Objective To analysis the relationship between osteogenesis character of osteonecrosis of femoral head and its therapeutic effect treated with core decompression.Methods 46 patients(59 hips) in ARCO Ⅱ or Ⅲ stage were treated with core decompression.They were divided into three groups based on their osteogenesis character in X-ray,type A with the same character to normal femoral head,type B with sclerosis changes,type C with cystis changes.Then they were followed up to two ending point:total hip arthroplasty or aggravated ARCO stage.Results They were followed up for 3~86 months with the average of 39months.There were type A in 26 hips,type B in 17 hips and type C in 16 hips.When total hip arthroplasty was defined as ending point,datum were analysed with K-M survival analysis.The average survival time was(65.31±5.80)months in type A,(85.50±0.35)months in type B,(44.43±7.88)months in type C.There was obvious difference when these 3 groups survival lines were analyses with log-rank test.When defined aggravated stage as ending point,the average survival time was(49.15±6.92)months in type A,(52.61±8.33)months in type B,(25.29±6.31)months in type C.There was obvious difference when these 3 groups survival lines were analyses with log-rank test.Conclusion The osteogenesis character of osteonecrosis of femoral head reflects the repairing process,had a clear effect on therapeutic effect.
王春生,艾克热木江·阿尔肯,张子琦,李有平,同志琴,杨佩,王坤正. 股骨头坏死成骨特征与髓芯减压治疗效果的关系[J]. 实用骨科杂志, 2018, 24(4): 298-301.
Wang Chunsheng,Aikeremujiang Aerken,Zhang Ziqi,et al. Relationship Analysis between Osteogenesis Characteristic and its Therapeutic Effect of Core-decompression on Osteonecrosis of Femoral Head. sygkzz, 2018, 24(4): 298-301.
[1]Samy AM.Management of osteonecrosis of the femoral head:A novel technique[J].Indian J Orthop,2016,50(4):359-365.
[2]David S,Hungerford.Treatment of osteonecrosis of the femoral head[J].J Arthroplasty,2007,22(suppl 1):91-94.
[3]Shah SN,Kapoor CS,Jhaveri MR,et al.Analysis of outcome of avascular necrosis of femoral head treated by core decompression and bone grafting[J].J Clin Orthop Trauma,2015,6(3):160-166.
[4]Lieberman JR,Engstrom SM,Meneghini RM,et al.Which factors influence preservation of the osteonecrotic femoral head?[J].Clin Orthop Relat Res,2012,(470):525-534.
[5]Bassounas AEL,Karantanas AH,Fotiadis DI,et al.Femoral head osteonecrosis:Volumetric MRI assessment and outcome[J].Eur J Radiol,2007,63(1):10-15.
[6]Pierre Lafforgue.Pathophysiology and natural history of avascular necrosis of bone[J].Joint Bone Spine,2006,73(5):500-507.
[7]Takashi NishⅡ,Nobuhiko Sugano,Kenji Ohzono,et al.Progression and cessation of collapse in osteonecrosis of the femoral head[J].Clin Orthop Relat Res,2002(400):149-157.
[8]Byung-Woo Min,Kwang-Soon Song,Chul-Hyun Cho,et al.Untreated asymptomatic hips in patients with osteonecrosis of the femoral head[J].Clin Orthop Relat Res,2008(466):1087-1092.
[9]Kenji Ohzono,Masanobu Saito,Kunio Takaoka,et al.Natural history of nontraumatic avascular necrosis of the femoral head[J].J Bone Joint Surg(Br),1991,73(1):68-72.
[10]Malizos KN,Karantanas AH,Varitimidis SE,et al.Osteonecrosis of the femoral head:Etiology,imaging and treatment[J].Eur J Radiol.2007,63(1):16-28.
[11]Ng VY,Granger JF,Ellis TJ.Calcium phosphate cement to prevent collapse in avascular necrosis of the femoral head[J].Medical Hypotheses,2010,74(4):725-726.
[12]Hanns Plenk Jr,Martina Gstettner,Karl Grossschmidt,et al.Magnetic resonance imaging and histology of repair in femoral head osteonecrosis[J].Clin Orthop Relat Res,2001(386):42-53.
[13]Masaki Takao,Takashi NishⅡ,Takashi Sakai,et al.Repair in osteonecrosis of the femoral head:MR imaging features at long-term follow-up[J].Clin Rheumatol,2010,29(8):841-848.
[14]Sugano N,Kubo T,Takaoka K,et al.Diagnostic criteria for non-traumatic osteonecrosis of the femoral head[J].J Bone Joint Surg(Br),1999,81(4):590-595.
[15]Samuel J,Parsons,Niall Steele.Osteonecrosis of the femoral head:Part 1—Aetiology,pathogenesis,investigation,classification[J].Current Orthopaedics,2007,21(6):457-463.
[16]Steinberg ME,Hayken GD,Steinberg DR.A quantitative system for staging avascular necrosis[J].J Bone Joint Surg(Br),1995,77(1):34-41.
[17]Yang P,Bian C,Huang X,et al.Core decompression in combination with nano-hydroxyapatite/polyamide 66 rod for the treatment of osteonecrosis of the femoral head[J].Arch Orthop Trauma Surg,2014,134(1):103-112.
[18]Aarvold A,Smith JO,Tayton ER,et al.A tissue engineering strategy for the treatment of avascular necrosis of the femoral head[J].Surgeon,2013,11(6):319-325.
[19]Giannoudis PV,Einhorn TA,Marsh D.Fracture healing:The diamond concept[J].Injury,2007,38(S4):3-6.
[20]Dallas Burton Phemister.Repair of bone in the presence of aseptic necrosis resulting from fractures,transplantations,and vascular obstruction[J].Clin Orthop Relat Res,2008(466):1020-1033.
[21]Nick A Athanasou.Pathology of bone injury[J].Diagnostic histopathology,2009,15(9):437-443.
[22]Sen RK,Tripathy SK,Aggarwal S,et al.Early results of core decompression and autologous bone marrow mononuclear cells instillation in femoral head osteonecrosis[J].J Arthroplasty,2012,27(5):679-686.
[23]Doblare M,Garcia JM,Gomez MJ.Modelling bone tissue fracture and healing:a review[J].Engineering Fracture Mechanics,2004,71(1314):1809-1840.
[24]Assouline-Dayan Y,Chang C,Greenspan A,et al.Pathogenesis and natural history of osteonecrosis[J].Semin Arthritis Rheum,2002,32(2):94-124.
[25]Geris L,Gerisch A,Sloten JV,et al.Angiogenesis in bone fracture healing:A bioregulatory model[J].J Theor Biol,2008,25(1):137-158.
[26]Dimitriou R1,Tsiridis E,Giannoudis PV.Current concepts of molecular aspects of bone healing[J].Injury,2005,36(12):1392-1404.