[Surgical treatment of necrosis of the femoral head in early stages with core depression and allo-fibular grafting].

OBJECTIVE

To study the effect of surgical treatment with core depression and allo-fibular grafting on osteonecrosis of the femoral head in early stages.

METHODS

From June 1998 to August 2004, 22 patients with necrosis of the femoral head (39 hips) were treated with core depression and allo-fibular grafting, including 17 males and 5 females. Necrosis was classified as Stages I - III according to ARCO classification system. Their ages ranged from 22 to 60 years and pain duration was 2 to 12 months preoperatively (6.5 months on average). The regular examinations of joint function, X-ray, ECT,CT and MRI were conducted before surgery and after 15 days, 3 months, and 6 months of surgery.

RESULTS

All patients were followed up for 3 to 74 months (31.4 months on average). Symptoms 17 of the patients were relieved evidently. Harris hip score from 78 points preoperatively to 91.6 points. The X-ray films 18 of the patients showed that the geography of the hip joint kept intact with no deterioration. Osteogenesis was observed by regular examinations. Two cases (4 hips, 10.25%) were revised by total hip replacement, and 3 cases (4 hips, 10.25%) without THR worsened postoperatively.

CONCLUSION

The method is less traumatic than common procedures. The joint function can be recovered within 2-4 weeks. Clinical symptoms are greatly improved. This method is effective at least in short term and the long-term effect needs further study.