from 26.3% to 84.2%. Conclusions The technique treating for early-stage femoral head necrosis with minimally invasive, rotary cutting pressure-relief, impacted graft, and tantalum rod supporting had a good short-term effects. Key words: Bone transplantation; Femur head necrosis/surgery; Tantalum/therapeutic use; Decompression; Surgical procedures, minimally invasive