Jiahao Sun, Bowen Ma, Chiyu Zhang, Tianwei Xia, Jirong Shen, Chao Zhang
Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
Front Bioeng Biotechnol. 2025 Mar 19;13:1495292. doi: 10.3389/fbioe.2025.1495292. eCollection 2025.
The Neck-shaft Angle (NSA) is a reliable predictor of the outcome of internal fixation for femoral neck fractures. Surgical Hip Dislocation Combined with Femoral Neck Rotational Osteotomy (SHD-FNRO) is an effective surgical method for treating femoral head necrosis. However, the potential role of NSA in predicting the outcomes of hip preservation after SHD-FNRO has not been explored.
This study aims to investigate the value of NSA in predicting the outcomes of hip preservation after SHD-FNRO by comparing the results among different patients with osteonecrosis of the femoral head (ONFH) who were treated with SHD-FNRO.
We retrospectively analyzed clinical data from 33 patients (33 hips) who underwent SHD-FNRO at our hospital between January 2017 and December 2021. Based on the outcome of hip preservation, patients were divided into two groups: group A (successful hip preservation) and group B (failed hip preservation). Statistical analysis was performed to evaluate any differences between these groups. Additionally, three-dimensional models with varying NSA values were created to analyze changes in maximum displacement and stress on the osteotomy surface.
During a mean follow-up period of approximately 40 months, successful hip preservation was achieved in 26 patients while 7 patients experienced failure. There was a statistically significant difference in NSA between these two groups (P < 0.05). Biomechanical analysis demonstrated a close relationship between NSA and postoperative biomechanical changes.
The size of NSA is closely associated with the success rate of hip preservation when treating osteonecrosis of the femoral head using SHD-FNRO. Therefore, careful attention should be given to selecting an appropriate osteotomy surface that can adjust NSA size effectively, thus achieving better outcomes for hip preservation.
颈干角（NSA）是股骨颈骨折内固定治疗结果的可靠预测指标。手术性髋关节脱位联合股骨颈旋转截骨术（SHD-FNRO）是治疗股骨头坏死的一种有效手术方法。然而，NSA在预测SHD-FNRO术后髋关节保留结果方面的潜在作用尚未得到探索。
本研究旨在通过比较接受SHD-FNRO治疗的不同股骨头坏死（ONFH）患者的结果，探讨NSA在预测SHD-FNRO术后髋关节保留结果中的价值。
我们回顾性分析了2017年1月至2021年12月期间在我院接受SHD-FNRO治疗的33例患者（33髋）的临床资料。根据髋关节保留结果，将患者分为两组：A组（髋关节保留成功）和B组（髋关节保留失败）。进行统计分析以评估两组之间的任何差异。此外，创建了具有不同NSA值的三维模型，以分析截骨面上最大位移和应力的变化。
在平均约40个月的随访期内，26例患者髋关节保留成功，7例患者失败。两组之间的NSA存在统计学显著差异（P < 0.05）。生物力学分析表明NSA与术后生物力学变化密切相关。
使用SHD-FNRO治疗股骨头坏死时，NSA的大小与髋关节保留成功率密切相关。因此，应谨慎选择能够有效调整NSA大小的合适截骨面，从而实现更好的髋关节保留效果。
